A healthy, pain-free and balanced Spine is a boon. With age, like all other organs and joints of the body, the Spine ages too. Generally, a body achieves the best bone mass and cartilage height by 20-25 years of age. After 35 it is widely believed that the bone mass and cartilage integrity gradually decline depending on the healthy habits the person has to slow it down.
As degeneration proceeds the body learns to heal and compensate. Symptoms of the Spine usually indicate that the problem has reached to a point where the body is unable to deal with the process. In the early stages it is possible to control the process by non- invasive interventions, lifestyle changes – the healthy habits that slow the process of Degeneration. It comes to a point when a surgical intervention is indicated when all these measures have been unsuccessful.
This is where the paradox becomes evident. In our society patients have a general apprehension of Spine Surgery. This leads to an attitude of delaying it, even when it is indicated, to the point when there is absolutely no other respite from symptoms. The paradox comes in the picture here. This psychology of saving oneself from “what if something went wrong” after surgery and there wasn’t an expected recovery leads to months and sometimes years piling on the already decompensated Spine. The pathology gradually worsens. What was once a simple surgical intervention becomes more challenging or complex with each passing year. The idea of self preservation itself causes accumulating harm to the patient’s spine, increases the risks of surgery, reduces the success rate and chances of anaesthetic issues subsequently. The paradox.
We haven’t learnt to measure suffering in monetary terms yet, Dr. Navneet Saraiya said. How much is a years back and leg pain, inability to sit, stand or walk properly and more importantly, inability healthily enjoy a mobile life worth in terms of Rupees. How does the cost of timely surgery with its relatively low risks and relatively higher success rates of early surgery (with the right indications of course) compare with the cost of a year or two’s suffering if it is delayed. Let us get some social scientists and economics wizards to figure out the cost of spending one day fully mobile, in little or no pain, with a healthy positive outlook towards life.
It is of course the surgeon’s prerogative to explain to the patients the natural progression of their Spine pathology. What will they be like in a year’s time if they did not rectify their problem and if they did? May sound quite like doomsday conspiracy or scaremongering from ones perspective but then such is life. A crack in the wall may be easy to repair now than after 2 years when it is about to take the wall down (and of course the gradual sense of impending doom looking at the crack growing each day). One stitch in time saves nine….
Dr. Navneet Saraiya
FRCS, Consultant Spine Surgeon
