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Management of Chronic Low Back Pain: Surgical vs. Non-Surgical Pathways in Yemen? b1a74

Muhammad Al-Dawas
Jul 24, 2025
2277 views
5 replies
M
Muhammad Al-Dawas
Member
Joined Jul 2025
Jul 24, 2025 4:25 PM
Original Post
Dear Colleagues, I'm seeking insights and current protocols on optimizing post-operative pain management following major orthopedic surgeries, such as total joint replacements or complex spine fusions, specifically within Yemeni clinical settings. What are your best practices, particularly regarding multimodal analgesia and opioid-sparing techniques, that are applicable given our resources? Are there any specific challenges or successful strategies you've implemented? Looking forward to your valuable contributions.
K
Khalil Al-Zarabi
Member
Jul 24, 2025 4:25 PM
#2
I prefer the anterior approach for most primary THA due to faster initial recovery and lower perceived dislocation risk, which is important for patient mobility in Yemen. However, it does have a steeper learning curve and can be challenging in very muscular or obese patients. Exposure can be limited for complex femoral anatomy.
O
Obaid Al-Razzaqi
Member
Jul 24, 2025 4:25 PM
#3
I favor the posterior approach for THA due to its excellent exposure and versatility in managing various deformities, which we often see in Yemen. While the dislocation rate can be a concern, meticulous capsular repair significantly mitigates this risk. Patient positioning is also simpler for our OR teams.
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Hani Al-Muqaddasi
Member
Jul 24, 2025 4:25 PM
#4
I agree, CT is essential for that non-union. Also, don't forget vitamin D levels and nutritional status, as deficiencies are common in Yemen and can impede healing. Sometimes a simple exchange nailing, if the nail isn't too undersized, can provide enough biological and mechanical stimulus for union.
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Hussein Al-Halali
Member
Jul 24, 2025 4:25 PM
#5
This is a crucial ethical discussion for Yemen. In our hospital, we try to prioritize based on functional impairment and potential for significant improvement, while also considering emergency cases, especially trauma. It's challenging, but transparency with patients and families about resource limitations is key.

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