UKZN neurosurgeon on a mission to treat movement disorders

The UKZN Discipline of Neurosurgery based in Inkosi Albert Luthuli Central Hospital once again leads with innovation in the field of neurosurgery in the province by developing its own "Functional Neurosurgery."

On the 12th and 13th of September 2019 , a team led by Dr Nomusa Shezi, KZN's first African female neurosurgeon, and Dr Amod (neurologist) partnered with Dr Slabbert (neurosurgeon, private sector-Netcare) to perform two DBS procedures to treat patients with Parkinsons disease and dystonia respectively, where they conducted procedures on two patients with movement disorders.

This procedure becomes necessary for patients suffering from movement disorders such as Parkinson's disease (PD) and dystonia that no longer respond to medical therapy.

The procedures were successful for both patients and Dr Shezi feels her team needs to ensure such procedures are performed regularly so that patients who desperately need the procedure get the help they need by restoring or improving their human body functioning so they can lead their normal lives.

Dr Shezi, who is KZN's first African female neurosurgeon, with a passion for movement disorders and epilepsy surgery, has now performed three DBS cases in the last 12 months and plans to increase the numbers annually to ensure this sector of the population within the public sector is treated.

Although these procedures are routinely done in the first world (private sector), they are uncommon in the developing world, especially in public hospitals. The public healthcare sector now has new hope for treatment of such diseases since Dr Shezi, a specialist neurosurgeon in the department of neurosurgery, in Inkosi Albert Luthuli, has been working hard in the last 18 months to initiate a movement disorder unit within the department to treat patients with this devastating disease.

The procedure has been performed twice before in the department more than five years ago, and though the procedures were successful for both patients, the team required to ensure the cases are performed regularly was not there which meant the patients who so desperately needed the procedure were left.

"Treating these patients is a team effort," states Dr Shezi, who credits Dr Amod (specialist neurologist) who has been seeing these patients for years and has been instrumental in not only diagnosing, treating and identifying candidates that would benefit from surgery but more importantly forming part of the team during the procedure as well. The team has had the addition of the neuropsychologist and hopes to expand to include a neurophysiologist and psychiatrist.

Dr Shezi also worked with Dr Slabbert and his phenomenal team. Dr Slabbert is one of the leading neurosurgeons in the country, who works in the private Netcare sector. Dr Slabbert spent three days out of his private practice to transfer his expertise and train the team at Inkosi Albert Luthuli, since most of these cases are done in the private sector and training in government to perform them is limited, if not altogether absent in most government neurosurgery training centres in the country.

The cases for PD are performed with the patient awake, being examined for improvement of their symptoms before the final placement of the leads. This ensures the best possible outcome is guaranteed for the patients, as the surgeon and the neurologist examine the patient while awake during the procedure. DBS is perfomed regularly in the private sector but has been unavailable for state patients in KZN. The procedure is proven across the world as having the best outcome for improving the quality of life, including some patients being able to return to their jobs and obtain independence.

Dr Shezi and her team hope this procedure will become a regular feature available for all government patients who require it and would benefit from the procedure, with the long-term benefit of improving the quality of life of patients and possibly allowing some patients to return to work.

This is an inspirational case for the black youth of South Africa. Our first black female neurosurgeon in KZN, who is only 34-years-old, is doing such a complex brain operation. This also highlights the plight of people living with movement disorders in this country, expressed Dr Basil Enicker, who heads the UKZN's Discipline of Neurosurgery at Inkosi Albert Luthuli Hospital.