Phone : +44(0)844 589 2020
The London Spine Unit is located on the Prestigious Harley Street, the UK’s most renown Healthcare district.
We are based at The Harley Street Hospital and offer some of the latest spinal treatments.
Small populations of stems cells are hidden throughout the body, such as in the bone marrow or adipose tissue. They can remain dormant for years until activated by disease or injury. They are able to divide indefinitely, regenerating the tissue around them by differentiating into the necessary kinds of cells. By injecting large numbers of stem cells into damaged tissues, doctors can reduce pain and inflammation and accelerate healing.
Until recently, it was only possible to extract stem cells from the bone marrow, but recent technological advances in separating the different components of fat tissue and blood can yield a potent combination of healthy pre-cursor stem cells and growth factors that can be used to help regenerate discs and cartilage.
Collagen and proteoglycans are essential components of disc and cartilage tissue and are vital for normal function. There is some evidence that production of these components can be stimulated by the transfer of healthy precursor stem cells and growth factors into spinal discs and joints, thereby healing worn cartilage and relieving pain.
Although many of these techniques are still considered experimental, they are being used in clinical practice in situations where the alternative option is more invasive surgery, such as joint replacement or spinal surgery.
Specialised spinal injections
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.
Laser disc surgery
Spinal Disc disease is a health problem that generally affects the population after the second decade of life, in their full working capacity. It is estimated that 60-70% of the population at any time of life has suffered from low back pain and 20% of patients with a herniated disc may require surgery.
The problems derived from disc degeneration, associated with predisposing factors such as standing, work activity and stress of the modern era, are responsible for the onset of this disease.
In most cases, back discomfort can be remedied by conservative therapies such as injections, electrotherapy, massage or medication. However, if these measures are not enough, doctors have to eliminate the cause permanently by using some form of invasive procedures.
In these circumstances, minimally invasive treatments are the first line approach, and percutaneous laser decompression has been designed specifically for this purpose.
Especially in cases of cervical, thoracic and lumbar disc hernias, the laser percutaneous disc decompression method (PLDD) achieves very good results.
It is a careful minimally invasive procedure and very appropriate for elimination or notable reduction of discomfort. Often, this method is suitable for patients with spinal disorders in which a microsurgical intervention is not indicated.
The advantages of this type of surgery over conventional surgery are that general anaesthesia is avoided, the hospital stay is brief, absence of postoperative epidural scar, conservation of spinal stability and that there is always the option of performing conventional open surgery of the disc in the event of failure of the percutaneous laser decompression of the herniated disc. In addition, it has less morbidity (less than 1% compared to conventional surgery at 7.8%), but only a small percentage of patients with herniated discs require open surgery.
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.
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.
We also specialise and routinely perform :
Anterior Cervical discectomy and fusion (ACDF)
Keyhole or minimally invasive discectomy
Balloon Kyphoplasty and Vertebroplasty