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Group seeks to bridge worldwide gap in spine technology and resources
World Spine Health Initiative plans to provide up-to-date equipment to surgeons in developing countries.
Some of the basic instrumentation and
imaging equipment needed to perform effective spinal surgery is severely
lacking in developing countries. To bridge the gap between their rudimentary
resources and those used by spine surgeons in developed nations, the World
Spine Society has stepped in.
Its World Spine Health Initiative (WSHI) was formed this summer to make some improvements in this area. The group was organized by neurosurgeon Edward C. Benzel, MD, who chaired the society’s recent meeting, and other concerned spine professionals.
The purpose of WSHI is to address the various philanthropic needs of developing countries, according to Lisa Ferrara, PhDc, director of spine research the Cleveland Clinic Foundation in Cleveland. She is cochairing the group with Chester E. Sutterlin III, MD, of Gainesville, Fla.
“The plan of the initiative is to provide education, equipment, fellowship and research opportunities to less-developed countries with respect to spine care,” she told Orthopaedics Today via e-mail.
Spine care overlooked
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Typical of the cases Kayanja saw in Uganda was this 26-year-old woman (left) with spastic paraparesis due to spinal tuberculosis. After undergoing corrective surgery, the woman regained her ability to walk and recovered approximately 75% of her lower limb function (right). COURTESY OF MARK KAYANJA | |
Just getting underway, the group drew attention to the worldwide disparity in spine surgery technology during World Spine II: The Second Interdisciplinary Congress on Spine Care held in Chicago. In a presentation made there, orthopaedic surgeon Mark Kayanja, MD, lamented the lack of orthopedic medical technology currently available in Uganda.
“There is a dire need for clinical and academic input from technologically underchallenged countries to bridge the gap, so that there is a more even distribution of spine care in the world,” Kayanja told Orthopaedics Today
An orthopedic surgeon trained in Uganda, Kayanja is currently a research fellow studying vertebral fractures at the Cleveland Clinic Spine Research Lab. He is a member of the WSHI international committee.
“I had an interest in spine because in Uganda, spine care tends to be neglected because of other more pressing issues … the most important [of which are] poverty and the inability of the health budget to adequately cater to the population,” Kayanja said in a phone interview.
For example, the annual gross domestic product is USD 1200 per capita, with USD 9 spent on health care per person each year. There are 13 orthopedic surgeons in Uganda, 10 in Kampala and three who are upcountry, serving a population of approximately 25 million people. The total national health care budget is USD 75 million, of which the two national referral hospitals only receive 10%, he said.
Undertreatment of spine conditions is also a problem. Only a few other Ugandan orthopedists share Kayanja’s interest in spine, and most physicians do not choose to treat the many patients with spinal tuberculosis and other deformities because patients are typically poor, Kayanja said.
“It’s like a hopeless situation and very depressing. Even if you wanted to treat them privately, they have no money to pay. So, it would be charitable work. But when you’re struggling to make ends meet yourself, that doesn’t really come into your focus,” he said.
The average monthly salary of a surgeon in Uganda is USD 400.
Better equipment needed
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Also, the tremendous lack of specialized diagnostic equipment hampers technological progress; there is no MRI system and just three computed tomography scanners in the entire country. Even more basic medical equipment like an operating microscope or current designs of pedicle screws or rodding systems is simply not available.
An information disparity also exists outside the operating room. Current medical textbooks and spine journals, for example, are practically nonexistent, a situation that WSHI officials eventually intend to address, by collecting out-of-date textbooks and other materials. Kayanja said he would like to see educational materials like these shipped to his colleagues back home. “In Uganda, we never receive this information.”
For your information:
- Kayanja M. World spine health symposium: Technology in underdeveloped countries. Presented at World Spine II: The Second Interdisciplinary Congress on Spine Care. Aug. 10-13, 2003. Chicago.