Why an Integrated Spine Clinic Matters: Team-Based Spine Care

The cost of surgery in our hospital for spinal problems can range anything from $3,500 for a discectomy and decompression to $5,500 or $6,000 for fixation of the spine at one level, and even up to $10,000 for more complicated cases — that's usually the range of costs patients most commonly have to bear. Most of these patients, who come walking because of pain in the neck, arm, or lower back going into the legs, usually stay in the hospital for about three to four days, and in the country for about two weeks.

Yes, we do use intraoperative neuromonitoring — we are one of the very few centres in the country who have been using this quite regularly. We were focusing on minimally invasive spine surgery and spine navigation in this talk because of limited time, but yes, we do have neuromonitoring available to us as well.

Yes, we have specialist spine surgeons and pediatric surgeons also, and I myself do a lot of spine surgery in children — whether they have neural tube defects such as meningocele, Chiari malformation, or tethering of the spinal cord which can cause weakness of the legs. In all those patients we do spine surgeries, also in children who've got scoliosis or hemivertebra deformities, or tumours of the spine. All those patients we have been tackling from the age of 6 months to 18 years of age.

The team combines a rheumatologist, an orthopaedic surgeon, a neurologist, a pain specialist and a spine neurosurgeon working together on diagnosis and treatment.

Dr. Rajan explains that complications in spine care often arise from errors made before surgery, at the diagnosis stage or when choosing the right doctor, which a single specialist's view is less likely to catch.

A centre that brings multiple specialists together to confirm a diagnosis, rather than relying on one surgeon's opinion, is more likely to recommend surgery only when it is truly warranted.

Reviewing a patient's case from multiple specialist angles before any surgery is recommended reduces the chance that patients undergo an operation without a clear indication.