One week ago, I was called into hospital in the middle of the night to see a young man. He fell 7 storeys and survived landing on both his feet and flexing his waist. He suffered open burst fracture of the right calcaneum (heel) and open fracture dislocation in the left ankle. He also broke… Continue reading Broken Back Surgery

Recently, I did an emergent surgery for a middle age male who had broken neck after a fall at work. He came in with weakness of the right upper limb from a herniated disc. Mechanism of injury was likely a flexion distraction force which tore through his cervical disc space and fractured the left posterior  facet… Continue reading Broken Neck surgery

Similar conditions somehow comes in threes. I managed a triplet of central cord syndrome recently… These sufferers are admitted with acute paralysis in all four limbs following a fall/minor trauma. They may be totally well before the fall but have silent pre-exitising spinal cord compression in the neck. The trauma suffered from hyper flexion of the neck… Continue reading Central cord syndrome — to operate or not?

Tuberculosis is rarely seen in Singapore now. Infection involving the spine is even more uncommon. Guess it is my luck, I have been asked to surgically decompress these every now and then. And they come in threes. Personally, they are “big” cases, requiring several hours to work on and are usually done emergently as the… Continue reading TB Spine in Singapore -sharing results

Spine surgery is fast changing and I firming believe in the harnessing of latest technology to enhance the safety and reliability of spine surgery. In the last decade or so, vast advances in optic and imaging technology has made spine surgery much more accurate and safe to perform. This has guaranteed a shorter hospital stay and… Continue reading Safety in Spine Surgery

This is normal aging of the musculoskeletal support system which starts from age 20 upwards. There will be the drying up (dehydration) of the intervertebral disc with mechanical backache as a result of loss of support. The condition progresses with osteophyte (bone spur) formation that stabilises the spine but leads to impingement of nerve sheath… Continue reading Degenerative Spondylosis

Axial view of central canal stenosis Sagittal MRI of L45 central canal stenosis This is a degenerative condition whereby the spinal canal is progressively narrowed by disc protrusion, overgrowth of posterior facet joints and buckling of the surrounding yellow ligaments. The neural elements are progressively pressed on. As a consequence patients experience numbness and weakness… Continue reading Lumbar spinal stenosis

Neck pain is a very common problem which brings the patient into office for a consult. The pain can be located over the neck and radiates into either or both shoulders. There is associated stiffness with difficulty turning. Young patients may find that they cannot drive well as they cannot turn whilst older patients have… Continue reading Mechanical Neck Pains

BACK PAIN Commonly refers to pain in the upper or lower back. Back pain is the second commonest medical complaint that brings people into a doctor’s clinic. Back pain commonly arise from injured muscles or tendons, which is described as soreness (酸 in Chinese) or may manifest as an acute sharp sensation that is worsened… Continue reading Back pains