Many Filipinos today suffer in silence from recurring pain in the back, neck and shoulders. In some cases, the pain becomes so severe they need painkillers to ease their suffering, and they sometimes become dependent on these painkillers, exposing them to a different set of medical problems.
Fortunately, there are now doctors that specialize in the treatment of their condition. One of them is Dr. Benjamin Tow, an orthopedic surgeon and specialist in back, neck and shoulder ailments at Mount Elizabeth Hospital. He was in town recently to give a talk about treatments for bone problems.
What are the most common ailments of the bone that are degenerative in nature?
For young people, scoliosis and herniated discs, when the cushion of the spine protrudes and pinches onto the spinal cord and the nerves. For older people, compressed discs, where the space for the nerves becomes tight, and they have difficulty standing and walking long distances. Elderly patients with osteoporosis tend to get spine fractures when they fall down.
What are the treatment methods for these ailments?
Depending on the extent of the condition, treatment can range from therapy to surgery. Majority of my patients don’t need surgery. I would first recommend physical therapy or injections to alleviate their pain or correct the condition. If these treatments fail, we may consider surgery.
Can you explain the minimally invasive spine surgery and how is it different from the traditional spine surgery?
My oldest patient was 95 years old and we did major surgery on him: spinal fusion with metal screws and plates. It was possible because he was healthy for his age. In his case, we did minimally invasive surgery which has less pain, less blood loss, less damage to tissues, and the recovery is very fast. In minimally invasive (or keyhole) surgery, we use very small incisions so the patient’s chances of getting other infections are minimized. The need for painkillers is also minimized so side effects are eliminated. A patient need only spend 24-48 hours in the hospital for the procedure.
How did you train for this breakthrough procedure?
I took my training for keyhole surgery in the US in 2006. I took my training in neurosurgery and orthopedic surgery there. When I came back to Singapore, medical technology and equipment for these procedures were slowly being introduced in our country.
What are the challenges in spine surgery and how have they been addressed?
More than half of spine surgeries are now keyhole surgeries which require a lot more technology and equipment. Keyhole surgery is slower because the incisions are smaller, but we work slowly on each section to ensure less tissue and nerve damage. For navigation, we use a computer eye to find the exact position of the damage. We also have neuromonitoring during surgery to monitor the location of the nerves in the spinal cord through electrodes attached to the patient’s body. Through neuromonitoring, we can avoid damage to the nerves of the spinal cord which is a major challenge during spine surgery.
For those experiencing recurring back pain, when should they seek medical help?
Most patients with back problems don’t need surgery. Depending on their condition, I may offer physical therapy or steroid injections to reduce inflammation of the joints. My philosophy is to do the least invasive treatment before doing major procedures. Conditions that require surgery are those where the patient is experiencing severe pain, or if you have a back condition where the bone cannot support the body’s weight, or if there is a compression of the spinal cord or the nerves.
Is there a team of doctors that handles surgeries?
For major open surgeries, I work with another surgeon so we can perform the work faster and lessen the blood loss. For some six-hour surgeries, a pair of surgeons can reduce the time to four hours.
For more information about the spine and other conditions, visit https://www.mountelizabeth.com.sg/healthplus. Health Plus is an online health and wellness resource developed by Mount Elizabeth Hospitals, Singapore. To make an inquiry or appointment, contact our Central Patient Assistance Centre’s 24-hour Helpline at +65 6735 5000 or e-mail firstname.lastname@example.org or visit http://www.mountelizabeth.com.sg