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Prioritized cervical or lumbar surgical procedure for coexisting cervical and lumbar stenosis: Prognostic evaluation of 222 case.

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Prioritized cervical or lumbar surgical procedure for coexisting cervical and lumbar stenosis: Prognostic evaluation of 222 case.

Int J Surg. 2017 Aug;44:344-349

Authors: Li H, Chen Z, Li X, Liu T, Shen B, Huang Y, Wu D

Summary
BACKGROUND CONTEXT: Single-stage surgical procedure is often utilized to enhancing the signs of coexisting cervical and lumbar stenosis. Normally, sufferers’ willingness, surgical procedure affordability, surgical trauma, surgical issues and sufferers’ tolerance to surgical procedure all restrict the appliance of single-stage surgical procedure. For sufferers who can’t obtain single-stage surgical procedure, we hope that we will discover out by weighing up deserves and flaws of the 2 surgical websites as a way to make choice of prioritize one of many two surgical procedure, in order to convey extra advantages to the sufferers.
OBJECTIVE: To verify which one in all prioritized cervical surgical procedure and prioritized lumbar surgical procedure has a greater impact in assuaging the signs of sufferers with coexisting cervical and lumbar stenosis.
STUDY DESIGN: A retrospective evaluation and a cohort research for 15 years.
PATIENT SAMPLE: The knowledge of 222 sufferers who had been recognized with coexisting cervical and lumbar stenosis over the previous 15 years was collected, together with 144 sufferers who underwent prioritized cervical surgical procedure and 78 prioritized lumbar surgical procedure, thereafter the modifications within the sufferers’ postoperative neurological capabilities had been evaluated.
OUTCOME MEASURES: Major consequence variables are the scientific analysis occasion and the occasion of surgical website positioning. Secondary variables are the occasion of postoperative perform modifications and the symptom enchancment occasion.
METHODS: The details about 222 sufferers with coexisting cervical and lumbar stenosis who had a follow-up of greater than 1 12 months throughout January 2000 and December 2014 was collected. The consequences of prioritized staged cervical and lumbar surgical procedures on the prognosis for the above-mentioned sufferers had been respectively evaluated through related analysis indexes.
RESULTS: The follow-up time was 18-156 months (58.zero ± 36.5). The lumbar reoperation charge after prioritized cervical surgical procedure was decrease than the cervical reoperation charge after prioritized lumbar surgical procedure (22.91% < 57.69%) (P < zero.01). The JOA rating and Nurick grade considerably improved (P < zero.01) and the ODI rating improved (P < zero.05) after prioritized cervical surgical procedure. No apparent enchancment within the JOA rating and Nurick grade (P > zero.05) was proven however the ODI rating markedly improved (P < zero.01) after prioritized lumbar surgical procedure.
CONCLUSIONS: For sufferers with coexisting cervical and lumbar stenosis, prioritized cervical surgical procedure is secure and efficient and is superior to prioritized lumbar surgical procedure on the advance of cervical and lumbar signs, the postoperative restoration of limb perform and the speed of reoperation on one other website.

PMID: 28711623 [PubMed – indexed for MEDLINE]

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Farzana
Farzana
2021-04-07
In February 2021 I felt excoriating pain in my lower back. I was unable to stand up straight with my right leg having spasms occurring every hour. The sciatic pain accelerated within days I was bed bound to the point I needed help with basic daily activities such as making a cup of tea. I read the reviews about Dr Akmal, which I found beneficial and decided to book a consultation to see him. I was booked for a Consultation with Dr Akaml as well as an MRI scan & blood tests. I was pleasantly surprised to find out that I would get the results on the same day with the treatment options. Dr Akmal was very friendly he discussed the MRI scan with me that showed disc L4-L5 impinging the nerve, he suggested two options. One was the laser treatment to shrink the disc or the second the option was a discectomy. This would be a day procedure with no overnight stay. At no point did I feel pressured to decide on the procedures. Dr Akmal is incredibly knowledgeable this was evident through his years of experience with spinal procedures, I was 100% that the best option would be the discectomy and the best Surgeon was Dr Akmal. I was so impressed with the service and care that was offered at the clinic it was no less than first class to be honest, with no waiting time at all. On the day of the procedure I was in a private room, a lovely healthcare assistant was there to help me get into the hospital gown. Every staff member was ever so kind, they all made me feel at ease. Once I woke up I felt no sciatic pain at all which was an amazing feeling, an emotional moment to finally be rid of that burning sensation. Of course, there was some slight discomfort where the procedure had taken place. After surgery, I was able to stand on my two feet as well as being able to walk without any discomfort. Finally making my own cooked breakfast was a heavenly feeling! I can say with complete confidence that I trust Dr Akmal he is no doubt, on top of his field, a great human being who I’m so grateful to have met. If you want your life back I would highly recommend you book yourself in for a consultation with Dr Akmal, he is worth every single penny! Thank you Dr Akmal!
JF
JF
2021-04-05
Good treatment, uncomplciated, great solution,
Sam Sahota
Sam Sahota
2021-03-28
My personal experience of The London Spine Unit in Harley Street London and the whole team of surgeon Mo Akmal written two weeks after my Surgery . It’s been an absolutely amazing experience. I am a 58 year old male . Many years ago I was breaking some concrete with a very large sledgehammer that’s where all my problems started. During these many years I have undergone Facet joint injections, many appointments with Osteopaths,Chiropractors,Acupuncture,Massages etc etc the list is endless.They would be helpful for a few days and then the pain in my back and weakness in my legs would return. 2019 had Mri of lumbar area showed disc bulge trapping nerves in l4/5 areas I underwent an open surgery on Nhs to cut away part of the disc that was causing the problem.I was in hospital for 5 days and recovery took many months, Then the pain returned!!I then decided to live with the unbearable pain as I couldn’t go through all that again, I was recommended to Mo Akmal, he arranged a much clearer Mri within two hours he took a look and identified the problem the following week after my pre op assessment my keyhole surgery was done within 2 hours , immediately I was pain free I noticed immediately the pain free sensation I was very happy with the outcome , it was so simple , I could walk painfree. I came in a taxi in the morning and took a taxi back home in the evening . Mo akmal Is a very professional surgeon it was like talking to a friend no rush at all , didn’t even seem like a surgery, Member of his team calls me three times a week to see how I’m getting on. Now I don’t even think about my back as I have zero pain , I sleep well, I feel much better from within, I have no hesitation in recommending Mo Akmal . I am a person that does so much research into things like this as I know the risks aswell as the benefits,I jumped at the opportunity that was given to me for this keyhole surgery. I did not tell anyone of my friends as they really did not know the pain I was in and if I had told them I know they would of discouraged me of going ahead. 2 weeks later I feel totally pain free. If in any doubt I do not mind Mo giving my email to anyone as long as I can help them out of pain .i was always told use hot and cold packs on your back , it didn’t help much mine was a much more deep rooted problem that need proper intervention I have learnt over the years that very seldom will a therapist ever tell you to get an MRI to see exactly what is going on inside your body it’s left to your own judgement, no amount of alternative therapy would of actually helped my problem if I wanted to get to the root of the problem..It’s your choice to go ahead with treatment or not BUT atleast you will know and have a better understanding of exactly what is causing your problem. I would say Don’t suffer in silence do something about it like I did .
Mrs Michelle Hunter
Mrs Michelle Hunter
2021-02-25
I would highly recommend Mr Mo Akmal and his team at the London Spine Unit. I have had issues with my lumbar spine for over 20 years and have struggled to find someone who could help. My situation was complicated by a separate neurological diagnosis 7 years ago. Mr Akmal listened to my medical history and offered informed and honest advice, taking a holistic view based on his extensive experience and listening to my opinion with an open mind. I have had 2 minimally invasive procedures at the London Spine Unit during the Covid pandemic. I felt very safe and well looked after on both occasions. The results were great, they allowed me to finally exercise without pain & weakness and to play with my 2yr old! (Which was very important with nursery closures in Scotland!). I still have a way to go but I feel like I have finally found someone who genuinely cares and understands, and I am no longer alone with my health journey. Thank-you Mr Akmal and your amazing team!!
Lee Burnside
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2021-02-24
Top notch service great staff and a fantastic after care support. After having partial disc removed i woke up to zero pain and could walk upright no problem well worth paying for the private treatment.
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customer
2021-01-29
I had been suffering with a trapped nerve in my back for 18 months which meant I could only stand for about an hour and I couldn’t sit in a chair. I was spending 70% of my day lying down. I had been off work all this time on universal credit (£80 a week). Four different doctors and two consultants said it was a muscle problem. NHS finally agreed to give me an MRI which clearly showed my L5/S1 disc was badly worn, the L5 vertebrae was arthritic and the vertebrae were rubbing together but still they told me it was a muscle problem. One consultant told me I was imagining my leg pain and said to buy a tennis ball and massage my muscle with it by pushing it into my back! I then went to a private hospital in Aberdeen, the consultant there was very arrogant and told me fusing vertebrae and replacing discs didn’t work. He said my problem would go away after a couple of years! This is when I found Mr Akmal! I did an internet search and while I was reading about The London Spine Clinic one of Mr Akmal’s team asked me via web chat if they could help. I briefly explained my back problem and arranged an appointment over the phone for the next day. I uploaded my MRI and Mr Akmal phoned me with his diagnosis. He gave me a fair and honest opinion and said I could take his diagnosis and get treatment elsewhere as I live 700 miles away. Mr Akmal said there was nothing left of my disc and needed an operation. After more fobbing off by the NHS I decided to get the surgery done by Mr Akmal. I flew from Orkney to London on my own on the Sunday, had the operation on the Monday. I went back to my accommodation 2.5 hours after the operation in a taxi. I went back for a check up by Mr Akmal on the Tuesday and flew home to Orkney on the Wednesday. The operation was for: Posterior Lumbar Decompression + Instrumented Fusion. I am so glad I chose Mr Akmal and The London Spine Clinic for this procedure. My whole experience from start to finish was amazing. All the staff were really friendly and helpful. Mr Akmal’s skill, experience and passion for helping people really shines through. The follow up appointments have been excellent. The whole experience was so laid back it doesn’t feel like I had major back surgery 18 days ago. My pain has completely gone. I walked 3 miles for the first time in 2 years the other day. I cannot put into words how this has changed my life! If you have back pain I cannot recommend Mr Akmal highly enough, he will give you an honest opinion and offer the best solution for your problem.
Tash Dean
Tash Dean
2021-01-29
I have had back problems for years after an injury at work when I was in my early 20s. I have seen multiple doctors, osteopaths, chiropractors and even other surgeons but for 8 years I struggled on with no improvement, if anything the condition got worse. At times I would often have to stay in bed for a week or take a lot of pain killers to get through a working day when things would flare up. Dr Akmal and his team were patient and really listened to my history and condition. He was quick to see the problem from an MRI and suggested different options for my recovery starting with the least invasive with the hope this would work. Sadly we tried a few things which didnt work but I am glad we went through the process of ruling out lesser procedures first and also physiotherapy. In the end we made the decision that I should have a L4/L5 lumbar spinal fusion as a day case. I was very nervous about this as I really wanted to avoid surgery however Dr Akmal and the team talked me through everything and reassured me that the benefits could really be amazing and I have to say they were really right. It took a few weeks to let everything heal but within 2 months I could already feel the benefits and now after 5 months from the surgery I feel like a new person, I have my full mobility back, can still comfortably, lift things and move and exercise in a way that I haven’t been able to in years and all without the fear of further hurting myself. I really cant praise Dr Akmal and the team enough. He is patient, kind and understanding and really put me at ease and answered any questions and concerns I had. I would recommend anyone with back issues to consult with him as it really could change your life and I am so grateful.
Premier Cars
Premier Cars
2021-01-22
My wife had been in severe back and leg pain for almost 3 months, we had tried going to A&E a few times to get help but all they did was keep giving her stronger pain killers and requested a scan which took 2 months to come through and was dated for a further month she was crying in pain and I had to literally carry her to the toilet and had to bath her I was left with limited choices I took her to Dubai for a quicker privately funded a MRI scan which showed her disc impairment and was advised laser back therapy treatment which did not help we came back to the uk, by this time she was in a wheelchair and completely reliant on myself which caused a lot of emotional stress along with having to see her cry all the time we then had some treatment in Sheffield which again did not help at this point I was sure she needed back surgery and the NHS wasn’t willing to help until they said she reached the peak of this problem and was told to dial 999 if her water works had stopped which I found even more worrying and pathetic I didn’t want to see my wife struggle or cry anymore so I searched up the best back specialists in uk and Mr Mo Akmal from Harley Street Hospital (HSH) came up he was available for an appointment the next day when we attended he reassured us by looking at her MRI scan report that she needed an operation but of course there was other cheaper treatments available to us to try before so I made it clear to DR Mo Akmal that money was no issue and we need the best treatment which was going to be having back surgery we was called back to HSH for an operation 2 days later DR Mo Akmal was amazing and provided the best reassurance and said “ she’s in a wheelchair but she will walk back out of here” I was jumping for joy my wife went in on a wheelchair and Alhamdulillah walked back out on her own 2 feet I just can’t thank DR MO AKMAL and his team at Harley Street Hospital the best place for treatment and the best care from the moment you enter their front door till you walk out 10/10
Devan B
Devan B
2020-12-29
I was seen by Mr Akmal for a L4/L5 discectomy. One of the biggest hurdles with any medical treatment is being comfortable and surrendering to the process. Mr Akmal and his team are consummate professionals with a very human bed side manner and give you the reassurance you need. I initially reached out to Mr Akmal via email and within a few hours he responded and an initial consultation was booked. The team is welcoming from front desk through to admin, theatre staff and all support doctors. This is a reflection of Mr Akmal himself. Everyone had plenty of time and no question was too trivial. I never felt rushed in my pre operation appointments when Mr Akmal discussed all options and we jointly agreed on my discectomy. Given my pain level surgery was planned and I was booked within days of my initial consultation. I very quickly came to realise that I was not just a number as in no time everyone knew my name. The day of the procedure I had a full briefing by the theatre staff who kept me updated on the time that I would be taken to theatre, with a pre op visit by Mr Akmal. The patient pods were very comfortable and clean. I walked to theatre and again the staff alleviated any anxiety I felt. Mr Akmal was already in theatre. Post op the recovery team were wonderful ensuring that I was comfortable and provided a light refreshment. Mr Akmal came to see me two hours post op and I walked with him - pain free! The discharge was seamless and for the first few days the team called to check on me. Mr Akmal reviewed me in clinic two weeks post op and again had plenty of time for all my questions. I am now 5 weeks post op and healing well. The London Spine Unit delivered on all my expectations. A very seamless team and service. A big thanks to Mr Akmal, Dr Lok, Rola and the whole team for looking after me.
Juan C H
Juan C H
2020-12-02
I was checking for recommendations on the best spine clinics in London, and the London Spine Unit came up. Without a doubt it is one of the best or I would say the best Spine Unit in London or even in the UK. I had the luck to be in the care of Dr Mo Akmal, which tried to find the best solution for my back issues and he did, I had surgery 2 weeks ago and it totally fixed my spine issue. I am pain free now and I can finally have a normal life with no pain at all, of course the care of the nurses and staff of the clinic very professional and very warm. Thank you for everything, I can't thank you enough for all the help given by the whole personal in the clinic.

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