THE developments in our understanding of the spine and therefore our ability to treat spinal conditions
THE developments in our understanding of the spine and therefore our ability to treat spinal conditions have improved rapidly in the last 10 years and led to the ability to provide a much more comprehensive, efficient and effective programme of potential options for the treatment of common spinal and related conditions.
Our understanding and differentiation of the causes of radicular pain (sciatica and brachialgia) and those conditions which cause back pain has improved as imaging modalities such as MRI scanning have become routine and less expensive.
With the introduction of more complex imaging modalities we have understood the importance of assessing the spine in a dynamic state and under load, and as a result we have been able to understand the spine as a dynamic structure where movement is important to maintain function.
During this process newer techniques have developed to allow us to treat the spine non-operatively as well as less invasively as more modern navigated, microscopic and keyhole surgical strategies have led to advantages for patients.
As we have realised the importance of collaborative working with other specialities such as rheumatology and specialist pain physicians, physiotherapists, osteopaths and chiropractors and other allied health professions, we have shared knowledge and developed better pathways to manage complex conditions more effectively.
Imaging in spinal pathology is now based on our understanding of the spine in movement. Although dynamic and load bearing X-rays are extremely helpful, dynamic and upright MRI scanning is now readily available and allows us to assess how the spine responds to being upright.
Seeing evidence of neurological compression under load means diagnosis and treatment can be more accurately determined and thereby ensure better outcomes particularly in those conditions presenting with more unusual clinical symptoms.
Some of the more exciting developments have been in the form of imaging and also in the development of minimally invasive techniques in treating the spine.
The expansion and adoption of these techniques has gained momentum over the last five years and minimally invasive surgery using keyhole techniques is now a routine option for many surgical procedures.
Treatments available include:
• Multidisciplinary approach to the treatment of back problems from inflammatory conditions to complex spinal injury.
• Screening, diagnosis, treatment and rehabilitation programmes.
• 3D ORBIC Imaging — exclusively available locally to the Berkshire Independent Hospital.