Hajiya Zainab walked into my clinic in real pain. I
said walked, didn’t I? She actually waddled in and could not wait to sit
down. When she sat, she leaned on the left cheek and stretched out the
right leg. This was done to ease her pain. She said the pain in the leg
travels from the back in shock-like sensations, arriving at her ankle
like a succession of locomotive trains.
It turns out she has low back pain and right leg
pain. The pain is caused by pressure on the nerves in the lower back due
to arthritis. The bones wear out following years of wear and tear. It
leads to new bone formation which then encroaches and presses on the
nerves. This pressure on the nerves, lead to pain, which shoots down the
leg. The leg pain is sometimes called sciatica.
Hajiya Zainab had lumbar canal stenosis. This means
there was pressure on nerves in her lower back. The pressure was due to
thickening of the ligaments in her back and new bone formations, causing
narrowing of the canal through which the nerves supplying her legs go
through. She was therefore advised to undergo an operation to remove the
pressure and free her nerves. At the time of discharge, following the
operation, she practically danced out of the hospital.
Mrs Adisa, an 82-year-old woman presented with a long
history of progressive deterioration in her level of function and
immobility. She had been wheel chair bound for over 7 years on account
of this problem. This pain in the neck and the various problems with
numbness and weakness affecting both arms and legs is caused by
arthritis in the neck. The medical term is cervical spondylotic
myelopathy: A real pain in the neck. On examination, she had weakness in
all muscles in the arms and legs and was unable to stand unaided. Her
MRI scan showed advanced arthritis in the neck and she was asked to
undergo the operation.
This was carried out and after 5 months of
physiotherapy, she was able to walk with the aid of a walking frame.
Now, she can at least help herself a little bit and reduce the burden on
the family.
Mr Ojukwu is a 65-year-old man married with children.
He was previously active and dynamic, a community helper and
contributor to many societies in the community. That was before his
hands and legs stopped working.
It all started like a joke. Initially, he had some
neck pain which the doctor diagnosed as arthritis. Slowly the pain in
the neck started shooting down the arm into the fingers. If he moves his
neck a certain way, a sharp electric sensation radiates down the centre
of his spine. Then, numbness started in the hands and feet. He also
complained of an unpleasant ‘drawing sensation’ in his arms and legs.
He required an operation to remove the pressure on
the spinal cord. This was performed uneventfully and he went on to make a
good recovery. He has become ambulant and able to cater for himself
with minimal assistance from the family.
Mr Ode, suffered a neck and spinal cord injury
following a road traffic accident. He was paralysed immediately due to
damage to his spinal cord. He was recovered from the scene of the
accident and transported to hospital in good condition. There he
underwent an operation within a few hours, which removed the pressure on
his spinal cord. Six weeks later, he was able to walk with the aid of a
nurse and using a walking support frame. He has since recovered even
more function and back to work.
Medical tourism to other countries
There are some illnesses such as spinal cord injury
requiring immediate medical attention that cannot wait for the flight to
other countries. The colossal sum of money spent abroad could therefore
be used to equip more local hospitals in Nigeria to perform even more
in delivering care. Supporting the local hospitals and ensuring that it
has both personnel and equipment may be the difference between life and
death. Develop your local hospital and help prepare them to be able to
help you when it really matters. Anyone proudly strutting off to India
and other countries is truly a big fool. That you can afford to travel
to other countries is simply not the issue. Many have gone to other
countries and return dead despite colossal sums of money spent.
The key issues are that such medical tourism is
eroding the fabric of our own health services and further depleting the
nation of medical facilities and expertise. It demoralises local medical
practitioners and increases the brain drain. It reduces training of
medical students, further creating substandard and poorly trained
doctors to look after us all in the future. It simply creates a vicious
circle we must break free of.
Promoting quality of care
Many cases of effective and efficient management of
cases of spine problems abound in Nigeria. Patients do not need to
continue to troop out to other countries in search of quality of care.
At least for spine, we can now boast of the capability to manage most
cases of spine problems to very high standards in Nigeria. There are
surgeons in Sokoto, Enugu, Abuja, Lagos and Ibadan making huge strides
in providing a quality care. Some are even in our public hospitals. As
usual, lack of information on what is available locally impairs access
to good care.
Spine: Plans for Nigeria
You need to know that the future is bright, for
patients in Abuja with spine problems. This is because there are four
trained surgeons in Abuja offering specialised spine care with a full
surgical team backup and all the necessary equipment. Neck and back
pains can be conveniently managed in Abuja and Abuja is set to be the
destination for Nigerians with spine trauma and degenerative diseases.
In fact, there are several big foreign companies such
as Medtronic and Covidien now coming to Nigeria to collaborate and
support local practitioners. Others such as Infax Nigeria Ltd and
Implants International, UK have long been in the game and helping to
prop up our failing spine. So, now you know that spine problems should
no longer be a reason to travel out of Nigeria. We need the confidence
of the people and their trust to move us further forward.
We promise to do our best to make ABUJA the SPINE capital of Nigeria.
