Dr. Neel Anand: Challenges & opportunities in spine population health


Clinical Professor of Surgery, Director, Spine Trauma at Cedars-Sinai Spine Center Neel Anand, MD, discusses how spine surgeons are thinking about population health, and who is responsible for educating patients about proper spine care in the future.

Dr. Neel Anand: Spine health is a pretty good determinant of public health. One of the biggest issues is chronic back pain because it sends patients down a spiral to many other problems. Back pain is depressing and stops people from enjoying their lives. The key is to treat the patient before it impacts their quality of life.


The onus is on the spine surgeons to educate patients in a number of things. You are dealing with patients who have spinal disorders, but surgeons don't cure backs; we make them better. This is just like patients with diabetes; you don't cure it, you control it. Back pain and chronic degenerative pain is no different than that.


You want to help the patient maintain quality of life, and education is an important part of that. Patients need education on preventing chronic back pain, and they need to know narcotics isn't the way to succeed. Narcotics only make it worse. It's more difficult to treat patients after they're addicted to narcotics.


Surgeons should be educating patients every day when they come in for a visit. We can still provide treatment, but we need to educate them on life changes to prevent back pain. We also need to curb their expectations. Just because they feel better after treatment doesn't mean they'll never have back pain again. They have to know what activities to avoid and how to control their pain.


The biggest challenge spine surgeons face with population health is the notion that spine surgery is the most horrible surgery in the world. For the right patient with the right diagnosis and right procedure, results are fantastic. And at the end of the day, there is nothing better than patients with good outcomes. For every patient that does well, another 10 patients will hear about it. There is no better marketing than that.


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