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Complex Deformity: Revision Scoliosis Surgery in an Adult Patient with Previous Fusion in Aden 27a14

Samir Al-Shamsi
Jul 24, 2025
972 views
4 replies
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Samir Al-Shamsi
Member
Joined Jul 2025
Jul 24, 2025 4:25 PM
Original Post
Esteemed Members, I'd like to initiate a discussion on the ethical dilemmas we often face in resource-limited settings in Yemen when prioritizing elective orthopedic surgeries. How do we balance patient need, urgency, availability of resources, and social equity? What frameworks or principles guide your decision-making when difficult choices must be made? Your practical insights are invaluable for our community.
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Tawfiq Al-Maflahi
Member
Jul 24, 2025 4:25 PM
#2
From a public health perspective in Yemen, such dilemmas highlight the need for stronger primary prevention programs to reduce the burden of preventable orthopedic conditions, thereby freeing up resources for more urgent cases. Advocacy for increased healthcare funding is also crucial.
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Ghanem Al-Khulani
Member
Jul 24, 2025 4:25 PM
#3
Absolutely, Dr. Al-Khulani! We've implemented a similar multimodal protocol in our Sana'a hospital. Adding gabapentin or pregabalin pre-operatively for chronic pain patients has also shown promising results in reducing post-op opioid needs. It's about tailoring the pain regimen to the patient's individual risk factors, which are often complex here.
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Tawfiq Al-Maflahi
Member
Jul 24, 2025 4:25 PM
#4
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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