Mr Martin Knight, Consultant Orthopaedic Endoscopic Spinal Surgeon at BMI Fawkham Manor Hospital specialising in spinal surgery, offers an overview of endoscopic keyhole minimally invasive spinal surgery, a radical type of surgery which he has been pioneering for the last thirty years.
“I have been practicing at Fawkham Manor in Longfield for about five years but my patients come from all over the world. Most of my patients have had previous conventional spinal surgery but continue to live with restricted mobility. The operations I perform are quite unconventional. The exact procedure varies depending on the needs of the individual patient, so this is “personalised medicine” but for the spine.
Endoscopic minimally invasive spinal surgery can be used to treat a range of pathologies including “slipped discs”, protrusions, extrusions, adult scoliosis, adult spondylolytic spondylosis, instability, degenerate spondylosis, stenosis (axial/foraminal).
The patient remains conscious during this surgery, which may sound a bit scary but it has many benefits – primarily the patient can communicate to me and provide feedback into what they can feel. Rest assured, we use painkillers! But the doses we use still do allow the patient to communicate to us about how their own body is reacting. Back pain can manifest as arm pain, or sciatica, and the patient’s feedback gives us much more information and allows us to pinpoint the problem better than our medical school textbooks during the procedure.
As this Endoscopic / “Keyhole” surgery is not performed under general anaesthetic it is suitable for patients who present with comorbidities, for example obesity, diabetes, DVT, MS. Age is also not a barrier. I have operated on patients in their mid-nineties. They are usually fed up with being told that nothing else can be done for them! However, I am seeing a trend in younger patients who have researched my procedures and are looking to avoid open surgery and undertake earlier intervention before the degenerative process has progressed too far.
Endoscopic minimally invasive surgery tends to have a shorter recovery period and results in less scarring than conventional spinal operations. However, the success of the procedure does depend on many factors. For patients to really reap the full benefits, they must commit to lifestyle changes dedicated to maintaining the strength and correcting the underlying malposture; I am a strong advocate of Muscle Balance Physiotherapy and Reformer Pilates.
It’s great to help people who have often given up hope of living a normal life again due to their crippling back pain. I have even had letters from patients who had their surgery twenty or more years ago. I never tire of hearing that my patients are now pain-free and fully embracing their lives again. Also, I do not believe that their pain is just in their mind. Our motto is that “Patients are not just for Christmas.We are in there for the long run”.
29th May 2018