The outcome of surgical resection in complete paraplegia patient due to thoracic schwannoma

Spinal schwannoma is the most common benign intradural spinal tumor. However, studies regarding the neurological outcome of tumor resection in complete paraplegia patients are still lacking. The authors report a case of complete paraplegia due to primary intradural extramedullary low-grade schwannoma of the spinal cord. Surgery was performed 5 weeks after the paraplegia complaint first occurred. The patient did not regain motor nor sensory function in the 1-month follow-up but resolution of pain was achieved. The patient was able to perform daily activity more comfortably. In the event of complete paraplegia, surgery should still be offered promptly as it can still benefit the patient. Possible factors that could have influenced the prognosis in our study are discussed.

Overseas Medical Treatment of Sri Lankan Medical Travellers

More and more Sri Lankans reach for overseas medical treatment with the raising standards of living in the country. However, it is largely an unexplored area. Economic burden of overseas medical treatment is largely an out-of-the-pocket expenditure. Considering the economic burden and low health insurance penetration among Sri Lankans, healthcare decision-makers should explore the clinical dynamics of this subset of patients to improve the services within the country. The study aimed to describe the clinical characteristics and cost of medical treatment by medical travellers for treatment overseas. A descriptive study was carried out by a team of experts analyzing the data of estimated overseas medical expenditure recorded at the President Fund, a body established to assist Sri Lankans who need financial assistance for the said purpose. The team studied the deidentified databases for 2018 and 2019. Of the 60 patients studied, liver transplant, treatment for scoliosis, and bone marrow transplant topped the list by the number of cases and the estimated cost for the procedure overseas. Advance cancer treatment, cardiac surgery, and brain and spinal cord surgery also contributed significantly to the burden. Highest estimated unit cost per procedure has been recorded by the liver and bone marrow transplant surgeries. In conclusion, the healthcare decision-makers should liaise with relevant professional bodies to establish liver and bone marrow transplant services, advance brain and spinal cord surgery including treatment of scoliosis, and advance cancer treatment and cardiac surgeries. Considering the lack of data sources on the economic burden of overseas medical treatment, authorities should act promptly to capture nationwide details of this important group of patients.