Posted by: wockhardthospitals | August 4, 2009

Skeletal Fluorosis : A Case Study

Ramachandra Banarjee, a 58 year old man, hailing from Kolkata was complaining of stiffness of upper legs and hands for the past one and a half years. He consulted several doctors and by the time he came to Dr. K N Krishna, Neuro Surgeon, Wockhardt Hospitals, he was totally bedridden and he couldn’t hold anything with his hands. The diagnosis showed it as Ossification of Posterior Longitudinal Ligament (OPLL) in spinal cord. His spinal cord was reduced to 20% of its original size.


A surgery was conducted, removed the extra growth under microscopic magnification and high speed diamond drill. Later the spinal canal was opened up and decompressed using a Titanium Cage; the spinal column was reconstructed and fixed with plate and screw system.


Ramachandra Banarjee’s recovery was dramatic; he started walking with minimum support the very next day. He was discharged from the hospital in 4 days. He is recovering well and if he does not take contaminated water he will be able to lead a normal life.


Skeletal / Spinal Fluorosis is a condition where excess deposition of fluoride salts found in ligaments, joints and bone of a person. This is a bone disease caused by excessive consumption of fluoride. In some cases, skeletal fluorosis causes pain and damage to bones and joints.


According to a World Health Organization estimate there are about 2.7 million people have the crippling form of skeletal fluorosis in China, while in India, 17 states have been identified as “endemic” areas, with an estimated 66 million people at risk and 6 million people seriously affected. In India, the most common cause of fluorosis is fluoride-laden water derived from deep bore wells.


In India Andhra Pradesh, Rajasthan, Orissa, border areas of Karnataka and parts of West Bengal are identified as areas more prone to Skeletal Fluorosis. Among water bodies in India Tunga River has been identified with high fluoride content.


The main cause of Skeletal Fluorosis is consumption of fluoride through contaminated water.


The early stages of skeletal fluorosis can be characterized by increased bone mass, detectable by x-ray. If very high fluoride intake persists over many years, joint pain and stiffness may result from the skeletal changes.

The most severe form of skeletal fluorosis is known as “crippling skeletal fluorosis” which may result in calcification of ligaments, immobility, muscle wasting, and neurological problems related to spinal cord compression.


According to Dr. K N Krishna, Neuro Surgeon Wockhardt Hospitals, “The person affected with advanced Spinal Fluorosis will have bones hardened and thickened because of excessive deposit of salt. It is a slow process and one can feel weakness from neck to the lower back bone. This can lead to paralysis. The only treatment for this advanced Skeletal Fluorosis is decompression of spinal cord through surgery. The early diagnosis and prompt surgical intervention can help patient recover from neuroparalysis and further prevention of fluorosis itself is possible by drinking defluroinated water.”


My chest was feeling congested, my lower body was stiff. My left leg and left hand was numb with no mobility and was unable to hold anything. I was totally bedridden for 2 months. I came here, got operated and the very next day I was able to walk 50 steps. Now I can use both my hands. I ate food with out anybody’s help” says Ramachandra Banarjee


When we came to Wockhardt Hospital, my dad had already lost mobility, it was a gradual process. We consulted Dr. K N Krishna; he advised to go for a surgery and explained to us why surgery is necessary and how it can spread to other parts of the body. Surgery started in the morning and lasted for 6 hours. Physiotherapy started the very next day after the surgery. Before surgery he couldn’t move at all, it took 3 people to move him and the very next day after the surgery he was able to move with minimum support” adds Animesh, Ramachandra Banarjee’s son.

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