The name, tsunami that was unknown to most Thai people, had hit west southern coast of Thailand on 26 December 2004. Following the disaster, prices have been paid and many lessons have been learnt. The current report provides a historical background of the incident, which was reviewed by documents, brief discussion and observation. Data of the patients from three hospitals involved in the management were collected and reviewed. Some of the illustrations were from the operating rooms of Takuapa, Surat Thani and Songklanagarind hospitals. There were totally 2311 patients. Of these, 45% were males and 40% were multinationals. Nearly 40% suffered from salted water aspiration, while 2% developed complication associated with near drowning. The most common orthopaedic-related injury were minor [559 patients (24%)] and major wounds [586 (25%)]. Around 7% sustained fracture dislocation. Lower extremity fractures were more common. The characteristics of wounds associated with the tsunami were severe contamination, multiple sites and organ involvement. Another characteristic was the early development and spreading of infection. The lessons proposed by the study are that minor wound should be left open, small penetrating wound should be thoroughly explored and observed and lacerated wounds need emergency dressing, debridement and subsequent cleansing procedures. Re-evaluation and closed surveillance of the seriously injured patients are mandatory to eliminate the complicated infection and life-threatening conditions. Medical record of any disastrous event should be completed by health care professionals. The model and reporting system should be internationalised.

Purpose: Adjacent segmental disease (ASDis) represents symptomatic adjacent segment degeneration causing pain or neurological deficit. Revision lumbar decompression and extended spinal fusion remain the surgical gold standard. The surgical technique removes all prior implants (pedicle screw and rods) and applies the new implant to previous surgical sites while extending fixation across adjacent segments with fusion; however, it leads to soft tissue trauma, massive blood loss, prolonged operative time, and an increased fixation cost. This study aimed to present the use of a domino connector for connecting the old rod and new rod for extension fixation without removing prior fixation as an alternative technique. Methods: This study retrospectively analyzed the data of 14 patients with ASDis who underwent revision surgery with the use of a domino connector for connecting the old rod and new rod for extension fixation without the removal of prior fixation. Results: All the patients were aged 59–85 years with a mean age of 67.2 years. The mean duration of ASDis was 4.38 years postoperatively. The patients were grouped according to the modified MacNab criteria as follows: no patient in the excellent group, 12 patients in the good group, and two patients in the fair group. Conclusions: This surgical technique for treating failed back surgery syndrome reduces the extent of the surgery by employing rod connectors without prior instrument revision. It can serve as an alternative for the operative technique for treating patients with ASDis.