HealthThe Stethoscope

RESULTS OF MANAGEMENT OF SPINE DISEASES IN ABUJA, NIGERIA

You are not alone
If you are experiencing low back pain, you are not alone. An estimated 75 to 85 percent of all adults will experience some form of back pain during their lifetime. Although low back pain can be quite debilitating and painful, in about 90 percent of all cases, pain improves without surgery.

However, some people are so debilitated by pain, numbness or weakness of the arms and legs that they need surgery. They need surgery to remove pain and to relieve them of paralysis in some situations. Yet, there is a real fear of spine surgery in Nigeria. Many people including doctors are truly scared of paralysis and death. They have heard and continue to hear tales of bad outcomes and death following spine surgery.

Wahala
Some patients have had operations performed in Nigeria, India, Germany and in Dubai with poor outcomes. The stories often widely reported are the tales of woe which scares others from undergoing much needed interventions. In many respects, people then wait and delay treatment till the condition worsens, making full recovery harder to come by. Yet, operations on the spine can be effective in delivering patients from a life of misery.

The Minister of Health recently agreed that the visibility of Nigerian hospitals need to be improved. A climate of openness and access to information about what services are available and where need to be created. We need to advertise the skills available, the facilities that can do it and how we can work together. He said, he was quite impressed when he heard about the array of skills present in Nigeria. He said, ‘We run down what we have, we create an impression that nothing is working and that is not correct’.

In an admonition, Adewole said: “So let us work together with you. There are centres here in Nigeria doing renal transplant, a lot of Nigerians go abroad for renal transplant, but it is being done in this country. So, let us use these facilities, we are not marketing or advertising Dr. XYZ but we market the facilities and services, and we are ready to work together with you.”

This therefore is a great opportunity for Nigerian hospitals to seize the gauntlet and push for improved visibility, accessibility and affordability.

Spine Fixed in Abuja
The Brain and Spine Surgery Hospital (BASS) in Abuja is a specialist centre that offers surgical intervention for patients with spine diseases. The hospital and many others like it in Abuja offer conservative or surgical management for patients with neck pain, arm weakness, back pain and leg weakness. These conditions are variously diagnosed as cervical spondylosis or lumbar spondylosis.

👆🏿 MRI scan of a patient with cervical spondylosis

Surgery is the option when the conditions are severe and especially when they lead to paralysis or unbearable pain. The brain and Spine surgery hospital has been carrying out these operations for a few years in Abuja. The hospital therefore reported an audit of the short-term outcomes following spine surgery.

X-ray showing a bendy spine called scoliosis.

Audit report 2018
In a report distributed online over the weekend, the hospital operated on 81 patients with spine problems in 2018 performing a total of 93 operations. Some patients had more than one operation to solve their problems.

Some of the patients had neck operations while the majority had operations on the back (lumbar spine). The operations often entailed instrumentation or putting screws and rods in the spine to hold it together. The hospital operated on some complicated cases who had their initial operations in other countries. This was because many could not afford to travel back to those countries.

Three of the major operations performed were also in Jehovah’s Witnesses. As you know, they do not have or take blood transfusions, so the operations were usually designed in a special way. The hospital reported good early outcomes in over 90% of its clients. Even those who had two or more operations did well eventually and had their problems resolved. In general terms, many patients were happy with their operations in the short term. A few still have niggling back or leg pains and remain on the necessary medications.

Notably, there was no single case of wound infection in any of the operations. This is the third year in a row, of such consistent results. Unfortunately, the hospital also lost 2 patients who suffered from aspiration of their food. This was an undesirable complication after straightforward operations. One such death occurred 2 days after surgery and the other occurred a week after discharge home.

Believe in Nigeria
Speaking at the weekend, the consultant spine surgeon said the results were encouraging though there is still a lot of room for improvement. The key message however was that spine surgery is safe in Nigeria and many hospitals are achieving good results for their patients consistently. Nigerians should trust in local health care as it can only lead to more improvements and better service delivery.

Watch the full report here: https://youtu.be/DwBJUVhtvKM

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