Brunei Carrying Out Scoliosis Surgery Independently

Author: Melvin Jong

Bandar Seri Begawan - Brunei is expected to carry out its own scoliosis (side-bending of the spine) surgeries independently, without the aid of any foreign institutions in the next one to two years, said the chairman of AO Spine Asia-Pacific yesterday.

Brunei receives about 20 reports of new scoliosis patients each year, most of which occur in teenage girls.

Hong Kong-based KV Menon told The Brunei Times that Raja Isteri Pengiran Anak Saleha (Ripas) Hospital's neurosurgeons are now capable and have already performed some 30 scoliosis surgeries under foreign supervision and expertise.

"I think Brunei should be able to perform right now because the Neurosurgery Department in Ripas have actually been performing these surgeries with us for over two years now," he said on the sidelines of the International Workshop on Scoliosis at Ripas from November 9-15.

"Maybe we can come once or twice again to generally supervise. The surgical technique is something that they are very confident with at the moment, maybe we can just help with a little of the planning and preparation work," said Menon, adding that there is currently no accreditation system for scoliosis surgery anywhere in the world, apart from spinal surgery accreditation.

According to the chairman, AO Spine visited Brunei for the first time in 2007 when they realised that several of the scoliosis patients had to be sent overseas due to the lack of know-how in Brunei. "This is a major expense for the patients and their families so we thought, why don't we come in and help you do this programme?" he said.

"I came in and performed three or four surgeries, basically to study the environment. We realised we can perform the surgery here very effectively as we have everything that is needed," said Menon, who explained that this led to a programme held twice a year in the

Sultanate to help train Brunei's surgical team.

Ripas Consultant Neurosurgeon Dr Maroon M Pillay said that Brunei diagnoses about 15 to 20 new cases of scoliosis a year on average, a ratio consistent with the rest of the world.

"They are mostly teenage girls and we still have no definite answer why this is so," he said. "There are a lot of theories and studies being done but no one has come up with a clear answer yet."

If left untreated, scoliosis could lead to tilting of the body, leading to not only bad appearances but also breathing difficulties, he said.

A total of 12 individuals from countries such as India, China, Iran and Nepal, participated in the workshop held with the main objective of knowledge transfer. "Scoliosis surgery is not routinely done, so many young surgeons are not exposed to scoliosis surgery," said Dr Pillay.

"Those who want to perform it will have to go through formal training and the goal of this workshop is to transfer this training onto them," he added.

Peng Yan and Rohit Kumar Pokharel, participants of the workshop from China and Nepal respectively, agreed that the workshop has considerably increased their knowledge on scoliosis and that this knowledge will be helpful for both them and their students back in their countries. They also agreed that they found the pre-operation planning training most useful.

"Before you do the operation, you will need to know some rules to guide you to perform the correct surgery. Sometimes if we don't grasp this knowledge, we might choose the wrong approach that might lead to negative results. This workshop has shown us how we can develop a good plan for better results," said Peng.

All these (planning) is essential to allow us to decide ourselves what is the best course of surgery," added Pokharel.

AO Spine is a non-profit foundation which started over 50 years ago to allow an association of surgeons to come together to develop new ideas and techniques for trauma surgery.

"Teaching young surgeons how to do things is our main job. We also develop new techniques, instruments and implants based on the research we do," said Menon.

Based in Switzerland, AO Spine currently boasts a membership of over 4,000, with 1,100 in Asia alone.-- Courtesy of The Brunei Times

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