Mama Yunusa stopped walking in March. Her arms and legs simply stopped moving. She also complained about pain in the neck. She was effectively bedridden and had to be carried to the bathroom by her daughter. A fiercely independent woman was reduced to a helpless state and indignity. Her MRI scan showed severe pressure on her spinal cord – by arthritis. She needs an operation. She is 80 years old.
Arthritis in the elderly
The causes of neck pain are nearly as numerous as terms used to describe the symptoms. Neck pain can be caused by arthritis which is really wear and tear of the joints in the neck. The joints simply wear out. More and more elderly will suffer from back pains, neck pain due to the degeneration caused by arthritis. Arthritis is one of God’s Apps: a computer program embedded in our genes!
Arthritis causes wearing out of the bones and pressure on the nerves and spinal cord. This destruction of the bone causes instability which may require an operation to reinforce the bones. The pressure on the nerves may require an operation to free the nerves and release the pressure.
Other causes of neck pain are injury from poor positioning of the neck to falls and road traffic accidents. People can break their necks following a road traffic accident. Another important cause is infection especially due to tuberculosis. Finally, we have some patients who have neck pain from cancer in the bones.
Age and spine surgery
There is a real fear of spine surgery, especially in the elderly. The poor results of the past are still clouding the present and jeopardizing the future. The fear is of paralysis and death as well as of becoming disabled due to the weakness of an arm or leg.
Because of this, many patients are not offered surgery and instead are taken to the village or church. Many are left at home in pain until death eventually comes. Before death though, someone has to look after mama or papa, and someone may have to leave employment to stay home with them.
Elderly patients suffering from arthritis of the spine should not be left in pains and misery. More importantly, what is happening in the present? How many days will mama or papa suffer in pain, helpless and hopeless? How much pain can they tolerate? How can you cope with the misery and the cries in the middle of the night? Something should be done when an older person starts crying in the mornings and praying for early death on dark nights.
The important issue as regards planning for surgery is a firm diagnosis, clear evaluation of the physical status of the patient, assessment of the fitness for surgery, a clear surgical plan, honest balance of the benefits and risks of surgery in the hands of the surgeon and effective post-operative support by spine-trained physiotherapists.
Surgery on the spine is safe if performed by experienced surgeons and with adequate expert support from the nurses and physiotherapists.
Spine fixed in Nigeria
Age is no barrier to surgery in the elderly. If it can be done safely and if the benefits outweigh the risks, then, no problem! Of course, no one can guarantee 100 percent success but the majority will benefit and have a new future.