The surgical team was headed by renowned spine surgeon Alvin Crawford, MD, and was organized by Shital Parikh, MD, a surgeon in our Division of Orthopedic Surgery.
The team visited Parikh’s hometown of Ahmedabad, India, Jan. 7-13, 2013, to perform the operations in conjunction with the Polio Foundation Hospital there, which was founded to combat polio but now treats a wide range of pediatric deformities.
Long, difficult operations
The procedures were quite complex, with each case requiring two surgeons working six to 10 hours in the operating room. “The local spine surgeons can do very good work, but only up to a certain limit. These were children they could not help because of the complexity of the deformities and the potential costs involved,” Parikh says.
Children with deformities this extreme require surgery or they risk becoming paralyzed before reaching early adulthood because the curvature of their spines can damage their spinal cords. The metal rods and implants they received will remain in their bodies for the rest of their lives.
Safely performing these operations requires expert surgeons, a highly skilled pediatric anesthetist, expensive implants and special neuro-monitoring equipment. Parikh spent more than four months organizing just such a team.
The team included surgeons Crawford, Parikh and Viral Jain, MD; and anesthesiologist Senthil Sadhasivam, MD; all from Cincinnati Children’s. The team also included Tiffany Frye and Janice Mader from Evokes Inc., a Cincinnati company that provided the neuro-monitoring equipment and supplies; and Brian Marzano, a representative of DePuy Spine USA, which donated the implants and provided other specialized instruments.
Costly equipment and supplies
Overall, the implants and surgical instruments were valued at $2 million, while the neuro-monitoring gear was valued at about $50,000, Parikh says. Not wanting to risk losing such valuable items by shipping them, the team members hand-carried the implants and related supplies in four bags weighing about 50 pounds each.
The children who received treatment ranged from age 3 to 14. To take on these cases, the local hospital created a temporary pediatric intensive care unit staffed by local pediatricians 24-hours-a-day to provide post-op care. Local spine surgeons will perform follow-up procedures on the youngest patients to lengthen the spine implant rods as the children grow.
Orthopaedics at Cincinnati Children’s was recently recognized as the No. 2 pediatric orthopaedic program in the nation by Parents magazine. “These would have been complex cases even here,” Parikh says.
While the Polio Foundation Hospital provided local hospitality, the team members paid their own travel expenses and there were no fees for their work. In fact, all the care provided at the Polio Foundation Hospital is free to the families. Physicians and surgeons volunteer their services and donations cover hospital expenses, Parikh says.
Trip provides teachable moments
In addition to the charity work, the trip included important educational components. More than 70 spine surgeons from the region attended lectures given by the team members as well as observing one of the operations via an interactive broadcast beamed live to a hospital auditorium.
To follow up on the training they received in India, a spine surgery fellow will visit Cincinnati Children’s in June for a two-month observership. An anesthesiologist and a staff member interested in neuromonitoring will visit later this year.
These training experiences will make it possible for local medical teams to handle more complex spine surgeries, Parikh says.
The January mission trip is the first of five annual trips to be organized by Parikh. Future trips will focus on hand deformities, hip repairs, neuromuscular conditions and sports medicine procedures.
For more information, or to provide support for future trips, send emails to Shital.Parikh@cchmc.org.