Meticulous multidisciplinary planning helped safely perform complex spine surgery in a patient with only 15% heart function, restoring mobility and improving quality of life
RAJKOT, GUJARAT | 04th AUGUST 2026 | A 72-year-old male patient suffering from severe back pain and pain radiating to both legs regained mobility after successfully undergoing a highly complex spine surgery at HCG Hospitals, Rajkot, despite having only 15% heart function due to advanced heart failure. Diagnosed with Koch’s Spine (Spinal Tuberculosis), which had caused severe compression of the spinal nerves, the patient had reportedly been denied surgery at multiple hospitals because of the extremely high cardiac risk. Through meticulous planning and a multidisciplinary approach, doctors at HCG Hospitals safely performed the procedure, relieving his pain and significantly improving his quality of life.
The patient had been experiencing persistent back pain for several months, but initially assumed it was a routine orthopaedic problem. As the condition progressed, the pain spread to both legs, making it increasingly difficult to walk and carry out everyday activities. Detailed clinical evaluation and imaging later confirmed Pott’s Spine (Spinal Tuberculosis), a condition that had caused significant compression of the spinal nerves and required surgical treatment. Despite the significant surgical risk, the multidisciplinary team carefully evaluated the patient’s condition, optimised the patient’s health before surgery, and developed a customised treatment plan to ensure the safest possible outcome.
The patient underwent L4 – S1 decompression and spinal fixation with L4 – L5 debridement and fusion using an autologous bone graft. The surgery was completed successfully, and the patient was extubated immediately after the procedure. Within 24 hours, the patient was shifted out of the intensive care unit and recovered steadily without any major complications. On the third postoperative day, GeneXpert and AFB smear tests confirmed spinal tuberculosis. The patient was subsequently started on anti-tubercular therapy under the guidance of infectious disease specialists. The patient’s pain reduced significantly after surgery, mobility improved steadily, and the overall recovery remained satisfactory.
Dr. Harsh Kotecha, MS Orthopaedic, Orthopaedic Spine Surgeon, HCG Hospitals, Rajkot, said: “This was one of the most challenging cases we have managed due to the patient’s extremely poor cardiac function. Careful planning, multidisciplinary collaboration, and meticulous execution enabled us to safely perform the surgery and achieve an excellent outcome. Cases like these reinforce the importance of timely intervention and coordinated care in treating even the highest-risk patients.”
Rajeev Bhan, COO, HCG Hospitals, Rajkot, said: “Managing such medically complex cases requires more than clinical expertise, it demands seamless collaboration across specialties, advanced infrastructure, and patient-centric care. This successful outcome reflects HCG’s commitment to delivering advanced treatment solutions for patients who may otherwise have limited options, while maintaining the highest standards of safety and quality.”
The patient said: “After being turned away from multiple hospitals, I had almost lost hope of getting treated. The doctors at HCG explained every step of the treatment with patience and gave me the confidence to undergo surgery despite the risks. Today, I am relieved that my pain has reduced, I can move much better, and I am grateful to the entire medical team for giving me a new lease on life.”
This case highlighted the importance of multidisciplinary collaboration in treating patients with complex medical conditions who are often considered unsuitable for surgery. Through advanced surgical expertise, careful preoperative optimisation, and coordinated postoperative care, the team successfully treated a patient with severe spinal tuberculosis and advanced heart failure, enabling significant pain relief, improved mobility, and a better quality of life.
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