Spine in space

The inevitableness of planetary colonization is now rooted in the human consciousness. The ever expanding global population and finite resources on planet earth have caused an acceleration in the race for space stations, planetary exploration and a very clear sense that humans have a limited time on this planet.

There are many questions as to what impact the weightless environment will have on the spine, and some answers have been derived mostly from earth based simulation labs and the physiological testing of returning astronauts. However as the conditions of travel become even more challenging one of the most prescient issues will be the optimal selection of individuals whose earth based anatomy and physiology give them an added advantage. It is well known that AA males have an increased bone density in comparison o Caucasians and will therefore be able to withstand a greater period of time before bone demineralization become critical. Identifying the optimal group of humans to engage in space travel will not totally eliminate the risks and pressures that that they will sustain on an extended period.

The movement of electrolytes particularly calcium and magnesium has been extensively studied with conclusions demonstrating a depletion in both bone and muscle with a negative impact on aspect of nerve conduction. These negative physiological forces are countered by the modification of diet which can restore the normal balance to an extent for a limited period of time. The effect of zero gravity has been extensively studied on each bodily system and so will not be repeated here but suffice to say the overall impact presents a significant homeostatic challenge to the body which intensive pre-flight training will partially mitigate.

In addition to the impact of zero gravity there will be a significant focus on the development of innovative diagnostic and therapeutic solutions whose development will generally be guided by the same principles of portability and efficient energy utilization. For example the treatment of a painful herniated lumbar disc will require the removal of the extruded part of the disc using tools that have been modified for the zero gravity environment and also understanding that the properties of human tissue and blood will alter thus prompting the surgeon to modify his technique accordingly to account for these altered physiological parameters.

The use of titanium hardware should it be required will present a different set of challenges that gain will have to be specifically modified for the unique environment of zero gravity. There will be an increased utilization of minimally invasive spine surgery which will allow all of the obvious benefits of this approach such as reduced blood loss, less pain and almost immediate return to function to perfectly fit the limited resources and space that most space. vehicles will possess. There will be an increased utilization of stem cell therapy to treat painful musculoskeletal joints including the spine thus avoiding the need for invasive shoulder and knee arthroscopy. As visualization technology improves with a continued migration towards increased minutarisation and sharply improved opitcs the need for the cumbersome diagnostic units used on planet earth wil subside. These portable googles will allow the practitioner to use it for both diagnostic and therapeutic purposes with another clear advantage being the almost complet absence of radiation.

Due to the increased demineralizing forces encountered in a zero gravity environment there will likely be higher incidence of vertebral body fractures that will need appropriate material reconstruction. Currently on earth various bone substitutes are used which include cement and a polyurethane based composite whose properties have not been adequately tested in the zero gravity situation. This issue will require further research before there can be any degree of confidence in the use in zero gravity situation. There are still too many questions as to weather the cement will heal and be strong enough to sustain the fractured vertebra.

One of the main guiding principles of the diagnosing and treatment of spinal conditions in space will be the increased tendency to use smaller light weight instruments that lead to almost zero blood loss. The size and weight of the diagnostic units will need to be markedly scaled down

Space physiology has been studied extensively since the first lunar landing but the ability to perform moderate to complex procedures in space has not been thoroughly researched and with the rate that exploration of the universe is occurring it would be prudent to begin this endeavor sooner rather later.

The space surgeons will have to acquire an almost completely new set of skills understanding the markedly different tactile forces that they will encounter through their gloves when handling the instruments. The simple transference of a surgeon from the planet to space without the training and recognition of the critical differences will lead to less than optimal surgical outcomes.

The issue of infection in the space ship has not been fully explored but for the early stages the same precautions of sterility will be taken. It may be that as further microbial research progresses the need for the. strict asepsis required on planet earth becomes unnecessary in the sterile atmosphere of space.

This is an extremely interesting area of technological progress and research because the time is coming sooner than we think when space travel will be become very normal followed by the actual colonization of planets. It will be important that we as a human race are properly prepared and have considered every possible physiological variant that we may encounter and the optimal manner in which to address it. The next decade is going to witness an increasingly competitive race for space and for the planets that inhabit it. The possibility of untapped resources is motivating a large number of both private and public enterprises and so it can be expected that the competition will become increasingly tough.

One of the biggest current hurdles to more aggressive space travel is the issue of energy limitation which is still currently carbon based and which itself has a finite limit. The country whose research identifies a form of clean, nuclear/magnetic energy will provide itself with the leading edge. One of the main concepts of physics that will help the understanding and development of magnetic based devices to steer ships once in space will without question lead any exploration pack. The key I believe lies with the creative use of magnetic force fields. The field that surround every object and are of great use when they surround a large planet.

Medicines will also need to be specifically manufactured for space travel since their density will change which alter their pharmacological efficacy. This is large task but will become necessary as the human race travels further and longer and it is to be expected that the pilots will suffer from degenerative diseases.

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