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Expert Opinion on Back Pain

The Back in 2 Hours concept was set up in the London Imaging Centre as a joint venture with the London Neurosurgery Partnership.  The neurosurgeons within that partnership are all very experienced in dealing with spinal problems and are particularly adept at being able to interpret in a clinical setting, information from MRIs of the spine and advise patients accordingly as to options of management.

Patients often nowadays appreciate that an MRI is probably the best thing to try to sort out what is wrong with their back; whether it be the lumbar spine, thoracic spine or cervical spine (neck). However, just getting anMRI alone can cause concerns and worries because one has to recognise that most patients will have some degree of wear and tear in their spine.  Our spines age just like the rest of our tissues and nobody would expect somebody to have a spine that looks like a 14-year-old’s when they are 60! However, the radiology reports will be very detailed and highlight areas where there might be some slight narrowing around a nerve etc, and this can cause a lot of worry, especially if the patient has some symptoms.

With Back in 2 Hours, we arrange the scans to be immediately reported by a consultant neuroradiologist who specialises in spinal imaging and brain imaging, and this report is fed back to a neurosurgeon who sees the patients usually immediately after their scan, often having had the opportunity to briefly see them before to just confirm which areas are best imaged. The advantage of this is that the patient does not have to wait to find out the result of the scan and, above all, they hopefully see we give sound and wise judgment as to where to proceed next.  In many cases, simple reassurance is all that is needed.

A very specific feature of Back in 2 Hours  is that we do not only focus usually on one segment of the spine, for instance the lumbar spine, but as part of the protocol for scans (this is rather unique to the London Imaging Centre arrangement), we also arrange for patients to have a whole scan of the spine, looking at the side views of the spine in the thoracic and neck area, to be sure there is no major problem elsewhere.  It is very important to remember that patients can have other problems that might tend to give them symptoms remote from the area suspected. We therefore have the advantage of allowing us to look at the spine “as a whole” and give overall advice too.

At the end of the two-hour clinic, patients are given a copy of the relevant images of their scan on disc, but also a copy of the radiology report and the consultant spinal neurosurgeon’s opinion, which will always be sent back to the patient’s general practitioner and therapist, if they have a specific therapist they have been seeing prior to the scan and are hoping to continue treatment with them. Many therapists find this extremely helpful, especially if they are a little uncertain about the progress a patient is making and feel they need a little bit more information and reassurance before trying other modalities of treatment.

On a final note, it needs to be remembered that only a small percentage of patients need a spinal operation, but by appropriately screening patients, we can pick out the patients who are really in a lot of trouble and might be much better suited to consider surgical options at an early stage, rather than go through a terrible “trial by ordeal” until they eventually get referred for a surgical opinion.  It needs to be remembered that the results of surgery for things like disc protrusion causing pressure on a main nerve root in the spine and resultant sciatica, tend to be better if the nerve is freed early rather than late.  The surgery is technically easier than trying to do an operation after a patient has pain for months and months and has formed a disc protrusion.

To date, this clinic has proven extremely popular with patients and we have had very good feedback.  We have set the pricing at as competitive a level as we can and, although it may seem a lot, patients do need to remember that having an isolated scan with a report (not necessarily done by a neuroradiologist) will only get them part of the way and if they need further advice they will have to pay for a further consultation and make all the arrangements for this, which can not only take time but may, in the end, be an inappropriate referral because the specialist involved may not actually be able to comment on the requirement for spine surgery.  If patients need pain management, then it would seem wiser that they get the information throughBack in 2 Hours  and then subsequently we will advise that they might be sent to a specialist in pain management, who will not be offering surgical solutions.

Mr Richard Gullan is one of the neurosurgeons from London Neurosurgery Partnership who has been involved with Back in 2 Hours since it began in 2012. 

Back in 2 hours is available for self-funding patients from just £450 and is held regularly at London Imaging Centre in Marylebone. With no referral necessary you can book immediately on 020 7042 0300 or email your enquiry.