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Surgery

Surgery

Dr Akbar Khan offers surgery for those whom need further treatment when non-surgical treatment hasn’t helped. You can view each surgical procedure I offer below with information on each procedure.

Lumbar Spine

 

The part of the spine comprised of five vertebral bodies (L1-L5) that extend from the lower thoracic spine (chest) to the sacrum (bottom of the spine).

 

Thoracic Spine

 

The thoracic spine is the area of the vertebral column commonly referred to as the mid and upper back. The thoracic spine is comprised of 12 spinal bones.

 

Cervical Spine

 

The cervical spine, also known as the neck, is comprised of seven vertebral bodies (C1-C7) that make up the upper most part of the spine.

 

General

Spinal Injections

Injections

Having an injection in your spine can be a frightening idea

Having an injection in your spine can be a frightening idea. However, the techniques have been developed at the London Spine Clinic to ensure that this is as safe as possible and painless for the patient. All spinal injections are performed in a sterile environment, using the facilities of an out-patient operating theatre. This allows accurate placement of the needle using a C-arm (low dose x-ray machine) and allows the anaesthetist present to sedate the patient if required. Injections can be painful, but as almost all our patients chose to have sedation, which involves an injection into a vein in the hand or arm, the patient sleeps through the procedure and wakes to find it is over.

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​They can be used to help diagnose where pain is coming from, or to treat pain, or both. For example, if a person is suffering from pain in the arm and an MRI scan shows that several levels (discs and/or joints) in the neck are damaged, a local anaesthetic injection at the point where just one nerve leaves the spine, would tell if that is indeed the source of pain.

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Steroids

Most spinal injections are performed using steroids. The aim of this is to suppress the inflammation which causes a lot of the pain and which is often responsible for “switching off” the muscles which normally support the spine. By reducing this inflammation, the muscles can be made to work again, using the right physiotherapy techniques and the patient should get good relief, long after the injections wear off.

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Spinal steroid injections are an “off-label” use of these drugs, meaning that the original licensing of the medication did not include these techniques. However they have been used in this context for decades, with good results and a low side-effect profile. Please speak to your doctor if you want more information on this.

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Radio-frequency

If a patient has a steroid injection and gets a good result, but the pain returns after a few weeks, it is worth considering radio-frequency (RF) treatment. This is another needle technique, but, instead of injecting through the needle, a radio-frequency probe is inserted to the necessary point. This is then connected to a pulse generator, which makes the tip of the probe vibrate at a very precise frequency and intensity. This vibration can be used either to heat the tissue and thereby kill off areas causing damage, or to pulse the treatment to assist healing. RF has been used for many years in the management of spinal pain and other related problems. The same technique is used in the functional neurosurgery in the brain, to treat Parkinson’s disease and other conditions.

Physical Therapy

Physical Therapy

My practice is designed to allow expert assessments to be performed on patients with spinal and other related problems. In the same area as the consultation suites allows for combined consultations with physiotherapist when needed. For example, if, for a particular patient, surgery is the best treatment option, the patient may be seen in a joint consultation by Dr Akbar Khan and therapist. This allows the patient to discuss the global issues regarding the impending operation, as well as the very important aspects of the overall treatment, namely return to fitness thereafter.

If the situation  is severe and surgery is needed, many patients will benefit from undertaking an exercise regime before their operation, to hasten their recovery afterwards.

Advice on dietary modification in regard to the spinal problem will be given, or appropriate referral to a dietitian or nutritionist will be made. most people are stressed at the prospect of undergoing back surgery, even though this is often a lot less invasive than is generally believed. Counselling is available in-house, to manage these issues.

Most back problems result from a combination of poor posture, either when seated at a desk at work, or during walking and in particular lifting. Furthermore, inappropriate self-taught exercises may actually make matters worse. This can lead to chronic pain in the lower back (lumbar spine) or neck (cervical spine). People in certain occupations or with particular recreational habits may be more prone to such problems. A number of people are born with a weakness in the spine, which may predispose them to problems, such as back pain, later in life.

These problems are exactly the ones which therapy can address. The trained physical therapist can, through a range of postural and dynamic exercises, educate the patient to develop a better posture or lifting pattern and by improving muscle tone, as well as usage, increase overall fitness. Most patients who are seen in the clinic will be offered physiotherapy as their initial treatment option, unless they have a condition requiring urgent surgery, or they have already been under an experienced physical therapist and failed to benefit. Such patients may well go on to need surgery. Any patient undergoing an intervention procedure by Dr Akbar Khan will be pre-assessed by our own, highly trained, staff. This should smooth the course after treatment and should improve the overall outcome. The patient will be aware of the necessary goals in terms of recovery that are likely to be set, and how best to achieve these.​