Patient with bulging disc
Patient with bulging disc | Spine health uk
Departments – The London Spine Unit specialises in the rapid diagnosis and treatment of all spinal disorders.
We have a proven track record and are able to avoid surgery for over 90% of patients. We have found that targeted non-invasive pain management procedures can often allow the body to heal while the pain and inflammation are controlled.
In our experience, a targeted approach to reduce inflammation, repair damage, reinforce stability and strengthen spinal structures can lead to healing thereby eliminating the need for major spinal surgery. However, we also undertake major surgery if required to do so.
Dr Mo Akmal is an Internationally renowned specialist consultant orthopaedic surgeon, who oversees your entire pathway and provides the most effective, tailor made solution for your problem.
Due to our success in providing highly effective solutions focused on patient needs, we are used by a number of large insurance companies as an official second opinion service.
Dr Mo Akmal is the preferred second opinion specialist for Medix International, a global health services opinion provider.
Dr Mo Akmal is the second opinion provider for patients about to undergo spinal surgery insured by Vitality Health Insurance Company.
Some of the unique procedures that we undertake are :
This is the first-line in treating any spinal conditions. Harnessing the body’s potential to heal itself, fine hair-like needles are guided with utmost precision with the use of X-rays into the spine to deliver cortisone, a potent anti-inflammatory and healing hormone, around nerves, discs and joints.
The patient is sedated under the care of our skilled anaesthetist to ensure the procedure is pain-free, and recovery rapid. Most patients are ready for discharge within an hour after their injections.
Our specialised techniques allows us to maximise the amount of medicine injected to the affected area. Our precision means we can target the whole spinal column, even in sensitive and intricate areas like the neck. As a result, we pride ourselves in our success rate, helping many patients avoid surgery.
In cases where there is a bulging disc compressing a nerve, and the condition is too stubborn for the concentrated cortisone injections to resolve, we can inject a more potent agent; ozone. The procedure is similar with cortisone injections. The patient will be sedated and X-ray guided. Instead/in addition to cortisone, ozone, a powerful activated form of oxygen is injected directly into the offending disc to break up the scar tissue and protruding disc material, allowing the body to digest and resorb the disc fragment more effectively.
Lasers have been used in surgery for many years with varying degrees of success. At the London Spine Unit, we use the latest development in medical laser technology, where a focal concentration of laser energy to target and vaporise protruding or bulging disc material without any danger of damaging surrounding vital structures like nerves or blood vessels.
The laser can be transmitted through thin, flexible capillary optical fibre, which means we can thread the laser probe through a needle into the spine under X-ray guidance. As such laser discectomy can be performed under supervised sedation as a day case; without the risks of general anaesthesia.
Unlike conventional open discectomy, the pinpoint accuracy also means only the offending disc fragment is vaporised by the laser, leaving the surrounding healthy disc tissue unharmed. This is especially useful in the neck where often the only surgical option is to remove the whole disc, necessitating the use of an artificial disc substitute.
There may be awkward occasions where a large amount of disc material has extruded from its enclosure, wrapping itself around the nerves, causing severe inflammation, pain and even nerve damage. Such disc extrusions may be highly resistant to cortisone injections, or because of the nerve damage and severe pain, require immediate relief of pressure on the nerves. Where previously, the only option is an open discectomy/spinal decompression, we can now thread a small camera through a natural opening in the base of the spine directly to disc extrusion within the spinal canal.
Because we are exploiting the body’s natural openings and channels, we do not need to strip off any muscle or bone to access the spinal canal, save a small cut in the skin.
The camera allows us to directly visualise the nerves and disc fragments, and using endoscopic instruments, carefully separate the nerves from the discs. The disc fragments can then be vaporised either by laser or physically extracted.
Again, because it is a percutaneous technique, it can be performed under supervised sedation as a day case. Leading to faster recovery and rehabilitation.
Disc prolapses are but one of several conditions that can cause nerve entrapment, leading to back pain and referred leg pain. In the older population, the nerves can be squeezed by the gradual narrowing of the nerve channels due to the accumulation of debris, gristle, and enlargement of worn joints, in a condition known as spinal stenosis. While many patients do derive good long-term relief with cortisone injections, a minority will constantly suffer from pains due to the trapper nerves. However, these patients only experience pain when standing or walking, and have good relief of pain when they sit down. This is because the nerve channels narrow down when the spine is in an upright position.
While surgery can be performed to widen the nerve channels, they do carry a small risk of nerve injury. More often than not though, it is the risk of general anaesthesia that contradicts surgery, as this condition occurs in the more elderly population.
Fortunately, we now have specially developed implants, known as interspinous spacers which are able to support individual spinal segments, and prevent the nerve channels from narrowing when the spine is erect. These supports are placed in between the spinous processes, the boney extensions at the back of each spinal segment. As such, they are relatively superficial and accessible, and can be inserted through little keyholes, under X-ray guidance without the need for general anaesthesia. An ideal solution for patients with high general anaesthetic risk.
Another spinal condition that is associated with old age and at times poor health, are vertebral compression fractures. These are breaks in the frontal boney mass at each spinal segment due to usually age-related porosity and brittleness of the bones (osteoporosis).
These breaks can occur with innocuous trauma, such as minor fall from standing height or bed. And in some severe cases of osteoporosis, simply through day to day movement and usage of the spine.
While these breaks rarely cause nerve or spinal cord damage, they can be very painful and restrictive as the spinal column supports the whole body. As this breaks occur in the older age group, the healing time is often protracted, and the collapse of the spine often leads to ugly and debilitating stooped postures.
Balloon Kyphoplasty is a safe and quick percutaneous procedure that rapidly ease the suffering from these fractures or breaks. Through a tiny cut in the skin, a balloon is threaded through the bone under X-ray guidance, and inflated to restore the height of the collapsed bone segment. Special bone cement, similar to those used in hip/knee replacement surgery is then carefully injected to fill up the space. The cement hardens within minutes, stabilising the broken segment, and thus reduce the pain dramatically, often before the patient leaves the treatment facility! And because the procedure is performed through tiny cuts in the skin, the patient only requires mild supervised sedation, avoiding the need for general surgery. It can thus be performed on virtually patients of any age group or with multiple medical problems.
Stem cells are powerful, universal repair cells hidden throughout the body. In the last 10 years, medical research have discovered ever more accessible ways to harvest and enrich stem cells throughout the body. Where previously, they had to be harvested from bone marrow (via inserting painful needles in the pelvis), we now have the technology extract, enrich and enhance stem cells from various areas, such as fat under the skin!
Stem cells are automatically recruited by the body to repair damaged tissues. Research on injecting large numbers of stem cells in damaged tissues have shown promise in reducing inflammation, pain and faster recovery.
While cortisone, ozone and laser are very useful in removing damaged, extruded/bulging disc fragments to stop them from irritating nerves, they are unable to address the underlying degeneration of discs that come inevitably from the loss of disc material in a disc prolapse, or simple aging of the body. Stem Cells and various naturally derived growth/repair factors, such as platelet lysate hold much promise in being able to slow down the inevitable degeneration of spinal discs, and may even be able to reverse some of these changes, leading to a healthier, younger disc.
At the London Spine Unit, we combine pioneering regenerative treatment of the spine with therapeutic interventions so not only do patients have immediate relief of their symptoms, but also long-term preservation of their spinal health.
The London Spine Unit is located on the first floor of The Prestigious Harley Street Hospital. We have london’s finest facilities available for our patients and offer exclusive and personalised care. Our State of the art operating theatres are equipped to treat all spinal conditions.
The London Spine Unit Islamabad is located on the top floor of Kulsum International Hospital. At the heart of the Diplomatic sector, our spinal unit has some of the best facilities in Pakistan and is dedicated to providing high quality and effective care.
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The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function.
Mr Mo Akmal has developed revolutionary techniques to perform Day Case Spinal Surgery. We avoid traditional General Anaesthetic for all surgery.
The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services.