Spinal Surgery

Alastair’s special interest is adult spinal surgery. Operations include -

• Microdiscectomy for disc prolapse (an intervertebral disc that bulges out from between the vertebrae):

These commonly occur in the lumbar spine and neck, causing spinal and limb pain. Surgery is indicated if you do not get better spontaneously over a 4- to 6-week period.

• Decompression and fusion for spinal stenosis (narrowing of the spinal canal):

This surgery is necessary if narrowing of the spinal canal pinches the nerves causing leg pain when walking, relieved by sitting down. There are a number of different surgical options depending on the findings on the MRI scan.

• Fusion for low back pain:

Some people develop low back pain which does not settle. A spinal fusion involves the insertion of bone graft and normally instrumentation in the form of screws, rods and plates. This surgery is successful in most patients with genuine conditions.

• Disc replacements for low back pain:

Alastair offers this surgery as an option for younger patients, especially in the neck and sometimes in the lumbar spine.

• Surgery for fractured vertebrae:

Sometimes following a fractured vertebra, a patient gets ongoing back or leg pain, which can be relieved by surgery. Likewise, the patient may have a deformity which can be corrected.

• Spinal tumours:

Patients with tumours in their spine sometimes benefit from surgery to relieve pressure on the spinal cord or to stabilise a painful, weak spine resulting from the tumour destroying bone.

Arthroplasty

Alastair performs total hip and knee joint replacement surgery.

Joint replacement surgery is commonly required to treat joints worn out by osteoarthritis, rheumatoid arthritis, trauma or any other illness damaging the joint and causing it to become painful and interfere with the patient's quality of life.

These procedures involve removing the damaged joint surface and replacing it with artificial surfaces normally made from metal (chromium cobalt alloy, titanium) and plastic surfaces (high density polyethelene) or ceramic, which act as alternate bearing surfaces for the damaged joint.

These days, with modern techniques, the operations only require the patient to be in hospital for a few days normally, followed by a period of rehabilitation at home.

Occasionally blood transfusions are required and if this raises any concerns, please discuss this with Alastair.

Arthroscopy

Alastair performs arthroscopic surgery of the knee.

An arthroscope is a fiber optic telescope used to look inside a joint. Through this type of keyhole surgery, fine instruments can be introduced through small incisions (portals) to allow surgery to be performed without the need for large cuts. This allows many procedures to be performed as a day stay and allows quicker return to normal function of the joint.

• Arthroscopic meniscectomy of the knee: This is removal of a torn meniscus, a common sporting injury and the most common arthroscopic surgery. Most patients can do their normal activities after two weeks, but sports require up to eight weeks recovery.

• Anterior cruciate ligament (ACL) reconstruction: The ACL is the big ligament in the knee which often gets torn in sports accidents. This can be reconstructed. Recovery back to sport is 6 to 7 months in general, to allow the new ligament to strengthen properly.

• Removal of loose bodies or damaged articular cartilage: This can be done arthroscopically in most instances and in most joints.