Two Novel Concepts of Spinal Pain - Martin Knight


This video encapsulates 30 years of experience derived from aware state surgery in which the patients have shown that the main cause of back pain and sciatica arises from the surface of the nerve rather than the disc. The disc wall is only painful when it is inflamed. The second source of pain that has been underdiagnosed is Cluneal Nerve Irritation.

Our understanding of these entities facilitates treatment by keyhole and pinhole means with minimal collateral tissue damage and accurate targeting of the source and improved understanding of the mechanisms of the pain production. This allows the use of higher risk open microscope-led discectomy, intervertebral fusion, sacro-iliac joint fusion and total disc replacement to be avoided.

Endoscopic Foraminoplasty allows the whole exiting nerve, disc and epidural space to be explored. Whilst radio-frequency ablation of cluneal nerve trigger points addresses the points of irritation of these nerves. Bothe techniques achieve excellent long-term outcome results.

These techniques have been used effectively to treat: Degenerative spinal disease, failed back surgery, disc protrusion, extrusions or sequestra, osteophytosis, lateral recess stenosis, axial stenosis, spondylolytic spondylolisthesis, degenerative spondylolisthesis, spinal “instability”, discogenic pain, high intensity zones, leaking discs, perineural scarring, degenerative scoliosis, failed cervical surgery.