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Surgical Procedures

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Surgical Procedures
Anterior cervical discectomy, fusion and plating
Revision lumbar canal decompression and discectomy
Primary or revision lumbar spinal decompression and fusion
Posterior cervical decompression and foramenotomy
Specialised pain relieving procedures
Morphine (intrathecal) pumps
Minor pain relieving procedures
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Please find the treatable conditions by Mr Munchi Choksey, if you have any questions please check our FAQ section and contact us if your question is not answered. If you are due to have your procedure please check our pre-operative patient guide.

Please note all treatable conditions are performed under General Anaesthetic unless stated otherwise.

Primary Lumbar Canal Decompression And Discectomy

The patients are positioned in the "Dinmore position" which is a modified knee/chest position. This produces excellent operative conditions because there is virtually no pressure on the abdomen, and hence epidural bleeding is minimised. Prior to preparation of the skin, an image intensifier x-ray machine is used in every case to establish the correct level.

The operation site is then marked and the skin is prepped and draped. I then make a longitudinal incision, exposing the spinus processes and the disc on either one side or both sides, if it is near to or crossing the midline.

I have a very low threshold for doing a bilateral approach. It is my belief that a generous decompression of the disc space and the posterior elements is an essential part of this procedure.

Intravenous  needle - Primary lumbar canal decompression and discectomy

The most important aspect of lumbar disc surgery is to have adequate access, and complete control of the operating conditions including bleeding. This also minimises retraction of the nerve roots as one obtains access to the lumbar disc, which must be remembered is underneath the nerves.

Once again, great care is taken over stopping the bleeding, and I then instil 5mgs of intrathecal Gentamicin into the disc space itself, as an adjunct to prevention of perioperative infection. Having established that the nerve is completely free, and that the disc space has been gutted of all loose disc material, I then establish that there is no bleeding, and close the wound over a drain.

Post operatively, patients are mobilised the next day and quite frequently sent home on that day. The entire in-patient stay may be as low as 24 hours.