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Spinal surgery

Expert assessment and treatment for spinal concerns

close up of specialist pointing at medical model of the spine
The spine is one of the most important parts of the human body. This complex anatomic structure is the scaffolding for the whole body, providing crucial functions that include protection and movement.

Keeping it healthy is essential if you want to live an active lifestyle that is free from pain, but unfortunately, the complexity of the spine means that it can be affected by many different problems.

Spinal issues can affect all areas of the spine, but it is problems with the lumbar spine that is most often the reason for patients to be referred to London Circle Health Group hospitals.

“Around 60% of patients we see have lower back pain” explains Mr Fady Sedra, Consultant Orthopaedic and Spinal Surgeon at The London Independent Hospital. “Neck and arm pain account for approximately 30% of patients, with the remaining 10% experiencing pain with their thoracic spine”.

Fortunately, even the most complex spinal disorders and conditions can be treated at The London Independent Hospital.

Please note that some of the details on this page are specific to The London Independent Hospital in Stepney Green, East London. If you live somewhere else in the UK and would like to know more about spinal surgery, you can find your local Circle Health Group hospital on this page.

To be able to understand spine conditions and why spinal surgery may be required, it’s important to have a clear understanding of spinal anatomy.

The spine is a column of 33 bones called vertebrae. Between each of these bones is an intervertebral disc — a spongy, gel-filled disc with a fibrous outer layer. These discs provide impact protection and aid in the movement of the spine.

The spine can be divided up into three key sections. These are:

  • The cervical spine. This is the very top part of the spine that extends into the neck and consists of the top seven vertebrae C1-C7. The cervical spine principally supports neck and head movements.
  • The thoracic spine. This is the term used to describe the middle part of the spine, where there are 12 vertebrae that extend from the cervical spine down to the lower back. Thoracic vertebrae are generally larger than cervical vertebrae and have longer spinous fingers that protrude out into surrounding tissue.
  • The lumbar spine. The lower part of the spine, the lumbar comprises of five vertebrae, which are the largest in the spine. This makes them able to carry the majority of your body weight. This part of the spine is also responsible for large movements like bending and twisting your body.

Contrary to what many people believe, the spine isn’t straight at all, but instead made up of four continuous curves that enhance its flexibility and make it better able to absorb impacts.

The spine has two key functions. The first is structural — providing a connection between the upper and lower body that is strong enough to support the top half, but flexible enough to enable movements such as bending and twisting.

The other is to protect the spinal cord, which is encased in the centre of the column of bones.

The spine also provides a base of attachment for other tissues, such as tendons, ligaments and muscles, and is packed with nerves. This means that any issues with the spine can also affect the surrounding nerves, causing pain.

There are many different issues that can affect the spine. Some are congenital defects that present from birth or develop later on in life, while many others are the result of degeneration of the anatomy of the spine that occurs with advancing age.

Patients who spend long periods of time sitting down, or who play sports either as an amateur or professional, are more likely to experience problems with their spine due to the excessive pressure their activities place on it.

Here are some of the most common spinal disorders that we see at The London Independent Hospital.

Slipped/herniated disc

A slipped/herniated disc occurs when one of the intervertebral discs slips slightly out of place, bulging outwards from the spine. This makes it less effective at cushioning the two vertebrae on either side.

The herniated disc can also irritate surrounding nerves, causing discomfort and other symptoms, such as shooting pain from the buttocks into the leg, called sciatica, and weakness on the same side. Around six out of every ten patients who are referred to The London Independent Hospital have a slipped disc.

Although anyone can suffer from a slipped disc, Mr Sedra explains that there are primarily two groups of people most commonly affected. He says, “One group of patients who we regularly see with slipped discs are those who work long hours sitting at desks, such as city workers doing eight to ten hours a day with little movement.”

One of the reasons for this is that poor posture can accelerate natural wear and tear on the spine.

Another demographic of patients commonly affected is those who are involved in sports, either at an amateur or professional level. Again, activities like running, cycling and even lifting weights can put abnormal pressure on the spine, accelerating the rate at which degeneration happens.

Neck pain/brachialgia

Neck or arm pain tends to be the second most common reason why patients visit The London Independent Hospital specialist spinal team.

Also known as brachialgia, it tends to be caused by either a slipped disc or osteoarthritis in the cervical spine.

Patients with brachialgia often experience pain, numbness and weakness that extends from the neck down into the arms and even hands, following the pattern of nerves that serve the top section of the body.

Spinal deformities

There are many different types of spinal deformities, and they can affect adults and children.

The most common spinal deformity in adults is known as degenerative scoliosis — a condition caused by accelerated wear and tear on the discs and joints of the spine that causes a side-to-side curvature that usually affects the lower spine.

Other adult spinal deformities include:

  • Kyphosis: characterised by the appearance of a ‘hump’ in the upper back, kyphosis involves the upper back curving forwards
  • Lordosis: a deformity in the lower back, causing it to curve inwards instead of outwards

It’s not only adults who can be affected by spinal deformities — children can have congenital spinal deformities too. Developing before birth, they can occur if the vertebrae don’t form properly.

Depending on the severity of the deformity, this can lead to other health problems as a child grows and develops. This can include developmental problems with the heart, kidneys or urinary tract, and problems with breathing, walking and moving around.

Spinal stenosis

Spinal stenosis is a condition in which the space in the centre of the spine narrows.

This can put pressure on the nerves that travel through the spine. The nerves can get trapped in the spinal canal or where they leave the spine, which can cause weakness or pain in your legs, and affect the way you walk.

If you have been experiencing issues such as back or neck pain, or your GP suspects that you have a spinal deformity, you will be referred to the specialist spine team at The London Independent Hospital.

When you choose Circle Health Group for spine care and spinal surgery in London, you will benefit from the knowledge, skill and experience of a complete multidisciplinary team of professionals. Our team comprises of dedicated spine surgery consultants, pain management consultants, nurses, physiotherapists, radiologists and psychologists.

Your care and treatment are their priority. This multidisciplinary approach ensures that no decision will be taken by just one person, and the team will use their collective experience to create your bespoke treatment plan.

“A multidisciplinary team (MDT) approach to spine care helps to safeguard patient outcomes,” advises Mr Sedra.

One of the biggest concerns that many patients have on hearing that they are being referred to a consultant spine surgeon is that they are automatically being referred for a surgical procedure. However, this is not always the case.

“Conservative methods to manage pain and other symptoms will always be the preferred option to surgery,” explains Mr Sedra. “We will only refer to surgery when other treatment options have been exhausted and the patient’s quality of life is still severely affected.”

Exactly how your patient journey will look will depend on the reason for your referral and how well you respond to treatment, but typically you can expect to follow some or all of the following steps.

Your initial consultation

Your initial consultation will take place following your referral to our specialist spine team.

You will meet with your spine consultant, who will talk to you about the symptoms that you have been experiencing, and how they are affecting your day-to-day life.

They will also look at your previous medical history, and whether you are currently taking any medications or receiving any other sort of medical treatment. This information will help your specialist spine team to determine which course of action will help improve your symptoms and restore your quality of life.

Pain management

If you have been diagnosed with a degenerative issue such as osteoarthritis, if you have a slipped disc or a pain condition caused by issues with your spine, you’ll be referred to a pain management consultant. As their name suggests, their job is to help you to control your discomfort so that it has less of an impact on your day-to-day life.

There are numerous pain medications which can be prescribed, and these are oral analgesics. It may take some time to find the correct medication and dosage to provide you with pain relief.

Nerve root injection

If pain medications don’t provide enough relief from your discomfort, or if after some time they become less effective at helping you to control your discomfort, you may be recommended to have a nerve root injection.

This injection is administered into a specific nerve, along with some steroid and local anaesthetic, to block the pain signals being transmitted to and from it. CT (computer tomography) imaging is then used to guide your radiologist to the correct nerve so that the injection can be administered.

Nerve root injections are performed as an outpatient procedure and usually take less than an hour, including preparation time.

Initially, you may notice more discomfort than before, but this usually eases within a few days, after which your symptoms should be reduced. The benefits of a nerve root injection can last anywhere from a few weeks to a few months depending on the patient.

Physiotherapy

Physiotherapy is a very important part of the management and treatment of spinal conditions, as well as during recovery following spinal surgery. This is because physiotherapists specialise in treating a range of musculoskeletal conditions and sports injuries.

They can provide bespoke treatment plans that can:

  • Strengthen your body
  • Prevent muscle loss
  • Improve your flexibility and range of motion
  • Teach you the safest ways to move around
  • Accelerate your recovery
  • Boost your athletic performance

Exactly when you see a physiotherapist will depend on your treatment plan. However, most patients can expect physio appointments to form part of their regular routine.

The decision to put a patient through spinal surgery is never something that is taken lightly.

However, when all other conservative treatment options have been exhausted, it is the next step in the patient journey.

Before surgery is agreed upon, your specialist spine multidisciplinary team (MDT) will conduct a multidisciplinary meeting — where all members of the team are present — to discuss your case. Only when everyone agrees will you be scheduled for surgery. This collaborative approach ensures that everyone is in agreement that surgery is the best option to restore your quality of life.

Exactly what will happen in your surgery will depend on the cause of your spinal issues. Your specialist spinal team will talk to you in detail about how to prepare, what to expect and what risks are involved.

Spinal surgeries performed at The London Independent Hospital are typically carried out using the latest minimally invasive techniques rather than with open surgery. Minimally invasive surgical techniques are proven to reduce post-operative pain and muscle mass loss and accelerate your recovery time. This also helps to reduce scarring.

There are a number of different types of spinal surgery. The right spinal surgery for you will depend on the underlying cause of your back problems. Here are a few common types of spinal surgery.

Spinal fusion surgery

Spinal fusion surgery is a type of surgery that is performed on the bones, discs and soft tissues of the spine.

You may need spinal fusion surgery if one or more of the joints in your spine have deteriorated or become unstable. This may be due to age-related changes, instability in the joints in the spine due to a developmental fracture, or a previous surgery causing instability. 

During spinal fusion surgery, the affected joint (disc) in the spine will be removed very carefully. This will then be replaced with a combination of a bone graft and a metal fusion cage.

Spinal decompression surgery

Spinal decompression surgery — also known as lumbar spinal decompression — is a type of surgery that is performed to treat compression of the spinal cord or the nerves surrounding the spine.

It’s often performed to treat spinal stenosis, a condition in which the space in the centre of the spine narrows. This can affect the way you walk.

Spinal decompression surgery is usually recommended when non-surgical methods are no longer effective.

How long it takes to recover from spine surgery is a key concern of many patients. Exactly what your recovery will look like will depend on the type of surgery you have had.

For example, if you have had a microdiscectomy, which is a surgical solution for a slipped disc, you may be able to go home the same or very next day, and back to work in as little as 48 hours depending on your job. You’ll also start physiotherapy within a couple of weeks.

However, if you require corrective surgery for scoliosis, you can expect to remain in hospital for up to three days. You won’t be able to start walking around until at least 24 hours after your procedure, and you’ll need at least three weeks off of work.

Physiotherapy will begin several weeks after you return home and may continue for six months or more, until your physio is satisfied with your recovery.

As with any surgical recovery period, it’s crucial that you follow the advice and guidance provided to you by your care team, including when to take pain medication, when to return to work and when you can get back to your usual daily activities. Following this advice will help ensure that you minimise your risk of complications and recover as quickly as possible.

Your Circle Health Group specialist spine team will be happy to answer any questions that you have and explain what you can expect from your recovery in greater detail.

Spinal issues can be painful and debilitating, but with the right support and care from the dedicated spine team at The London Independent Hospital, it’s possible to restore your quality of life.

If you believe you may be affected by a spinal issue and you would like to speak to a professional you can trust, please contact The London Independent Hospital specialist spine team today.

Contact us today to discuss spinal surgery and see how we can help. You can book an appointment online today or call us at 020 7780 2400.

How to find us

The London Independent Hospital can be found at 1 Beaumont Square, Stepney Green, London, E1 4NL. It is accessible by bus, tube (Stepney Green) and a car park with 30 spaces.

We look forward to welcoming you to The London Independent Hospital.

Specialists offering Spinal surgery

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Mr Syed Aftab

Consultant Spinal Orthopaedic

MA CANTAB, MBCHB, MSC, FRCS (T&O)

The London Independent Hospital

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Mr Anthony Ghosh

Consultant Neurosurgeon and Spine Surgeon

MBChB, MD(Res), FRCS(Neuro.Surg)

Chelsfield Park Hospital 1 more The London Independent Hospital

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Mr Alireza Shoakazemi

Consultant Neurosurgeon

MD, FRCS (Neurosurg)

The London Independent Hospital

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Mr Fady Sedra

Consultant Spinal Surgeon

MB BCh, MSc(Orth), MRCS(Glas), EBOT, FRCS(Tr&Orth), MD

The London Independent Hospital 2 more Syon Clinic The Clementine Churchill Hospital

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Mr Ramsey Chammaa

Consultant Orthopaedic & Spinal Surgeon

MD, MRCS Eng, Dip Sports & Exercise Medicine, FRCS (Tr&Orth)

Hendon Hospital 1 more The London Independent Hospital

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