A Hyderabad-based anesthesiologist received Indian Book of World Records recognition for a novel anaesthetic approach in cervical spine surgery
The procedure was performed on an elderly, medically high-risk patient unsuitable for conventional general anesthesia
An alternative hypobaric segmental spinal anaesthesia technique was used instead of general anesthesia
The case highlights how individualized anaesthetic planning can reduce risk in complex spine surgeries
A Hyderabad-based anaesthesiologist has been entered into the Indian Book of World Records for performing a complex cervical spine surgery using an uncommon anaesthetic approach in an elderly patient with multiple medical conditions. The procedure was carried out at Glenfield Mallareddy Brain and Heart Hospital, Hyderabad, and the recognition was formally announced on February 6, 2026.
The anaesthetic management of the surgery was led by Dr. Sohail Anjum, MBBS, DA, FCPS (Anaesthesiology), FIPM, a Hyderabad-based anaesthesiologist. The operation took place at Glenfield Mallareddy Brain and Heart Hospital, a tertiary care centre specializing in neurological and cardiac care.
The Indian Book of World Records formally recognized the procedure on February 6, 2026. Hospital officials and representatives of the Indian Book of World Records were present during the formal recognition event held at the hospital premises.
The Indian Book of World Records acknowledged the procedure as a unique surgical feat due to the anaesthetic technique used for a high-risk cervical spine tumor surgery.
This was described as a first-of-its-kind achievement under the criteria of the Indian Book of World Records, recognising the use of a novel hypobaric segmental spinal anaesthesia technique for cervical spine tumor surgery, rather than a universal global first. A method not traditionally employed for procedures at this spinal level.
The patient was over 65 years of age and had multiple comorbidities, including a history of coronary artery bypass surgery, chronic kidney disease, and thyroid dysfunction. These factors significantly increased the risk associated with conventional general anaesthesia.
In an interview given by Dr. Sohail Anjum to A4S News Channel, he explained that the technique was developed to minimise haemodynamic instability and systemic stress in patients who are poor candidates for conventional general anaesthesia.
Dr. Sohail Anjum stated in the interview that the patient also had a malignant condition involving the cervical vertebrae, which was compressing the spinal cord.
He explained that delaying surgery could have resulted in progression to quadriplegia, a condition in which an individual is conscious but experiences paralysis of all four limbs, often with loss of sensation, resulting in significant dependence for daily activities.
Cervical spine surgeries are commonly performed under general anaesthesia to ensure patient immobility and airway protection.
In this case, general anaesthesia was considered high risk due to multiple factors, including:
History of coronary artery bypass surgery
Underlying chronic kidney disease
Thyroid dysfunction affecting metabolic stability
Advanced age with reduced physiological reserve
According to the treating team, the tumor was causing repeated episodes of weakness and paralysis in the patient’s upper and lower limbs, making surgical intervention necessary despite the elevated risk.
The surgical team therefore opted for an alternative anaesthetic strategy to reduce systemic stress while still providing adequate pain control and surgical access.
The team administered hypobaric anaesthetic drugs through a continuous thoracic subarachnoid block. This technique involves delivering anaesthetic agents into the cerebrospinal fluid at the thoracic level of the spine. Hypobaric solutions are less dense than cerebrospinal fluid and can be guided by patient positioning to selectively affect specific spinal segments.
By using this method, the surgical team aimed to achieve sufficient anaesthesia for cervical spine surgery while avoiding the cardiovascular and respiratory risks associated with general anaesthesia in a medically fragile patient.
Dr. Anjum further explained that hypobaric drugs are lighter than cerebrospinal fluid and can be guided by patient positioning, allowing the drug to float upward and selectively block the required area.
This helped maintain cardiovascular stability, preserved breathing, and allowed the patient to remain conscious throughout the procedure, without experiencing pain or respiratory distress.
The procedure was carried out by a multidisciplinary team that included neurosurgeons, spine surgeons, anaesthesiologists, and postoperative care teams such as physiotherapy and neurology specialists.
Dr. Sohail Anjum emphasised in the interview that the success of the case was the result of coordinated teamwork and hospital preparedness, rather than the efforts of a single individual.
He also specifically acknowledged Dr. Jaleel Kirmani as part of the treating team during the interview.
According to Dr. Anjum, multiple discussions were held with the patient’s family, and they were taken into confidence regarding the high-risk nature of the surgery before proceeding.
According to hospital officials, the details of the surgical and anaesthetic approach have been documented in a peer-reviewed American medical journal.
Dr. Anjum described the acceptance as a major milestone, indicating international recognition of the technique.
The approach, commonly referred to as segmental or singleton anaesthesia, aims to block only the region where surgery is required, instead of producing widespread motor and sensory blockade.
He expressed the view that hypobaric and isobaric segmental anaesthesia could represent the future of anaesthesia, even for long and complex surgeries, if further research supports its safety and effectiveness.
This documentation allows the wider medical community to evaluate the technique, understand its indications, and assess its applicability in similar high-risk cases.
While such approaches may not be suitable for all patients, the case highlights the role of individualized anaesthetic planning in complex spine surgeries. It also underscores the importance of multidisciplinary decision-making when standard protocols pose significant risks.
Further studies and peer-reviewed evaluations will be required to determine the reproducibility and safety of such methods across different clinical settings.
According to postoperative follow-up details shared by Dr. Sohail Anjum in the interview, the patient remained neurologically stable for several months after surgery, underscoring the clinical benefit of the tailored anaesthetic approach in this high-risk case.
(Rh/SS/MSM)