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	<title>C1 Blog&#187; spinal fusion</title>
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	<description>Healthcare thoughts from the best little clinic in Bristol</description>
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		<title>Spinal surgery &#8211; was it really necessary?</title>
		<link>http://www.c1healthcentre.co.uk/wordpress/index.php/spinal-surgery-and-can-it-be-avoided/#utm_source=feed&amp;utm_medium=feed&amp;utm_campaign=feed</link>
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		<pubDate>Wed, 07 Jul 2010 14:39:21 +0000</pubDate>
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				<category><![CDATA[Uncategorized]]></category>
		<category><![CDATA[chronic low-back pain]]></category>
		<category><![CDATA[Painkillers don't work]]></category>
		<category><![CDATA[spinal fusion]]></category>
		<category><![CDATA[Spinal surgery]]></category>

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		<description><![CDATA[Look at this crazy article I found in the Daily Mail (on line though!) Initially, it appears a great and heart-warming article of surgical success – but read between the lines a bit and you’ll see a damming example of all that’s wrong with the current system of medical care for the low-back. Look for [...]]]></description>
			<content:encoded><![CDATA[<p>Look at this crazy article I found in the Daily Mail (on line though!)</p>
<p>Initially, it appears a great and heart-warming article of surgical success – but read between the lines a bit and you’ll see a damming example of all that’s wrong with the current system of medical care for the low-back.  </p>
<p>Look for these key points:<br />
1.	10 years of pain!<br />
2.	Constant pain.<br />
3.	GP and painkillers – sure to work, them!<br />
4.	Didn’t, so back to the GP.<br />
5.	Referred to surgeon for a life-threatening three-hour operation (though I’d have thought the risk of paralysis that she mentions, the MRSA, anaesthetic induced death and, well, just death was not likely or serious enough to stop her having this operation as she had been in constant pain for 10 years!)<br />
6.	“The beauty of this operation is that it doesn’t constitute major spinal surgery”!<br />
7.	£10,000!</p>
<p>So, here it is:<br />
“Around eight in ten Britons are affected by back pain at some time in their lives. Anne Baker, 65, a retired shopkeeper living in Sheffield, had a pioneering procedure to cure her debilitating back ache. She tells ANGELA EPSTEIN her story.</p>
<p>Pioneering surgery: Anne Baker can now enjoy life after having spinal fusion<br />
THE PATIENT<br />
My back has always been a problem, particularly after playing golf or lifting things. But over the past decade, it slowly worsened until I was in constant pain.</p>
<p>I went to my GP, who said it was wear and tear in my spine and gave me painkillers.  Unfortunately, the benefit was only short term — I had a constant nagging pain in the centre of my back, which made me stoop, and I couldn’t hold my head up properly without being in immense pain.  I was forced to give up golf and increasingly relied on my husband to do jobs around the house. He even had to fasten buttons on the back of my clothes.</p>
<p>It reached a point, five years ago, where even lying in bed was uncomfortable and the only way I could get a moment’s sleep was by half-sitting up on the sofa.  As well as being in awful pain, I was exhausted all the time, which made me miserable. </p>
<p>I went back to my GP — after several appointments in previous months — in desperation, thinking there must be something that could be done.  The painkillers were now having little effect so he referred me to a specialist, Lee Breakwell.</p>
<p>Although I was afraid of surgery — I’d heard stories of people coming out even worse after very invasive operations — there seemed to be no alternative.  It was either an operation or a wheelchair and I was already practically housebound, so what was there to lose?  A scan revealed one of the discs in my spine had degenerated so badly over the years that it had slipped out of place, causing the vertebra on top to tilt downwards by 30 degrees.  Without the cushioning effect of the disc, two of my vertebrae were resting on each other, which was causing the dreadful pain.</p>
<p>So I was amazed when Mr Breakwell said that he could cure me using a new technique which was much less invasive than the conventional procedure.  First I would need the disc removed — usually the vertebrae on either side would then be ‘fused’ together using screws: this stops the movement and the pain.  But, instead, Mr Breakwell said he would use a bone graft, which helped the vertebrae to fuse better together, with fewer complications.  I was a bit nervous about having a general anaesthetic and couldn’t help worrying that if something went wrong, that would mean being paralysed.</p>
<p>Although I was very sore from the stitches when I came round, incredibly, the constant nagging pain in my back was gone.  The feeling was indescribable.  The day after the operation, I could stand up straight without that terrible pain.  The nurses helped me with exercises which I continued to do at home after being discharged, five days later.</p>
<p>Within three weeks, I could stand up straight without any pain.  It was astonishing to see myself in the mirror after so long stooping — I seemed to have grown an inch-and-a-half. </p>
<p>Progress was slow, and I had to walk using crutches for seven weeks.  But I could sit up properly and lie down flat without any discomfort after a couple of weeks — a milestone after sleeping on a sofa for two years.  About six months later, I was able to play golf for the first time in four years.  I’m constantly aware of my good fortune — even little things such as fastening the buttons on my dress.</p>
<p>Before the surgery, I felt like an old woman and thought my future was a wheelchair and pain for the rest of my life.  Now, I can wear nice clothes and high heels and play golf.  I even have a perfect swing, as the metal rod in my back helps keep my hips straight! It’s like being given a whole new lease of life.</p>
<p>THE SURGEON<br />
…[To begin the three-hour operation, I made a 10cm vertical incision in the small of the back along the spine, and peeled back the spinal muscles to reveal the base and bones of the spine.  I then drilled into the vertebrae on either side of the damaged disc and stabilised them with small screws in order to remove the disc (a disc is around 10mm high and four cm in diameter).  I packed a teaspoon of bone graft — grated bone, which is better absorbed by the body than solid bone, taken from Anne’s pelvis during the operation — into a banana-shaped piece of plastic (a ‘spacer’) about 10mm high with a hole through it.  The plastic is then placed into the space where the disc used to be, so that the bone from the graft can grow and fuse with the joints on either side.  The bone graft doesn’t need any treatment to prompt it to grow. However, the adjacent joints need still to be in order, to keep the space open for the new bone to grow in. I do this by locking little screws into the joints.  The bone graft takes between six and 12 weeks before it gets taken up by the body and turned into proper bone.</p>
<p>While the bone graft doesn’t act as a new disc, it makes that part of the spine solid and puts an end to the pain previously being caused by a jarring damaged disc.</p>
<p>We need discs in our back to provide shock absorbency for the spine.  However, missing one disc shouldn’t matter too much, as we have other discs to compensate.  The beauty of this operation is that it doesn’t constitute major spinal surgery [!]. The procedure is quite localised, yet it can cure a disabling disc problem. It relieves pain and enables the patient to function normally again.<br />
Anne’s return to the golf course is a wonderful example of this.  And it should solve her problem for life. </p>
<p>The operation is available on the NHS. It costs £10,000 privately.”</p>
<p>Good grief, why didn’t they spend a little time and money (I’d estimate about 1/33th of what they paid for the operation alone) on some early care in the first few years and maybe, just maybe, none of this madness would have had to happen.  </p>
<p>Now, I am really glad that Anne is functioning well and that the surgery was a success but I am appalled at the loss of a decade of her life due to medical mismanagement.  </p>
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