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Anterior Spine Surgery: a great way to help nerve pain

Recently I had the pleasure of looking after a very fit and active 70 year old lady. She had previously enjoyed free climbing and hiking and had plans to trek Machu Pichu and to Everest Base Camp over the next 2 years! She presented to her GP with worsening pain radiating down the leg in the region of the L5 dermatome (lateral calf and dorsum of the foot) for 6 months. She struggled with getting around the local shopping centre and with some activities of daily living.

Spinal Deformity – a Multidisciplinary Solution

A man in his 60’s consulted me with intractable back pains associated with degeneration of his lumbar spine.  There was widespread degeneration of the lumbar facets and discs, and he presented with a significant history of narcotic use, in a vane attempt to get his pains better controlled.

Neck pains and occipital headaches – a rare pathology

A 69 year old male presented to his GP with a slowly progressive, 6 month history of left sided neck pains and occipital headaches. Examination was unremarkable and in particular, strengths and reflexes in all 4 limbs were normal.

CT scan revealed some degenerative changes low down in the cervical facet joints and a referral was made to an orthopaedic spinal specialist, and from here facet joint injections were undertaken.

First O’arm spinal surgery on the Sunshine Coast

Recently, I had the pleasure of undertaking the first ever ‘O arm’ spinal surgery case at the Buderim Private Hospital. The ‘O arm’ is a sophisticated device that provides surgeon with real-time CT quality imaging intraoperatively during spinal fusion procedures.

Spinal fusion surgery is technically demanding and stressful for both patients and surgeons, it’s vital to have access to the most sophisticated technology in order to reduce the rate of complications.


A 75 year old female presented to her local hospital with pains in the chest and was admitted under a Respiratory Physician with (incidental) rib fractures, that in retrospect were old.  Clinical suspicion lead to further investigation and the diagnosis of an intradural mass at the level of T6 and T7 vertebrae.

An MRI suggested showed the mass with significant spinal cord compression, but despite these rather dramatic findings on scan, the patient maintained good strength in her lower limbs and normal sensation and function of the bladder and bowel.

Going off legs: thoracic myelopathy

Most unstable spinal fractures affect the thoracolumbar junction or the cervical spine. Fractures elsewhere in the spinal column tend to be stabilised by the rib cage and rarely cause neurological deficits. Whenever a fracture causes spinal cord compression elsewhere in the thoracic spine, a secondary process such as infection (osteomyelitis) or neoplasm (primary or secondary) is more likely to be present. With advancing age, the transitional cervico-thoracic region is subject to degenerative and osteoporotic changes and spinal cord compression can occur.

Thoracic Disc Herniation

Most of the degenerative spinal pathology that we see as specialists as well as in primary care affects the lumbar or cervical spine. This is interesting as the thoracic spine contains a similar number of intervertebral discs and facet joints than the rest of the spine put together. However, the relative immobility of the thoracic region due to the rib cage limits motion-dependent degenerative processes such that most spinal surgeons would really only operate on thoracic disc herniations once or twice over a several year period.

Sit and suffer

I am very often asked by patients, both those who have undergone surgery and those for whom surgery for lumbar back ache is not available, what exercise regime they should follow. There is a generally held view that a structured exercise program must be good for maintaining spinal hygiene and there is no end of work hardening programmes, core strength exercise programmes and abdominal muscle strengthening regimes etc. etc. touted to restore the spine to pristine health, almost all of them lacking much hard evidence of real efficacy.

Just don’t do it!

Falls off ladders are a surprisingly common injury in our community, and whilst most amount to nothing more than dented pride when they occur, some are considerably more serious – just ask Mr Ian (Molly) Meldrum.

Recently we had cause to treat yet another considerably more serious “ladder injury”.  A 56 year old man had been painting his ceilings at home when he fell off his ladder.  Whilst this may read as any other 6 foot step ladder incident, this particular event was made all that more serious by the fact that the ladder was perched precariously on the kitchen bench at the time.