2019 Laos Blog

December 19, 2019 by law9xc@virginia.edu   |   Leave a Comment

Elliot Winters, CA2. post:

The Lao People’s Democratic Republic is a high burden country for tuberculosis. Pott’s disease is a rare but severely debilitating complication of TB when mycobacterium spread hematogenously to the spine and creates caseous necrotic lesions within the vertebral column. These lesions compress the spinal cord and can leave patients permanently disabled. The current training level in Laos in spine surgery and neurosurgical anesthesia is often inadequate to offer surgical cure for the more complicated patients The Lao People’s Democratic Republic is a high burden country for tuberculosis. Pott’s disease is a rare but severely debilitating complication of TB when mycobacterium spread hematogenously to the spine and creates caseous necrotic lesions within the vertebral column. These lesions compress the spinal cord and can leave patients permanently disabled. The current training level in Laos in spine surgery and neurosurgical anesthesia is often inadequate to offer surgical cure for the more complicated patients suffering from this disease.

In the beginning of February, we travelled to Laos with an orthopedic spine surgery team based out of Indiana on their 35th trip to Laos in the last 11 years. They specialize in providing complex repair with instrumentation for patients that cannot be offered surgery under normal circumstances in Laos.

I saw the effectiveness of this approach when an 8-year-old boy came to see the team for follow up on our first day. At 3-years-old, due to severe spinal disease, he could only feel sensation in one big toe but otherwise had completely absent sensation and motor function in all 4 limbs. Given the severity of disease and complexity of the case, the Laotian providers referred the child to the orthopedic spine surgery team on their next visit. The operation was performed, the child recovered full function and on the day I saw him in clinic, (5 years after surgery) he was literally running around the hospital ward without residual deficits. What an incredible experience to be a part of!

 

 

 

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