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Nearly one in five adults in Singapore are estimated to seek treatment for back or neck problems in their lifetime. To meet the growing needs of patients, a collaborative partnership between Changi General Hospital (CGH) and National Neuroscience Institute (NNI) resulted in the setting up of the CGH-NNI Integrated Spine Centre. Located at the CGH Medical Centre, the centre provides holistic and focused care — from diagnosis and surgery to physiotherapy and rehabilitation — to patients with spinal conditions.
“This one-stop spine centre uniquely brings together a team of neurosurgeons, orthopaedic surgeons, rehabilitation medicine specialists, pain medicine physicians, spine nurses, and physiotherapists, who specialise in spinal conditions, to deliver multidisciplinary, quality care for patients with diseases and disorders of the spine, spinal cord, and nerves,” said Dr Shree Kumar Dinesh, Head and Senior Consultant, CGH-NNI Integrated Spine Centre, and Head, SingHealth Duke- NUS Spine Centre. “The integration of these specialties transforms care delivery, bringing about streamlined coordination of care and treatment for patients, thereby reducing wait time for consultations and surgeries, and improving recovery time.”
Tapping on the rapid evolution of surgical techniques and treatment options, the facility is also a centre of excellence for minimally invasive spine surgery with computer navigation. This includes minimally invasive spinal fusion with navigation and robotics, artificial disc replacements, and minimally invasive and endoscopic decompressions. “It was important to bring together both orthopaedic spinal surgeons and neurospine surgeons under one umbrella to enhance our surgical capabilities, and synergise operative theatre equipment and workflow to deliver optimum care to our patients who require surgery. Likewise, for patients who do not require surgery, it was important to harmonise our rehabilitation and physiotherapy options,” said Dr Shree.
In the past, patients with spinal disorders would mostly seek treatment from general orthopaedic surgeons or neurosurgeons who may not specialise in spinal surgery. However, as demand continues to increase, the one-stop centre has facilitated the collaboration between multidisciplinary teams of CGH orthopaedic spinal surgeons, rehabilitation physicians, and NNI neurosurgeons, who specialise in spinal surgery, to provide comprehensive treatment, including intradural spine tumour removal as well as upper cervical and cranio-cervical stabilisations for patients who require it. “Most patients benefit from minimally invasive spinal surgery techniques, where appropriate, allowing them faster recovery and earlier discharge. We also address spinal emergencies round the clock,” added Dr Shree.
Major concern
Spinal disorders make up a fairly significant proportion of patients with musculoskeletal disorders. Diseases and disorders affecting the spinal axis range from mild back pain or neck strains to more devastating spine injuries or conditions.
In Singapore, musculoskeletal disorders (12.6 per cent) are among the top three largest contributors to the nation’s combined burden of early death and disability, just behind cardiovascular diseases (14.2 per cent) and cancers (13.4 per cent), according to a Ministry of Health report done in collaboration with the University of Washington on The Burden of Disease in Singapore between 1990 and 2017.
“With our rapidly ageing demographic, degenerative disorders of the spine are becoming more prevalent. These patients may present with back and leg pain, or neck and arm pain. In some cases, they may progress to develop neurological deficits, which may impair their ability to walk and affect their independence in the activities of daily living,” said Dr Shree.
Common conditions treated
The most common conditions treated at the CGH-NNI Integrated Spine Centre are degenerative disorders of the spine such as spinal stenosis, spondylolisthesis, and herniated disc. Other common conditions include degenerative cervical myelopathy, spinal deformity, spine trauma and spinal cord injury, spinal infection, and spinal tumours including metastasis. There has been a 20–30 per cent year-on-year increase in spinal surgeries at CGH from 2018 to 2021, with close to half being emergency cases.
Memorandum of Understanding
SingHealth signed a Memorandum of Understanding with the Nepal National Academy of Medical Sciences (NAMS), which signifies a shared vision and commitment towards advancing spinal education,research and innovation on a global scale. Through this partnership, the two organisations aim to exchange knowledge, share best practices, and jointly develop innovative solutions to spinal health issues. The educational initiatives will focus on training the next generation of spine specialists, equipping them with the skills and knowledge needed to tackle spinal diseases in any context.
From a global health perspective, this collaboration embodies the essence of solidarity and mutual support. The potential of this partnership, which transcends borders and brings together diverse perspectives and expertise to address common challenges, is tremendous — not only will it enhance spinal care in Singapore and Nepal, but also contribute to the global body of knowledge, setting new standards in spinal health.
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