About the Charity
The Charity Objectives:
"The relief of persons requiring spinal surgery by the provision of laser or other Endoscopic techniques and the provision of such medical or other charitable care or facilities as may be ancillary thereto"
The Foundation is a charitable trust and fund raising is underway to support the Spinal Foundation as it develops the Endoscopic Laser Foraminoplasty procedure and continues to establish the evidence base for the procedure so that it may be widely offered to NHS patients.
Key Facts
The NHS spends about £480m a year on services for people with back pain - many of which are ineffective.
Around 16 million people a year, in the UK alone, will experience back pain.
Possible treatments will include visits to the GP; referrals for X-rays; outpatient consultations; physiotherapy; acupuncture - the list goes on!
Most back pain sufferers will take time off work, with periods of absence from around one week to a year or longer.
The research conducted at the Spinal Foundation indicates that many of these patients can benefit from laser assisted spinal surgery who, otherwise, would be left to suffer.
Background (NICE & RCT)
The Spinal Foundation focuses upon MISS and as a non-NHS provider has been trying to prepare the evidence base for these techniques so that they may be widely employed in the NHS. The Spinal Foundation has performed robust independently evaluated research. The current climate favours only the results of Randomised Clinical Trials (RCT) and ignores the results of prospective studies. Regrettably National Institute for Clinical Health and Excellence (NICE) has relied upon data from ill informed anonymous sources and issued guidelines which tend to deter Primary Care Trusts (PCTs) from referring patients to the Spinal Foundation. However the Manchester Zone PCTs have reviewed our data and are prepared to refer patients to the Spinal Foundation providing they are entered in to a Randomised Clinical Trial.
The Spinal Foundation has constructed a Randomised Clinical Trial according to MRC guidelines. Patients will be referred by randomisation for fusion or MISS.
However the Spinal Foundation meets the requirements of NICE for direct referral out with the Randomised Controlled Clinical Trial and patients are increasingly being referred to the Spinal Foundation for the specialised endoscopic treatment which it offers.
In the light of the withdrawal of reimbursement for Fusion and Total Disc Replacement in the USA, it is likely that NICE will conduct a review of these procedures and conclude that the NHS should not fund their implementation. This should at last open the doorway for a more reasoned evaluation of the endoscopic techniques pioneered at the Spinal Foundation.
However this all takes time.
The Spinal Foundation needs to meet the costs of the overhead of the facility and running a Randomised Controlled Clinical Trial if it is to be able to derive enough evidence to convert the NICE guidelines and so render the MISS techniques available to NHS patients countrywide
How does Minimal Invasive Spine Surgery Work?
Minimally Invasive Spine Surgery has been developed through a number of stages at the Spinal Foundation. Keyhole surgery started with Percutaneous Manual Discectomy and progressed through Laser Disc Decompression to Flexible Endoscopic Intradiscal Discectomy and then Endoscopic Laser Foraminoplasty. Current improvements in equipment with the introduction of multi-phasic radiofrequency ablation, powered reaming and additional advances have resulted in less reliance upon the laser and more effective decompression of the nerve in the technique now termed Endoscopic Laser Decompression & Foraminoplasty.
The Holmium Laser and radiofrequency work by sealing as they clear and have the advantage that the patient does not require a general anaesthetic. This, in turn, means that the patient has a much shorter stay in hospital - usually either one day as a day-patient or sometimes an overnight stay. Please explore the related pages on diagnosis and treatment to find out more.
How Can this Treatment Help You?
At The Spinal Foundation, they can address the problems of arthritis and narrowing of the spine, scarring and infected abscesses, tumours and large disc protrusions and also bone spikes digging into nerves. With these techniques, they can help the elderly and the infirm as well as the younger person to return to a healthier life style.
Achievements
The team has already successfully treated over 4,800 complex cases using laser "keyhole" surgery on patients who would otherwise have required a major intervention such as fusion - or even worse - who would have simply been left to cope with their pain and disability.
What does the future Hold?
Their experience with minimal intervention surgery, over the last few years, has led them to the threshold of keyhole disc replacement initially in the lumbar spine and with the application extending to the cervical spine subsequently. Endoscopic minimal intervention surgery is not only a current treatment but a vehicle for future keyhole therapies ranging from fusion to disc regeneration.