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The
Declaration of Independence
IN CONGRESS, July 4, 1776.
The
unanimous Declaration of the thirteen united States of America,
We
hold these truths to be self-evident, that all men are created
equal…….
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Despite these
good words from the Declaration of Independence we were not all created
equally (from the biologic standpoint). The most significant medical
advance of the 20th century was the introduction of antibiotics.
The most significant medical advance in the next century will certainly relate to
the early identification and understanding of genomic problems.
By the year 2020 it can be predicted that each newborn child will have a swab taken from the
inside of their cheek to collect cell samples which will then be sent for a comprehensive DNA
analysis. The resulting computer generated report will provide an
extraordinary amount of information. What to do with, and how to
use this information, will then be the challenge.
This information will clearly cause great changes in everyone's life.
If there is good news it will be that because of this information life planning and
disease and disability prevention will finally become possible on a widespread basis.
At this point in time, however, our scientific abilities in genomic testing are
primitive and in their infancy. We are, however, advanced in
imaging technology. The role of the magnetic resonant imaging
(MRI) scanner in the diagnosis and prevention of spinal disease has
become our most important radiologic tool (on a practical basis).
The MRI scan has allowed the appreciation of a host of genomic
conditions affecting the spine which were, until recently, literally unknown.
Quality MRI
information when combined with a patient's clinical history now allows
appreciation of the risk factors unique to that individual.
Clinical experience has also now allowed spine care specialists to be able to
combine this information and associate it with existing therapeutic and preventive programs.
As a means of expressing a patient's spine status the term "savings
account" has been introduced as a understandable concept of
identifying the status of an individuals spine.
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In the context
of a savings account those individuals with a "zero" balance are
clearly "walking on thin ice" in regard to future disability.
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