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    Orthopedic Unit & Spine-Academy

    Result of Treatment for Elderly Patient with Hip Fracture
    Results of Treatments for Spinal Disease Patients

    Hip fracture in the elderly is one of the common health problems, especially the elderly with the osteoporosis which is the condition of the bone that is thin and brittle than usual. In case of inappropriate treatment, the patient may turn to bedridden which causes complications such as pressure ulcers, respiratory infection and urinary tract infection. In case of delayed treatment, it may be severe to death. Patients, relatives or caregivers are advised on how to take care of the patients after hip surgery including the care of the surgical wounds, the prevention of repeated falls to reduce the chance of repeated hip fractures.

    The indicators of post-operative care of The Orthopedic Unit & Spine-Academy, Bangkok Hospital Phuket are as follows:

    • The infection rate of surgical wound
    • The rate of elderly hip fracture patient with no unplanned re-operation with a hip fracture within 28 days.
    • The rate of elderly hip fracture patient with no repeated fall within 30 days after discharge.

    The results of the indicators are respectively.

    Infection Rate of Surgical Wound of Post-operative Hip Fracture in Elderly Patient

    In 2023, hip fracture patients aged 60 years and over were treated by the surgical procedure. There was no surgical wound infection in all patients.

    The Rate of Hip Fracture Elderly Patient with Unplanned Re-operation Within 28 Days

    In 2023, hip fracture patients aged 60 years and over were treated by surgical procedure. There was no unplanned re-operation with hip fracture within 28 days in all patients.

    In 2023, hip fracture patients aged 60 years and over were treated by surgical procedure. There was no repeated fall within 30 days after returning home which is a great statistic compared to the same rate of the American Geriatrics Society. 

    *Source:

    [1] JJW Roche ,R T Wenn,O Sahota, C G Moran.Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study BMJ.2005(Published 18 November 2005).https://doi.org/10.1136/bmj.38643.663843.55

    [2] National Hip Fracture Database annual report 2017 (NHFD).https://nhfd.co.uk/files/2017ReportFiles/NHFD-AnnualReport2017.pdf

    [3] Jane Mahoney Mark Sager Nancy Cross Dunham Jill Johnson. Risk of Falls after Hospital Discharge. Presented in part at the annual meeting of the Gerontological Society of America.2015 (Version of Record online: 27 April 2015).

    Read more

    Back Pain Patients

    Back pain can occur at any age. Most of them are found in working age, the elders and those with risk behaviors, such as sitting for work for long hours, lifting heavy objects, accidents from playing sports, activities or traveling. It is mainly caused by the spine moving over the nerve, spinal disc herniation or fibrosis and stone formed pressing the nerve, resulting in back pain, cracking down the legs along the nerve line. Depending on the severity of the nerve compression, the treatments are varied, such as taking pain relief medications, injection of anti-inflammatory medications into the spine, physical therapy, and rehabilitation by specialized physiotherapists. In the case of chronic symptoms, the physician would recommend surgical treatment to ensure better treatment outcomes.

    To assess the pain, we use the international standard of pain assessment which is the Visual Analogue Scale (VAS) and Numerical Rating Scale (NRS), where level 0 means no pain and level 10 means the most pain.

    The treatment results that patients received from the Orthopedic Unit & Spine Academy at Bangkok Hospital Phuket

    In 2023, patients with low back pain in the Orthopedic Unit & Spine Academy at Bangkok Hospital Phuket were undergoing the treatment by taking pain relief medications, receiving physical therapy and rehabilitation by specialized physiotherapists within 6 weeks. If the symptoms did not improve, the physician would recommend the injections into the spine to reduce the inflammation.

    Patient Rate with Better Quality of Life After Receiving the Injection to Reduce Inflammation

    Quality of life means the ability to carry out various activities as normal. To assess the quality of life, we use the Oswestry Disability Index [3] that consists of the assessment of pain, self-care, movement, walking, standing, sitting, sleeping, lifting, sexual intercourse and socializing.

    In 2023, all 133 patients with low back pain at the Spine Academy, Bangkok Hospital Phuket underwent injection into the spinal canal to reduce inflammation. the quality of life in patients was measured by the Oswestry Disability Index Assessment Form mentioned above. According to the international standards, the assessment was performed within 2 weeks, 6 weeks, 3 months, 6 months before and after the treatment. We measure and report the results by comparing the treatment before and after 6 months of treatment. In 2023, 126 out of 131 patients picked up in terms of symptoms as a whole (treatment targets include patients striking quality of life scores on an Oswestry Disability Index basis below 20, and those with improving symptoms hit 96% on average, compared with previous outcomes with no treatment)

    Patients with Spinal Injuries:

    Patient Rate with Better Quality of Life after Spine Surgery

    Quality of life means the ability to carry out various activities as normal and is assessed by the EuroQOL Thermometer Assessment Form [4] that consists of the assessment of movement, self-care, regular activities, discomfort, anxiety and the health condition at that time.

    In 2023, prior to the spinal surgery all patients in the Orthopedic Unit & Spine Academy, Bangkok Hospital Phuket will be evaluated the quality of life by the Euro QOL Thermometer Assessment Form to allow the physician to monitor the patient’s symptoms as well as to consider the treatment plan. Within 6 months after the surgery, the result came out that all patients had a better quality of life. The quality of life score increased by 25 percent compared to the result before the treatment.

    In 2023, no patients were injured the spinal cord after the spine surgery which is an outstanding statistics when compared to the rate of patients without spinal cord injuries of the North American Spine Society.

    Sources:
    [1] Royal College of Physicians.The assessment of pain in older people.CONCISE GUIDANCE TO GOOD PRACTICE A series of evidence-based guidelines for clinical management.October 2007. https://www.britishpainsociety.org/static/uploads/resources/files/book_pain_older_people.pdf
    [2] Ellard DR, Underwood M, Achana F, et al.Facet joint injections for people with persistent non-specific low back pain (Facet Injection Study): a feasibility study for a randomised controlled trial.Southampton (UK): NIHR Journals Library; 2017 May.https://www.ncbi.nlm.nih.gov/books/NBK436377/
    [3] https://en.wikipedia.org/wiki/Oswestry_Disability_Index, National Council for NCOR Osteopathic research.Oswestry Disability Index.2006.https://www.ncor.org.uk/wp-content/uploads/2012/12/Oswestry-Disability-questionnairev2.pdf
    [4] Mandy van Reenen, Bas Janssen.EQ-5D-5L User Guide Basic information on how to use the EQ-5D-5L instrument.April 2015
    [5] Sadiqi, Said. Spine Trauma Outcome Measures for Patients and Clinicians. UMC Repository (North American Spine Society). 2018. https://dspace.library.uu.nl/handle/1874/369695

    Read more
    Result of Treatment for Elderly Patient with Hip Fracture

    Hip fracture in the elderly is one of the common health problems, especially the elderly with the osteoporosis which is the condition of the bone that is thin and brittle than usual. In case of inappropriate treatment, the patient may turn to bedridden which causes complications such as pressure ulcers, respiratory infection and urinary tract infection. In case of delayed treatment, it may be severe to death. Patients, relatives or caregivers are advised on how to take care of the patients after hip surgery including the care of the surgical wounds, the prevention of repeated falls to reduce the chance of repeated hip fractures.

    The indicators of post-operative care of The Orthopedic Unit & Spine-Academy, Bangkok Hospital Phuket are as follows:

    • The infection rate of surgical wound
    • The rate of elderly hip fracture patient with no unplanned re-operation with a hip fracture within 28 days.
    • The rate of elderly hip fracture patient with no repeated fall within 30 days after discharge.

    The results of the indicators are respectively.

    Infection Rate of Surgical Wound of Post-operative Hip Fracture in Elderly Patient

    In 2023, hip fracture patients aged 60 years and over were treated by the surgical procedure. There was no surgical wound infection in all patients.

    The Rate of Hip Fracture Elderly Patient with Unplanned Re-operation Within 28 Days

    In 2023, hip fracture patients aged 60 years and over were treated by surgical procedure. There was no unplanned re-operation with hip fracture within 28 days in all patients.

    In 2023, hip fracture patients aged 60 years and over were treated by surgical procedure. There was no repeated fall within 30 days after returning home which is a great statistic compared to the same rate of the American Geriatrics Society. 

    *Source:

    [1] JJW Roche ,R T Wenn,O Sahota, C G Moran.Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study BMJ.2005(Published 18 November 2005).https://doi.org/10.1136/bmj.38643.663843.55

    [2] National Hip Fracture Database annual report 2017 (NHFD).https://nhfd.co.uk/files/2017ReportFiles/NHFD-AnnualReport2017.pdf

    [3] Jane Mahoney Mark Sager Nancy Cross Dunham Jill Johnson. Risk of Falls after Hospital Discharge. Presented in part at the annual meeting of the Gerontological Society of America.2015 (Version of Record online: 27 April 2015).

    Read more
    Results of Treatments for Spinal Disease Patients

    Back Pain Patients

    Back pain can occur at any age. Most of them are found in working age, the elders and those with risk behaviors, such as sitting for work for long hours, lifting heavy objects, accidents from playing sports, activities or traveling. It is mainly caused by the spine moving over the nerve, spinal disc herniation or fibrosis and stone formed pressing the nerve, resulting in back pain, cracking down the legs along the nerve line. Depending on the severity of the nerve compression, the treatments are varied, such as taking pain relief medications, injection of anti-inflammatory medications into the spine, physical therapy, and rehabilitation by specialized physiotherapists. In the case of chronic symptoms, the physician would recommend surgical treatment to ensure better treatment outcomes.

    To assess the pain, we use the international standard of pain assessment which is the Visual Analogue Scale (VAS) and Numerical Rating Scale (NRS), where level 0 means no pain and level 10 means the most pain.

    The treatment results that patients received from the Orthopedic Unit & Spine Academy at Bangkok Hospital Phuket

    In 2023, patients with low back pain in the Orthopedic Unit & Spine Academy at Bangkok Hospital Phuket were undergoing the treatment by taking pain relief medications, receiving physical therapy and rehabilitation by specialized physiotherapists within 6 weeks. If the symptoms did not improve, the physician would recommend the injections into the spine to reduce the inflammation.

    Patient Rate with Better Quality of Life After Receiving the Injection to Reduce Inflammation

    Quality of life means the ability to carry out various activities as normal. To assess the quality of life, we use the Oswestry Disability Index [3] that consists of the assessment of pain, self-care, movement, walking, standing, sitting, sleeping, lifting, sexual intercourse and socializing.

    In 2023, all 133 patients with low back pain at the Spine Academy, Bangkok Hospital Phuket underwent injection into the spinal canal to reduce inflammation. the quality of life in patients was measured by the Oswestry Disability Index Assessment Form mentioned above. According to the international standards, the assessment was performed within 2 weeks, 6 weeks, 3 months, 6 months before and after the treatment. We measure and report the results by comparing the treatment before and after 6 months of treatment. In 2023, 126 out of 131 patients picked up in terms of symptoms as a whole (treatment targets include patients striking quality of life scores on an Oswestry Disability Index basis below 20, and those with improving symptoms hit 96% on average, compared with previous outcomes with no treatment)

    Patients with Spinal Injuries:

    Patient Rate with Better Quality of Life after Spine Surgery

    Quality of life means the ability to carry out various activities as normal and is assessed by the EuroQOL Thermometer Assessment Form [4] that consists of the assessment of movement, self-care, regular activities, discomfort, anxiety and the health condition at that time.

    In 2023, prior to the spinal surgery all patients in the Orthopedic Unit & Spine Academy, Bangkok Hospital Phuket will be evaluated the quality of life by the Euro QOL Thermometer Assessment Form to allow the physician to monitor the patient’s symptoms as well as to consider the treatment plan. Within 6 months after the surgery, the result came out that all patients had a better quality of life. The quality of life score increased by 25 percent compared to the result before the treatment.

    In 2023, no patients were injured the spinal cord after the spine surgery which is an outstanding statistics when compared to the rate of patients without spinal cord injuries of the North American Spine Society.

    Sources:
    [1] Royal College of Physicians.The assessment of pain in older people.CONCISE GUIDANCE TO GOOD PRACTICE A series of evidence-based guidelines for clinical management.October 2007. https://www.britishpainsociety.org/static/uploads/resources/files/book_pain_older_people.pdf
    [2] Ellard DR, Underwood M, Achana F, et al.Facet joint injections for people with persistent non-specific low back pain (Facet Injection Study): a feasibility study for a randomised controlled trial.Southampton (UK): NIHR Journals Library; 2017 May.https://www.ncbi.nlm.nih.gov/books/NBK436377/
    [3] https://en.wikipedia.org/wiki/Oswestry_Disability_Index, National Council for NCOR Osteopathic research.Oswestry Disability Index.2006.https://www.ncor.org.uk/wp-content/uploads/2012/12/Oswestry-Disability-questionnairev2.pdf
    [4] Mandy van Reenen, Bas Janssen.EQ-5D-5L User Guide Basic information on how to use the EQ-5D-5L instrument.April 2015
    [5] Sadiqi, Said. Spine Trauma Outcome Measures for Patients and Clinicians. UMC Repository (North American Spine Society). 2018. https://dspace.library.uu.nl/handle/1874/369695

    Read more