Spinal surgery exploits some of the most advanced surgical techniques available, and this area of medicine is a catalyst that drives further advances in the research development of surgical procedures. But spinal surgery is far from being a modern concept, in fact the earliest evidence of spinal surgery dates back to the 7th century.
Written details of the first spinal surgical procedures are detailed by the man that is often considered the father of medical textbooks, Greek physician Paulus of Aegina. In the 6th volume of his classic 7-book anthology, Epitomoe Medicae Libri Septem (Medical Compendium in Seven Books) Paulus devoted numerous chapters detailing his revolutionary procedures in spinal surgery.
It is fair to say that, 14 centuries later, spinal surgery procedures bear little resemblance to those of Paulus. It is unlikely that he would have envisioned MISS, (Minimally Invasive Spine Surgery), but it his medical knowledge, skills and vision that remain the basis of so much of today’s modern medical intellect.
Although the centuries have passed, knowledge has progressed and procedures evolved, some things remain the same. Firstly, there can never be a 100% guarantee of success. Secondly, post spinal surgical procedure, a patient will certainly require further assessment and some level of treatment. The type and intensity of further treatment will be directly necessitated by the level of success gained from the initial surgery.
There are numerous forms of spinal surgery carried out every day by surgeons across the world. Spinal fusion, artificial disk replacement, discectomy and foraminotomy procedures are routinely conducted, as are nucleoplasty, spinal laminectomy, vertebroplasty and kyphoplasty, all with varying degrees of success.
The success of spinal surgery undertaken upon a patient is dependent on numerous factors. Astute, expert and detailed assessment and diagnostics are the first vital factor. Any level of failure here will certainly lead to complications later. This initial assessment must also explore and appreciate a patient’s underlying medical conditions, existing medical issues must be factored in to maximize the benefits of any treatment program.
Any spinal surgery should only be undertaken by specialist spinal surgeons. The spine is a complex component of the human body, to understand it and its intricate functions require an immense level of knowledge, experience and skill. The spinal surgeons and their teams of supporting technicians at Samitivej Srinakarin Revision Spine Center are of the highest caliber and leaders in their field.
Armed with the very best in diagnostics and having the most skilled and knowledgeable experts in the field, simply is not enough. The brains and abilities need the correct equipment and environment in which to operate. Samitivej Srinakarin Revision Spine Center recognizes the importance of modernity throughout the center. The most technologically up to date equipment is always employed, on this point expense is secondary to quality.
Equally recognized by the Revision Spine Center team is the fact that the building, although in itself an entirely inanimate object, has great bearing upon the center’s success. Modern, forward thinking maintenance, cleaning and sterilizing routines are strictly adhered to. The highest levels of health, safety and hygiene have become benchmarks at the Samitivej Srinakarin Revision Spine Center.
Failed Back Surgery Syndrome
Many recipients of spinal surgery are left with further spinal problems or persistent back pain; this is an acknowledged condition referred to as ‘Failed Back Surgery Syndrome’ (FBSS). In some cases, spinal problems can become more complicated following surgery with pain and discomfort exceeding that which was experienced pre-surgery.
Assessment, diagnostics and treatment of FBSS is a specialist area of expertise, and this has been recognized by Samitivej Hospital. Their recognition of the importance of specialized treatment for FBSS led them to open Bangkok’s first dedicated FBSS clinic at the Samitivej Srinakarin Hospital. With Clinical Care Program Certification (CCPC), which ensures that the quality of treatment given is equal to that received by patients in the United States, patients can be assured of a world class medical service.
The director of the Samitivej Srinakarin Hospital Revision Spine Center, Professor Prakit Tienboon M.D. leads a team of doctors, surgeons and rehabilitation specialists that are the forefront of this specialized area of medicine. Refreshingly, profit is not the primary goal of the Revision Spine Center. Effective treatment, education, research and development in striving to relieve suffering and improve life quality are the objectives.
Following failed back surgery, it should not be automatically assumed that further surgery is inevitable. At the Revision Spine Center all patients are assessed by the team’s experts. Pathological and neurological studies are undertaken with the results put alongside the effects of a patient’s problem on their quality of life. Only then can a decision be made as to the appropriate course of treatment.
Using an evidence based approach and following comprehensive consultation by the entire team of experts, it may be that further surgery is the most appropriate option. However, with the team’s broad approach and its multi-faceted skills base, additional surgery may be avoidable, or even non-preferential.
Evidential based data show poor results of success where reoperation is undertaken as an automatic remedy for failed back surgery, the same is true for medication based corrections. By contrast, carefully planned active exercise routines, physical therapy and behavior rehabilitation show far better results.
Careful medication management, implant technology, neuromodulation, interventional and alternative procedures, such as adhesiolysis, can all play a part in the treatment for FBSS. Or more likely, a combined treatment approach, individually drafted for each patient, will gleam the best results.
The team at Samitivej Srinakarin Hospital Revision Spine Center have cast out the ‘Off the Shelf’ idea of remedial cures. As much as the knowledge and skills of the medical team have led to an impressive level of success, so has their broad, opened minded belief in individualized treatment. They understand that no two people are the same and that similar medical conditions affect people’s health and lives in different ways and to different degrees.
In Bangkok, the only dedicated Revision Spine Center is operated by the Samitivej Srinakarin Hospital. Indigenous and overseas patients are now benefitting from this unique facility, its unique approach and its ‘Care Comes First’ vision. Professor Prakit Tienboon has assembled an expert team with multiple skills which operate one cohesive unit. Having broken down preconceived ideas and developing new, progressive treatment regimens, they are now improving, not only people’s health, but their quality of life.