Spinal surgery helps housewife, 62,overcome back problems

Madam Lim now wears a corset and can walk without involuntarily bending forward or to the side.

Housewife Lillian Lim, 62, suffered excruciating pain every day for three years.

She hurt herself after falling down four steps in her home while carrying a large basin of water to the garden.

And it made a disease, which she probably already had but did not know about, worse.

"I landed hard on my backside at the bottom of the steps. From that day, I suffered bad backaches," she said.

Madam Lim has degenerative scoliosis, a medical condition in which a person's spine is curved from side to side, caused by the wearing down of the facet joints on the backbone.

This form of scoliosis occurs most frequently in people over 60 years old and occur predominantly at the lower back, caused by uneven deterioration of the discs as well as compression fractures.

Professor Wong Hee Kit, who heads the University Spine Centre at the National University Hospital (NUH), said that with the aging population, there will be more patients with degenerative scoliosis.

"We have been seeing an increasing trend of these patients seeking treatment for this condition, particularly over the past five years. We see about 700 of such patients a year, who present with back pain with or without spinal nerve compression symptoms," he said.

A 2010 study, conducted by the centre, found more than 11 out of 100 people aged 40 years and older develop degenerative scoliosis.

Prof Wong said the prevalence is similar to that in North America, which is 8.9 per cent or nine out of 100 persons.

The 2010 study, which put 6,500 patients aged 40 years and older through Dexa scans for osteoporosis, also found the prevalence of scoliosis increased significantly between the ages of 40 and 80 years.

The Dexa or Dual Energy X-ray Absorptiometry scan is the most commonly used and accurate test to measure bone density.

Orthopaedic surgeon Hee Hwan Tak, who operated on Madam Lim, said she was probably already suffering from degenerative scoliosis.

"And it was accelerated after the injury which damaged the supporting structures of the spine," said Dr Hee, the medical director of the Singapore Medical Group's Centre for Spine and Scoliosis Surgery.

While most patients can be treated successfully with physiotherapy and painkillers, "those with more severe or progressive spinal deformity will need multi-level spinal reconstructive surgery because their symptoms cannot be controlled by non-operative treatment," Prof Wong said.

Madam Lim fell under this category.

She told The New Paper: "Every time I walk I find myself bending involuntarily either to my side or front. I had to stretch my arms regularly to straighten out."

After ascertaining that she did not suffer any cracks or breaks in her spine due to the fall, Madam Lim turned to acupuncture and even specialised pain management to alleviate her suffering - but to no avail.

"I spent more than S$10,000 trying this remedy and that treatment. It was until I read in the papers about degenerative scoliosis and the option of surgery that I told myself, this was it," she said.

Implant

Dr Hee performed surgery for six and a half hours on Madam Lim on Aug 8 this year, during which he implanted a titanium intervertebral cage into her spine to provide support and fuse a couple of her vertebrae. He also corrected her spinal curve and hump.

"Surgery is usually the last resort if the patient failed conservative treatments and continual pain disrupts the patient's quality of life," he said.

Dr Hee added that age is not the primary determinant when it comes to opting for surgery. "For healthy adults, we can offer surgery to patients in the 70s and even selectively in the 80s.

We just need to be aware of the potential issues in fixation of the osteoporotic spine," he said.

It has been almost two months since Madam Lim went under the knife. She wears a corset and can now walk without involuntarily bending forward or to the side.

"I can't wait to be better and remove the corset. I want to travel and hope that within a year, I'd be able to visit Taiwan, a place I've often wanted to go," she said.

"I spent more than S$10,000 trying this remedy and that treatment. It was until I read in the papers about degenerative scoliosis and the option of surgery that I told myself, this was it."

- Madam Lillian Lim

juditht@sph.com.sg

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