Surgical Options

If you have a Disc Bulge which is placing pressure on the nerve then the surgeon will remove the bulging portion of the disc, while preserving the rest of the disc which acts as a shock absorber between the vertebral bones. There are several techniques that can be used:

• Microdiscectomy: a minimally invasive technique, often using a microscope to remove the bulging part of the disc.
• Partial discectomy: where the bulging section of the disc is removed.

If your specialist and you feel that having discussed the risks and complications of an operation, you would like to proceed they will guide you through the process to consent to the surgery and to be evaluated by our Pre-Operative Assessment Team (POA). The following are links to the British Association of Spine Surgeons Website. They outline details of different spinal surgery procedures along with outcomes, risks and complications of that surgery. They also discuss the approximate recovery times needed after each operation.

New Hall Hospital offers fast access surgery for both patients wanting to Self Pay and those who have Private Medical Insurance. We also see a large number of NHS patients.

•  British Association of Spine Surgery Lumbar Disc Protrusions – Surgical Options can be found here

If the nerve in your spinal canal or the exit hole (foramen) where the nerve comes out of the spinal canal, is compressed then the objective of the surgery is to reduce the pressure on the nerve. If you have wear changes in your joints and the ligament sitting at the back of the canal, causing Stenosis, then this too can cause pressure on the nerve. The surgery in this case would be to nibble away the bone around the enlarged/worn joint and to remove the section of ligament that may be buckled and putting pressure on the nerve. This is called a spinal decompression.

There are several different surgical techniques to access the nerves, joint and ligament within the spinal canal, such as:

• Microdecompression: this is a minimally invasive technique with a small incision. A microscope is often used during the surgery.
• Laminotomy: which is partial removal of the lamina bone at the back of the spinal canal.
• Laminectomy: which is complete removal of the lamina bone at the back of the spinal canal.

Sometimes if you have a combination of bulging disc and wear in the joint and ligament you will require both a decompression and partial discectomy.

If your specialist and you feel that having discussed the risks and complications of an operation, you would like to proceed they will guide you through the process to consent to the surgery and to be evaluated by our Pre-Operative Assessment Team (POA). The following are links to the British Association of Spine Surgeons Website. They outline details of different spinal surgery procedures along with outcomes, risks and complications of that surgery. They also discuss the approximate recovery times needed after each operation.

New Hall Hospital offers fast access surgery for both patients wanting to Self Pay and those who have Private Medical Insurance. We also see large numbers of NHS patients.

• • British Association of Spine Surgery Lumbar Spine Stenosis- Surgical Options can be found here

Spinal fusion surgery is considered when there is structural deformity, such as Spondylolisthesis with evidence of instability (excess movement) at that segment of your vertebral column. This can be determined by a standing X-Ray. Spinal fusion surgery can be done in a number of ways as outlined in the British Association of Spine Surgeons (BASS) website links below. The surgery involves decompression and then fusion of the spinal segment to stop it moving. This can be done using several different techniques which your spinal specialist can discuss in more detail, depending on your circumstances. Spinal fusion may also be indicated in other instances, such as if doing a repeat (revision) operation at the same level of previous surgery. Fusion surgery is a supplement to a leg pain operation such as Lumbar Decompression or Lumbar Discectomy Surgery. It may also help to reduce low back pain, but is rarely done for low back pain symptoms without leg pain.

If your specialist and you feel that having discussed the risks and complications of an operation, you would like to proceed they will guide you through the process to consent to the surgery and to be evaluated by our Pre-Operative Assessment Team (POA). The following are links to the British Association of Spine Surgeons Website. They outline details of different Spinal Surgery Procedures along with outcomes, risks and complications of that surgery. They also discuss the approximate recovery times needed after each operation.

New Hall Hospital offers fast access surgery for both patients wanting to Self Pay and those who have Private Medical Insurance. We also see large numbers of NHS patients.

• British Association of Spine Surgery Lytic Spondylolisthesis- Surgical Options can be found here

• British Association of Spine Surgery Degenerative Spondylolisthesis Lumbar Spine – Surgical Options can be found here

• British Association of Spine Surgery Symptomatic Lumbar Degenerative Disc disease- Surgical Options can be found here

• British Association of Spine Surgery Anterior Lumbar Interbody Fusion can be found here

New Hall has a large and busy Spinal Service. You may be assessed by any member of the team on the NHS, or your chosen Consultant Privately. Currently we have eight Spinal Orthopaedic Surgeons who operate on the cervical spine (neck):

• Mr David Chapple
• Mr Paul Davies
• Mr Harshad Dabke
• Mr John Fowler
• Mr Nick Evans
• Mr Andrew Hilton
• Mr Mike Hutton
• Mr Matt Stenning

The team also includes an Advanced Physiotherapy Practitioner, an Associate Spinal Specialist and an Advanced Clinical Practitioner

We have three Spinal Nurse Specialists:

• Jolyon Lockhart
• Helen Aldridge
• Elaine Gaffney

Our Consultant Anaesthetist also does spinal injections for the team. Our Pre-Operative Assessment Team evaluate and give advice regarding any other medical conditions you have and your medical fitness for surgery. The team are supported by our Spinal Services Manager and Administration Team. The team also work closely with the Radiologists and Radiographers in the hospital.

British Spine Registry (BSR)

At Ramsay New Hall all of our Spinal Orthopaedic Surgeons are signed up to use the national British Spine Registry (BSR). If you attend New Hall to see a member of the spinal specialist team, you will be asked to complete some BSR forms. The link below explains what the BSR is and why we are asking you to participate. Please make sure you give us an e-mail address as any changes you record after treatment are collected via an e-mail questionnaire. Do not worry, you will not be contacted for any other purpose other than BSR, unless you have consented for us to do so.

What is the British Spine Registry (BSR)?

It aims to collect information about spinal surgery across the UK. This will help us to find out which spinal operations are the most effective and in which patients they work best. This should improve patient care in the future

https://www.britishspineregistry.com