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Spinal surgery

Expert assessment and treatment for spinal concerns

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Of all the major pains most of us can suffer from at one point or another in life, it's back pain. It doesn't matter if we're young or old, active or inactive, getting an ache from lifting a box or being forced to stay in bed due to some other illness, it's often our backs and the stress put on our spines that comes into play. 

But of all the pains we do feel in our backs, the most painful is due to entrapment or pressure from a herniated disc on our sciatic nerve.

The cause for entrapments such as a slipped disc can come from an accident of some sort, which damages a region in our spine, or from a thousand miniscule bits of damage done by every day activities over an extended period of time. 

A slipped disc (also called a herniated disc) can happen at any time in life and is due to the soft gel in the centre of each disc (which keeps our vertebrae from rubbing against each other and causing even more pain) oozing out and compressing the nerves that emanate from the spinal cord that runs from the skull down through the spine.

Of course, not all back pain comes from this, which is why every patient is listened to carefully so we understand their history as well as their current symptoms, followed by a detailed examination to make sure the diagnosis is correct.

We take patient care seriously at Goring Hall Hospital, so whether you've been referred to us by your GP, chiropractor, or physiotherapist, or you've just had enough and want to find a solution to help you get better as fast as possible, we welcome your call. Our number is 01903 506699

The spine consists of three main sections with two smaller sections below them. Starting at the top, we have the cervical region. This connects the skull to the spine. Nerves from here affect the neck, head, and arms all the way out to the hands and fingers.

Next is the thoracic region, whose nerves inform the brain of any problems within the chest area and upper back and, like all nerves, are the conduit through which all signals are sent from our bodies to our brain and back again.

The lumbar region is below that and is where the sciatic nerve emerges from the spinal cord and descends all the way down to our feet. This is where the most common problems arise not least because it also contains the largest vertebrae, and hence the largest discs, making them more vulnerable to damage.

It's also the most flexible part of our spines (allowing us to bend at 90% or more), which is just one of the reasons it is more prone to damage accidentally or otherwise.

Below the lumbar region are the two final sections called the sacrum and coccyx. These vertebrae become fused together into a single bone mass, but can still cause problems, particularly the coccyx, which can cause great discomfort when doing the simplest of things, even just sitting down. 

Where damage has occurred in the neck part of the spine, the cervical, it is called cervical radiculopathy.

Whilst the pain can feel as bad as sciatica from the lumbar region, a herniated disc in the neck part of the spine can also cause immense damage if not properly treated, especially if the damage to the affected nerve or nerves is allowed to get worse.

This is why you will often be referred to a specialist spine surgeon if your GP or other medical professional feels further investigation is needed.

And remember, if you are in any doubt, you can always call us here at Goring Hall Hospital to seek further advice or book a consultation with one of our specialists. We are here to help. 

Every vertebrae on the spine has a number and prefix for easy identification. Because many of the nerves that emerge from the spine end up at specific parts of our legs and arms, a trained spine surgeon can fairly easily ascertain which area of the spine is causing the issue.

For example, problems with our legs caused by pinched or damaged nerves in our spine can be identified by the vertebrae numbered from L1 (L denoting the lumbar region) down to S3 (the third vertebrae of the sacral).

If there is pain in the groin or genital area associated with the spine, then the first place to check will be the disc separating the L1 and L2 vertebrae for signs of damage or slipped disc.

Problems with herniated discs from L2 to L4 are associated with parts of the thigh, a section of the lower leg, hips, and knees.

Of course, there are other similar problems with our bodies that are not due to a spinal or nerve injury of one sort or another, but a trained spinal surgeon will be able to diagnose this quickly in any case. 

In the majority of cases a course of painkillers along with rest (but with regular gentle exercise) is all that's needed, although it can take a couple of months for a full recovery depending on how severe (or how painful) the damage is.

If you've been referred to us by your doctor (or you've booked yourself in privately), upon examination, we may need to take an MRI scan to confirm our findings if we suspect damage of some sort to your spine.

This will also show us precisely where that damage is so we can make a full diagnosis and recommend the best options for you. 

One of those options may be a corticosteroid injection (using Xray to ensure the steroid is delivered to the precise point of the damage).

Steroids are anti-inflammatories, meaning they help reduce the swelling to whatever is being affected, and over a period of about a week, will reduce the pressure on a trapped nerve, which at the same time, will allow a herniated disc to begin the healing process.

You will still most likely need a course of painkillers whilst the steroid takes effect and the healing begins, but if all goes well, you will be able to start doing things (gently) almost immediately.

In fact, we encourage you to keep active during your recovery period to stop other problems arising including stiffness caused by lack of muscle movement.

Should a steroid injection be considered the best course of treatment, you will be in and out of hospital the same day. Make sure you have someone to help you get home again following surgery, as although in most cases you won't need a full anaesthetic, strong sedation will be most likely recommended. 

If a steroid injection fails, or the herniated disc is very badly damaged, a surgical procedure called a microdiscectomy will be recommended.

This uses keyhole surgery to remove and repair the herniated disc. You will need an overnight stay in hospital if this is the case, for which you'll have your own private room with full en-suite facilities.

Even then we will still help and encourage you to exercise and move about gently to ensure your back stays as flexible as possible to help your long term recovery. 

Specialists offering Spinal surgery

Mr Shuaib Karmani

Consultant Spinal Surgeon

BDS, FDSRCS, MBBS, FRCS, MSc FRCS (Trauma & Orth)

BMI Goring Hall Hospital

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Mr Tony Elias

Consultant Neurosurgeon

MS, MCh, FRCS (Ed), FRCS (Glasg), FRCS (Surgical Neurology)

BMI Goring Hall Hospital

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Dr Alastair Hepburn

Consultant Rheumatologist

BSc(Hons), MB BS, PhD, FRCP

BMI Goring Hall Hospital

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