TREATMENTS OFFERED
Manual therapy (Physiotherapy, Osteopathy, Chiropractic)
Physical therapy that includes manipulation of the spine, exercises, education and advice about posture and going about activities of daily living.
Cognitive behavioural therapy
Most pain is not purely biological (Biopsychosocial model). An element of the pain can be due to psychological and social factors. This therapy addresses these other factors and is often used in combination with physical therapy.
Acupuncture
Fine needles inserted by a professional into specific areas of the skin to relieve many conditions. Some good evidence to suggest it helps with back and neck pain.
Facet joint injections
Usually performed under local anaesthetic using X-Ray control. Steroid and local anaesthetic injected. There is no clear evidence that these injections help in the long term. Can be useful to find where the patient�s pain is coming from.
Nerve root injections
Usually performed under local anaesthetic using X-Ray control. Steroid and local anaesthetic injected. Good evidence that these injections help in a meaningful way. Can settle the pain while nature takes care of the problem and therefore avoid surgery. Can also be useful to find where the patient�s pain is coming from.
Microdiscectomy (lumbar)
An operation where a slipped disc is removed through a small incision in the small of your back. The part of the disc that is trapping the nerve is removed, not the whole disc
Spinal decompression (lumbar, cervical and thoracic spine)
Most spinal surgery is a decompression of one sort or another. In essence the nerve structures that run down the spine are being freed up, i.e. any structure which is trapping them (applying pressure) is removed freeing up the nerve.
Spinal fusion
Used to describe a procedure that abolishes movement at one or more levels of the spine. Can be achieved with just bone graft placed next to the level that needs fusing or supplemented with screws and rods or cages
Dynamic stabilisation (motion preservation stabilisation)
An implant that is placed into your spine to control and restrict painful movements of an affected level in the spine.
Minimal access surgery (Key-hole)
A procedure that takes place through a small incision with the advantage of minimising the amount of damage that occurs to the muscles at the time of surgery
Vertebroplasty
Under X-Ray control, liquid cement is injected in to a vertebral body (a block of bone that makes up your spine). This is most commonly used for breaks in the bone, especially in osteoporosis, or for tumours
Kyphoplasty
Similar to Vertebroplasty but with a balloon catheter to contain the cement
Nucleoplasty
The disc (the piece or gristle that is found between each block of bone) has a gelatinous core and can be a source of back pain. This procedure is performed with a probe under X-Ray control for pain arising from the discs. It uses plasma to reduce the volume of the gelatinous part of the disc and decrease the pressure within the disc.
Decompression and stabilisation for spinal tumours
Tumours of the spine can weaken the bone resulting in collapse. This collapse of the bone and also by tumour growth can result in compromise of the nerves and spinal cord running through the spine at this level. The resultant pain and lack of nerve function can be improved by removing the tumour on the nerves and spinal cord surgically and stabilising that part of the spine with screws and rods. Tumours of the spine are often the result of spread from another part of the body and therefore the procedure is to improve quality of life and is not a curative one.
Debridement and stabilisation of spinal infections
The majority of spinal infections including TB do not require surgery and can be treated by medication. Occasionally infections of the spine can weaken the bone resulting in collapse. This collapse of the bone can result in compromise of the nerves running through the spine at this level. The resultant pain and lack of nerve function can be improved by removing the infection and stabilising that part of the spine with screws and rods. After surgery is performed a prolonged course of antibiotics is prescribed on the advice of a microbiologist.
Revision spine surgery
Not all surgery is successful despite our best efforts. In addition to this recurrent problems can occur after successful surgery. Repeat surgery to the same area of the spine can produce good results but a detailed consultation is required is explain the risks and benefits before it is undertaken.
For more information we strongly recommend a review of the booklets available on the ‘British Association of Spinal Surgeons’ Web site spinesurgeons.ac.uk/booklets