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Famous neurosurgeons from the Wrocław hospital on Borowska street have conducted a unique surgery. A man got a chance to regain physical fitness after having fallen from a height and breaking his spine 18 months earlier. Unfortunately, the Polish state health fund was not supportive.

150K such surgeries a year in the world, 5 in 20 years in Poland

150K such surgeries a year in the world, 5 in Poland

A 49-year-old man fell from his balcony 18 months ago. A fragment of his lumbar spine broke into pieces and injured the spinal cord. The man received rehabilitation and afterwards started to walk. However, he didn’t regain full physical fitness. As a result of the injury to the spinal cord, his nerves in the sacral bone area could not control the work of the sphincter, among other things.

He wanted to have a normal life again

He came to us to receive help – says post-doctoral MD Paweł Tabakow, who became famous about a year ago when he transplanted glial cells to a patient with a cut spinal cord. Thanks to this operation, the patient regained the use of his legs. – This time the man had serious urological problems, he had troubles with impotence, and perineum and buttocks muscle weakness. We call it the conus medullaris – explains dr Tabakow.

The man could not go back to work, he was using panty liners and diapers. As a person who is very sociable, he suffered even more.

Additionaly, during urination, very high pressure was created in his bladder, which made the urine go back to the kidneys, slowly damaging them. Among people with similar problems, kidney complicatons are the most common cause of death – informs dr Krzysztof Tupikowski from the Urology and Urological Oncology Clinic at the Wrocław hospital.

Electrical current in the neurons

Neurosurgeons from the Wrocław University Clinic Hospital together with urologists suggested an innovative solution. Dr Paweł Tabakow, Dr Krzysztof Chmielak (neurosurgeon, as well) and a special guest – Martti Johannes Aho from the Finnish University Clinic Hospital of Tampere gathered at the operating table. In Finland, hundreds of such operations are performed each year. Aho travels all around the world as an expert and shares his experience with other doctors.

The surgery under general anaesthesia lasted two and a half hours.

We introduced electrodes which stimulate the neurons to the nervous weave near the sacrum and attached them to an external power source. For now, the patient will wear the electrostimulator on a belt. After a couple of weeks, if the results are satisfactory, the electrostimulator will be implanted under his skin. We hope that it will allow him to live normally – says dr Tabakow.

Poland far behind other countries

Information concerning performing such surgeries should make the Polish Ministry of Health feel ashamed. The method has been known for 20 years and has been used every day in hospitals all around the world. In Poland, it was used in 1994 for the first time. Since then, it has been applied only 5 times, whereas in the rest of the world – 150 thousand times a year – notices dr Krzysztof Chmielak.

The treatment applied by the neurosurgeons from Wrocław is not refunded by the National Health Fund (NFZ), despite the fact that last year it received a positive opinion from the Medical Technology Evaluation Agency, which determines if a treatment should be funded by the state.

The price of such a surgery amounts to circa 30 thousand złoty. The surgery we performed in our hospital was conducted thanks to the financial help of the Lower Silesian Health Care Development Fund (Dolnośląska Fundacja Rozwoju Ochrony Zdrowia “DOLFROZ”). Polish patients can apply for such treatments only through non-governmental institutions – says dr Tabakow.

 

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