Richard Cowell's Story


I am 42 and have suffered back problems since seventeen and like others in similar circumstances have had times when I didn’t know whether I could take much more (namely over the last 6 years). Physically desperate and fatigued and challenged to the hilt emotionally, not to mention the pain, I feel sad in knowing there are many people who need help but simply don’t know where to go, nor are they being referred on to the right person.

But there is somewhere to go, somewhere where the surgeon doesn’t just draw a ‘blank’ from looking at an MRI scan. Evidently problems like mine, as with many of us are not obvious to a radiologist, or to conventional less experienced spinal surgeons.

With over 10 years of nerve pain in my back, right buttock and leg and with long periods of severe spasm I had tried physiotherapy, acupuncture, chiropractic therapy, osteopathy, epidural injections and root blocks. In September 2007 I needlessly (I do explain a bit further on) underwent an L4/5 microdiscectomy performed by a conventional spinal surgeon, followed by extensive conservative care and pain management, all without benefit.

My pain worsened as did the frequency of severe episodes of spasm. My medications included Tramadol, Morphine, Pregabalin, and Citalopram (for reactive depression). In 2009 I saw another surgeon in a different hospital who said he could do nothing for me and I remember him saying “it’s a very complicated puzzle to solve”. He was right, but what he and his previous colleagues all failed to tell me was that although they could not help there was someone (they know!) who could.

It is regretful to think of any practicing spinal surgeon not realising there is someone NHS approved that would be better placed than themselves to help in cases such as mine (and of course the multitude of cases unimaginably worse than mine). But that unfortunately seems the way things are at this time. A simple referral to The Spinal Foundation from the surgeon and I needn’t have had a microdiscectomy in the first place! It did absolutely nothing for me.

I was informed about Mr Knight at The Spinal Foundation by a friend who had cut details from a newspaper explaining about Mr Knight's pioneering methods in treating back pain. I then told my GP about The Spinal Foundation and Minimally Invasive Spinal Surgery (MISS). I was fortunate to have a forward thinking GP who could see I may be benefited.

Mr Knight and his team at The Spinal Foundation were much more than a breath of fresh air to me. For the first time ever I felt I had had a meaningful consultation during which I was carefully listened to and treated sympathetically. Following my visit, I had weight bearing X-rays and an up to date MRI carried out. Mr Knight’s PA Christine Haygarth dealt with my local Primary Care Trust (PCT) and the issue of funding my consultations.

On my second visit Mr Knight discussed and explained to me the potential options outside of his domain of treatment such as conservative management, injections, conventional discectomy, decompression surgery, total disc replacement or fusion, comparing their outcome results and complications. i.e. Mr Knight made sure I knew of all my options and I couldn’t have wished for a more helpful and informative consultation. Then he told me what the Spinal Foundation could potentially offer me.

This is where it all gets very clever so I won’t go into too much detail but this is the crucial part, the part that differentiates Mr Knight’s approach from conventional surgeons.

He told me how ‘minimalist’ and ‘aware state’ surgery, a keyhole procedure through the foramen may help me. This would involve a tiny incision and then the inserting of a probe about 3 - 4 inches to the right of my spine, and by going this route we would minimise any disturbance to the spinal canal itself. He then went on to tell me how with the aid of a camera and laser (ELD) he would first diagnose (find the source of my pain) by probing (to recreate the pain) and then conduct the procedure whilst I was in a ‘twilight’ state on powerful painkillers.

Mr Knight explained to me that he would be willing to operate if I were willing to accept that I may only see a 50% improvement in my condition.  

By undergoing Endoscopic Laser Foraminoplasty (ELF) and Endoscopic Laser Decompression (ELD) in January 2010 I have seen a staggering 80% improvement to my back pain/condition and a 70% improvement in leg pain. Mr Knight discovered unusually thick scarring in the foraminal zone at L4/5 and the nerve was densely tethered and adherent to the disc, superior foraminal ligament, inferior pedicle and facet joint. This explains the nerve pain. I have not finished my consultation/treatment yet as the pain I still have may indicate a similar problem but at an adjacent level. Mr Knight also treated both L4/5 and L5/S1 with the laser and I have not had a severe episode of spasm since the operation.

I can now physically play with my children, lift them (carefully!) and I am now starting to rebuild my life. I have been able to drastically reduce the amount of medication I take.

Core stability exercising and exercising somewhere somehow is my attitude now, anything, Mr Knight cannot do that bit for you.

Mr Knight performs his operations in this country at the BMI Hospital in Huddersfield and I stayed overnight only.

If you are reading this and thinking about asking The Spinal Foundation to help you then rest assured you will be in the hands of a professional and highly efficient team and organisation.

I thank Mr Knight and the Spinal Foundation from the bottom of my heart for all they have done and are still doing for me.