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Year : 2021  |  Volume : 8  |  Issue : 4  |  Page : 59-60

Presidential Oration-NSSA 2021

Head of Department, Department of Neurosurgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India

Date of Submission14-Oct-2021
Date of Acceptance15-Oct-2021
Date of Web Publication24-Dec-2021

Correspondence Address:
Sajesh K Menon
Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/joss.joss_14_21

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How to cite this article:
Menon SK. Presidential Oration-NSSA 2021. J Spinal Surg 2021;8:59-60

How to cite this URL:
Menon SK. Presidential Oration-NSSA 2021. J Spinal Surg [serial online] 2021 [cited 2022 Jan 21];8:59-60. Available from: http://www.jossworld.org/text.asp?2021/8/4/59/333611

Dear Colleagues,

My journey through the spine surgery, started back when I was doing my postgraduation in orthopedic surgery. My then professor suddenly asked me one day, “why don't you take up spine surgery as your specialty?” Those words somehow substantially impacted me, and pursuing spine surgery became something of a cherished dream. To fulfill this dream, I took up M. Ch. Neurosurgery degree in the hope that it would give more insight and depth to my knowledge and skills, which would make me a complete spine surgeon. It paid off in full. I learned to use the microscope, got trained in intradural and intramedullary tumor surgeries, management of craniovertebral junction (CVJ) anomalies, and many more procedures, which at the time, orthopedic spine surgeons were not exposed to in general.

Today, when I look back, I am satisfied by the way in which spine surgery has evolved. There is a better understanding of the pathophysiology of most disease processes and newer and deeper insight regarding the biomechanics of the spine and its deformities. The improvement in neurophysiological monitoring and imaging capabilities has made spine surgery as safe as possible with predictable clinical outcomes after the procedures. Reminiscing instrumentation, I started my stabilization with Harrington distraction rods, followed by Steffee variable plates and screws, and then graduated to Moss-Miami pedicle screws. After that, there has been a tremendous improvement in instrumentation techniques. We have a wide array of implants available for fixation extending from CVJ to the sacrum, all of which add to better and effective stabilizations.

Despite all these advancements, two problems bother me.

The first is the frustrating status of spinal cord injury management. Science has reached unimaginable heights. Man has sent probes to Mars, cured genetic diseases, isolated the God particle, but we are still groping in the dark as far as spinal cord injury is concerned. The tragic accident of Christopher Reeves brought spinal cord injury to the forefront of medical research, and there were a few glimmers of hope in the form of stem cell therapy, electrical stimulation, gene therapy, etc., However, none of these could give the sustained results that we've hoped for. As a clinician, my role in this research is limited, though I always pray for effective management whenever such a patient comes to me for a cure.

Though not as significant as the first one, the second issue is the state of implants available for pediatric patients. As we know, pediatric spine is a different ball game altogether. There are many issues here, like bone quality, a mismatch between implant and bone size, fusion-related issues in the growing spine, etc. To date, there are no dedicated implants available that can take care of all these problems. I have often had to resort to many innovative techniques, including tailor-made implants for my pediatric spine cases, which could still fail even after all these efforts.

According to Hindu spirituality, the base of the spine is the seat of dormant spiritual energy known as the “Kundalini.” This energy, cultivated and awakened through tantric practice, is believed to rise through the spine to the brain lead to salvation. Once these problems are sorted out, all of us can become complete spine surgeons, and that might be our salvation. I hope, pray, and wait for that day.

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There are no conflicts of interest.


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