Spring 2006 Issue

Complex Spinal Fusion Is Used To Prevent
Paralysis In Patient With Gorham’s Disease


Malcolm’s spinal column was “rebuilt” using 21 screws and implants to provide as much support as possible due to his Gorham’s Disease.
Malcolm was able to walk his daughter, Julie, down the aisle only six months after surgery..
In April of 2005, Malcolm Brelsford was suffering from a spinal staph infection that had left him unable to walk and almost completely paralyzed in his legs. The infection was causing the bones of his spine to deteriorate, and if left to progress would have resulted in fractures in his spine and eventual permanent paralysis. To complicate matters, the affected area was located directly behind Malcolm’s heart, a region where most spine surgeons won’t even attempt surgery. Malcolm was also suffering from Gorham’s Disease, a rare condition that causes bones to deteriorate.

With the odds stacked against him, Malcolm was referred to Carolina Neurosurgery & Spine Associates and neurosurgeon Vinay Deshmukh, M.D.

"When I was consulted, Malcolm's spinal infection was severe, his spine was gradually becoming more crooked, and there was pressure on his spinal cord," said Dr. Deshmukh. “We needed to clean out the infection and essentially rebuild his spinal column with screws, rods, and spinal fusion.”

Because the infection was behind Malcolm’s heart, Dr. Deshmukh recruited cardiovascular and thoracic surgeon, Medhat Takla, M.D., and neurosurgeon, Mark Redding, M.D., also of Carolina Neurosurgery & Spine Associates, to perform the surgery with him. Over the course of two surgeries and 12 hours in the operating room, they cleared the infection, placed a metal cage around the area, and fused Malcolm’s spine from his skull to his lower back in order to provide added support because of the Gorham’s Disease.


The surgery was successful. Not only had paralysis been prevented, but Malcolm’s mobility improved to the point where he could walk across a room. This meant even more to Malcolm in the fall when he was able to walk his daughter down the aisle at her wedding. Nearly a year after surgery, Malcolm is doing well. He’ll need to take medication the rest of his life to fend off future staph infections, and must continue to be monitored due to the Gorham’s Disease.

“We went to an area of the spine that is generally considered inoperable by most spine surgeons,” said Dr. Deshmukh. “Mr. Brelsford underwent the most technically challenging spine surgery you can have and can now walk today.”

For more information about the spine services offered by Carolina Neurosurgery & Spine Associates, call 800-344-6716.



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