Ryma is crawling up stairs and even standing before taking a few steps with assistance. Prior to a life-changing surgery in Toledo for the 5-year-old girl from Algeria, those activities were thought impossible.Ryma has lipomyelomeningocele, a form of spina bifida that resulted in a mass the size of a softball connected to the spinal cord located under the skin of her back. The condition puts pressure on the nerves and affects motor function.
“It is an extremely complicated procedure to remove the mass without injuring the nerves and spinal cord attached to it. If you simply were to remove all the fatty tissue, it would lead to paralysis,” said Dr. Azedine Medhkour, associate professor of surgery and a UTMC neurosurgeon.
“We needed to remove as much of the tumor as we could, and leave only a thin layer of fat tissue attached to the spinal cord, and meticulously replace the spinal cord in its natural spinal canal. It is an extremely delicate procedure, performed under sophisticated monitoring and high magnification using the microscope.”
Medhkour coordinated with UT Medical Center’s pediatric services, Mercy Children’s Hospital and the pediatric ICU team to perform the surgery in Toledo, where there was the needed technology and expertise. The 15-hour surgery was performed Oct. 29. Ryma spent 40 days in the hospital with follow-up procedures to ensure that the neural canal was closed.
“She’s performing some physical tasks that she has never done before,” Medhkour said. “We are hoping she can most likely be walking prior to returning home. That was not expected before we started seeing her amazing recovery.”
The LightHouse, a ministry of ISOH/IMPACT (International Services of Hope and Impact With God Crusades Inc.), was instrumental in helping the family settle in Toledo for her treatment and recovery. Ryma now has returned to The LightHouse, where she is expected to stay for a few more months as she undergoes physical and occupational therapy and evaluation by the pediatric orthopedic team for possible treatment of her lower extremities. Her parents, Abdenour and Lila Djoudad, accompany her. Her father is staying at the Ronald McDonald House.
Linda Greene, president of ISOH/IMPACT, said Ryma fills The LightHouse with singing and laughter and she is determined and tough in her recovery.
“She is nothing short of a miracle,” Greene said. “Ryma has a very strong will and is wise beyond her years. We love watching her progress and are impressed with the amazing person she is.”
Medhkour was first contacted to help Ryma about a year ago after her family learned he had provided a similar surgery free of charge to Ayoub Hamdi, who then was a 14-month-old boy from Algeria.
Medhkour said this couldn’t have happened without the extensive medical community support from UT Medical Center, Mercy Children’s Hospital (in particular the pediatric ICU team), the neurosurgical network team at Mercy St. Vincent’s (in particular Dr. Michael Healy and Dr. Malini Narayanan for their follow-up care), UTMC pediatric services, ISOH/IMPACT, the Ronald McDonald House, and the health-care team donating their time and talents to Ryma’s treatment and recovery.