Guyana leading the way in Vault C spinal implant surgery

Guyana has become the first country in South America to perform a Vault C Anterior Cervical Discectomy and Fusion System (ACDF) implant surgery successfully; not once but twice. The surgeries which were performed by Guyana’s leading Neurosurgeon, Dr Amarnauth Dukhi at two separate private institutions gave two patients the ability to utilise their motor skill after being partially and fully paralysed.
According to Carlo Koren, President of Innovation Medical Technologies Incorporated, Guyana is the only country in the South American continent to perform the procedure. Innovation Medical Technologies is the South American distributor of the titanium plate, which is manufactured by Precision Spine, a US-

based company that was used in the surgery.
Speaking with the Department of Public Information (DPI), Dr Dukhi explained that both patients – ages 51 and 65 – suffered from spinal injuries due to separate motor vehicular accidents which left them bedridden and paralysed.
Dr Dukhi said in the case of the 51-year-old male, a double implant was performed and prior to the surgery, the patient experienced severe weakness in the upper and lower limbs, difficulty walking and limited or no function of the arms. While, in the case of the 61-year-old male, the patient suffered a motor vehicular accident in December 2017 in the interior which left him completely paralysed.
However, post-ACDF implant, he was able to recover movement of the upper limbs and is currently under rehabilitation of the lower limbs. His surgery was done five days after the incident.
In explaining the technical procedure, the surgeon said, “a small incision is done on the neck, where you have to go from the anterior approach through the skin, then you separate the trachea, the oesophagus to one side and then all the vessels and the nerves to the other side. You go through all those structures through the neck to the spine. When you get to the spine then you have to prepare it; after preparation – the traumatic disc that has migrated and compressing the cord will be removed.”
Dr Dukhi continued, “So you decompress the cord by removing that disc and now [in] that space that is left empty, the implants are placed. It is fixated into that spacing so you reconstruct and realign the spine using implants, then it is fixed by

utilising the screws.”
He noted that surgery of this nature is a very complex procedure that has a limited timeline in order to yield successful results.
“This type of surgery depends on how quickly you get the patient. This surgery will not change the prognosis in patients who are paralysed for a prolonged period and surgeries delayed for long periods. If there is hope, the correct thing to do is immediate surgery. If the spinal cord is damaged, there is also no point for surgery. Timing is critical,” he stressed.
Dr Dukhi also revealed that in a move to further enhance neurosurgery in Guyana; four doctors are presently being trained in neurology at the Georgetown Public Hospital Corporation. He is also collaborating with Professor Ivor Crandon from Jamaica to design a “University of Guyana/University of the West Indies” programme to train local doctors at a post-graduate level. Dr Dukhi is optimistic it will be ready in less than a year.
Dr Amarnauth Dukhi has been transforming neurosurgical procedures in Guyana since 2015 and has successfully completed over 450 surgeries, giving patients a second chance at a normal life.