Guiding a little girl towards recovery

Carmen Amro is almost two years old and lives with her family in Qatar. When she was around 10 months old her family discovered she had bilateral cataracts, and she was treated at Moorfields Eye Hospital in Dubai. However, a few months later, her mother Iman noticed that her motor development wasn’t as expected for her age, and she wasn’t developing as she should. Her cognitive development was slow and she couldn’t crawl or stand independently.

The family pushed for an MRI scan which showed that Carmen had an abnormally shaped vertebra at the very top of her spine pushing on the spinal cord and likely contributing to her poor motor development. Their local hospital could not offer a solution, so the family travelled to four countries and consulted with different specialists. Unfortunately, no one and nowhere could offer a treatment option for Carmen.

The family knew of Great Ormond Street Hospital (GOSH) in London, so they travelled to meet with Dr Dominic Thompson, a world-leading neurosurgeon at GOSH. After reviewing Carmen and the MRI scan, Dr Thompson concluded that he needed to do a surgery to remove the abnormal vertebra and decompress the spinal cord.

Carmen was scheduled to have the operation at GOSH in September this year. Carmen’s father Raed talks about the confidence they felt after meeting with Dr Thompson “You know the sense of confidence you get the minute you speak to someone. That’s what we got from Dr Thompson. We knew this man is the right man to do the job… It was scary that she needed surgery, but for us it was a relief that we knew something was being done.”

Carmen had her operation at GOSH on Monday 14th September, and left hospital on Thursday 17th September. “She was meant to stay for five days but she recovered remarkably well. We came in Monday and left Thursday. She’s such a fighter.” says Carmen’s father.

Carmen’s father also praised the medical care she received at GOSH “It’s not just Dominic himself, it’s the whole team of doctors and nurses. The whole experience has been amazing. We were very calm because we knew she was in safe hands. It’s exactly what you want when you have a sick child that needs to be good taken care of.”

Carmen is now doing well after treatment and the family have returned to Qatar. They are discussing her follow up treatment with Dr. Thompson and will return to GOSH for check-ups in approximately 6 months.

Dr Thompson explains Carmen’s operation and his hopes for her future development “Carmen’s operation involved moving the muscles at the back of the neck and exposing the junction between the skull and the spine. Electrical activity in the spinal cord was monitored by the electrophysiology team in the operating theatre while a 2cm piece of bone was drilled away from the back of the spinal cord. Carmen went on to make an excellent recovery. The hope is that her spinal cord will now be safer and allow her motor functions to improve.”

Discussing Carmen’s condition, Dr. Thompson explained “Developmental abnormalities at the top of the spine are generally quite rare but do have the potential to cause very severe neurological damage, including paralysis, loss of breathing control and even death. Over the past 15 years we have treated many children (from as young as one year) with these rare abnormalities and now have one of the largest experiences of such conditions in the world. This type of surgery relies heavily on the expertise of many people including anaesthetists, spinal orthopaedic surgeons, electrophysiologists (who are able to measure spinal cord activity throughout the surgery), physiotherapists, specialist nurses and neuro-radiologists. These specialists work together as a multidisciplinary team using the latest technology in an attempt to provide the best outcomes for these children.”

Dr Dominic Thompson is a Consultant in Paediatric Neurosurgery at GOSH and Honorary Senior Lecturer at the Institute of Child Health in London. He trained at Charing Cross Hospital in London and was demonstrator in Anatomy before embarking on his surgical career. His neurosurgical training was at The National Hospital for Neurology and Neurosurgery, Queen Square; The Atkinson Morley’s Hospital, Wimbledon and GOSH. He has particular expertise in the management of congenital abnormalities of the spine and spinal cord. He has written numerous articles and book chapters on this subject and regularly teaches and lectures at national and International meetings.

The Orthopaedics and Spinal Surgery Unit at GOSH is one of the world’s largest spinal centres. Great Ormond Street Hospital is recognised as one of the few truly world-class hospitals for children. As a global leader, GOSH has top clinical and research experts working every day to find new and better ways to treat children. While breakthroughs and medical expertise are essential to the treatment of patients, GOSH also places great emphasis on the support and care provided for children by nurturing an open and supportive atmosphere, ensuring that parents and patients are well informed and closely involved in the treatment process. Children receive the highest standards of care and attention from the expert team of medical and support staff during their stay at GOSH, and are always treated with respect, trust, concern and openness.