treatments
Mr Bell has over 30 years of experience and has helped thousands of patients with a huge variety of spinal issues, from minor back pain or injuries, through to the complex, delicate surgical procedures necessary to repair spinal damage. You can find out more about the specific treatments he specialises in below.
And if you don’t see the specific treatment you’re interested in listed here, don’t worry. We’re here to help with any symptoms or pain, ongoing conditions, or concerns about your spinal health, so please don’t hesitate to get in touch.
Lumbar decompression surgery
Your lumbar spine is the lower part of your backbone. It’s made up of five vertebrae with spongy cushions sitting between them, called intervertebral discs. Their job is to absorb shock and help keep your spine stable.
Nerves run from this region of your back, controlling your lower body’s pain and movement signals. Damage in this area caused by an accident or general wear and tear can compress these nerves, leaving you with severe lower back pain. Sometimes you’ll also experience pain and numbness in your legs.
Lumbar decompression surgery aims to relieve pressure on your spinal cord and release any compressed nerves, and Mr Bell specialises in non-surgical and minimally invasive techniques to help relieve the pressure on your spine.
Mr Bell is a strong advocate of trying non-surgical treatments first. They can include physiotherapy, steroid injections to help reduce pain and inflammation or ice and heat treatments, which can promote healing.
However, if these don’t improve your quality of life, Mr Bell will talk through your options and tailor treatment to your specific circumstances. One of the following types of lumbar decompression surgery may be recommended:
- Laminotomy or laminectomy: A laminotomy involves widening your spinal canal by removing a section of the lamina, which is the bony arch in the back of a vertebra. A laminectomy removes multiple laminae or, in some cases, your entire lamina.
- Discectomy: This removes a section of your slipped disc to relieve pressure on a nerve.
- Foraminotomy or foraminectomy: This procedure enlarges the openings in your spinal column where your nerve roots exit the spinal cord. Mr Bell will remove any excess bone or bulging disc that’s irritating your nerve roots and causing pain.
- Corpectomy: Removes the large front portion of your affected vertebra and sometimes the damaged disc too. That vertebra is then replaced with an artificial spacer and the vertebrae above and below it are fused, to make your spine more stable.
- Minimally invasive surgery: Mr Bell can make one or more small incisions and insert a small metal tube with a camera (an endoscope) through the incisions to inspect the site and perform the procedure. This approach causes much less damage to your muscles and soft tissues, reducing the risk of infection and speeding healing compared to open surgery.
Mr Bell will discuss your best surgical option with you, explain your procedure, outline any possible complications and let you know about your recovery times.
Your procedure will be performed under a general anaesthetic, so you should avoid eating and drinking for at least six hours before you go into theatre.
You’ll probably experience some back pain after your surgery. This might be mild or more moderate as the healing process begins. You’ll need to plan for that and give yourself time and space to recover.
Your pain levels should gradually improve over the six to eight weeks after your surgery, with a noticeable improvement by week 12. Patients are often able to manage pain with medicines such as paracetamol and ibuprofen.
You’ll be booked in for a follow-up appointment about three months after your surgery. This allows you sufficient time to recover and for Mr Bell to assess your next steps.
CERVICAL spine SURGERY
If you need surgery on your neck, we understand the pain your condition can cause and the anxiety a potential procedure can create. Mr Bell is a specialist consultant neurosurgeon who has treated many hundreds of patients with complex spinal problems.
He’ll work with a skilled, experienced multidisciplinary team to accurately diagnose the cause of your problem and create a tailored treatment pathway for you.
Surgery in your cervical spine can be an effective treatment for any compressed nerves, spinal cord abnormalities, or misaligned discs that are causing neck problems.
Your treatment may involve removing the parts of your spinal disc that are causing nerve pain. Mr Bell can fuse adjacent vertebrae together to improve your neck stability. He can also relieve compression on your spinal cord by removing any tumours or other masses, which will widen your spinal canal.
Sometimes, it may be necessary to combine several approaches in a single procedure, such as in anterior cervical discectomy and fusion (ACDF), a common surgical technique for this condition.
Mr Bell will discuss all your treatment options in full, so you’re fully informed and prepared before any surgery.
Your procedure will be performed under a general anaesthetic, so you should avoid eating and drinking for at least six hours before you go into theatre.
All neck surgery carries a small risk of complications. The most common is difficulty swallowing as you recover, which is called dysphagia, and there is a very small risk of more serious complications, but Mr Bell will discuss these with you before your procedure to give you peace of mind.
You’ll likely experience neck muscle inflammation and swelling after your surgery. Everyone recovers at their own pace, but it’s generally advised that you rest and limit your physical activity for around four to six weeks. This helps reduce inflammation and allows your neck muscles to heal.
Your pain levels may rise for up to three days after surgery, but should improve over the following few weeks as your muscles heal and the swelling subsides.
If you’ve had an anterior cervical approach (from the front of your neck), you’ll have minimal trauma to your neck muscles and less pain. We can help you to manage your recovery at home with medication, therapeutic exercise, rest and limited activity.
laminectomy
As we age, it’s common for our spines to change, becoming less stable and more likely to cause pain or discomfort. It’s also common to damage them through repeated strenuous activity or active sport.
Mr Bell often performs a laminectomy to relieve degenerative changes in the structures of your spine and the narrowing of the lumbar canal that occurs as you get older.
The spongy discs that separate your vertebrae act as shock absorbers. Over time, these can shrink and dry out due to wear and tear, becoming less flexible and less able to absorb shock.
A laminectomy eases pressure on your spinal nerves by removing part of the bony arch in the back of your vertebra covering your spinal canal, called the lamina. This relieves any compressed nerve roots.
Mr Bell will often perform a laminectomy along with spinal fusion surgery to help with any leg pain you may be experiencing and to stop your symptoms from getting worse.
Mr Bell will talk you through what to expect. Your procedure will be performed under a general anaesthetic, so you should avoid eating and drinking for at least six hours before you go into theatre.
It’s important to note that this procedure can’t reverse the effects of degenerative changes that may have occurred over many years. However, a laminectomy can stop your symptoms from getting worse.
You should find that your mobility has improved and that you can walk further without pain. If you suffer from pain in your lower back, buttocks and legs or numbness, pins and needles and cramping when you walk, those symptoms may improve. The aim is also to help prevent them from getting worse.
LUMBAR BACK SURGERY
If your lower back is affected by injuries, diseases or deformities, Mr Bell can carry out surgical procedures to remove, stabilise or adjust your spinal structures. Surgery is usually only advised if you’re in the minority of patients whose lower back and leg-related pain has become chronic, and non-surgical treatments haven’t been effective.
If you have tried non-surgical treatments such as physiotherapy, pain relief or rest and they haven’t been effective, and your lumbar pain has progressed to the point that it’s unrelenting, Mr Bell may recommend surgery as a way to improve your quality of life.
If you have symptoms such as ongoing severe pain, numbness in your legs, groin or buttocks, pain at night or you’re struggling to control your bowel or bladder movements, seek help urgently.
Lumbar surgery, like all surgery, has a risk of complications. Mr Bell will discuss your procedure and any specific risks with you beforehand and make sure you’re able to balance any possible risks against the potential benefits.
Your procedure will be performed under a general anaesthetic, so you should avoid eating and drinking for at least six hours before you go into theatre.
SCIATICA SURGERY
Your sciatic nerve runs from your lower back down to your feet. Any pressure on the nerve, irritation or damage to it can leave you with tingling, numbness, burning sensations or shooting pain in your legs. We know this can be a very difficult condition to live with, and Mr Bell is here to help diagnose the specific cause of your symptoms and help you decide whether surgery is an appropriate option.
Sciatica has a variety of causes, from a herniated disc to the degeneration of your spine due to wear and tear, all of which can irritate or compress your sciatic nerve and cause pain. You may find that this is worse when you’re moving, sneezing or coughing, and you may develop mild back pain too.
If your pain hasn’t improved with non-surgical methods such as physiotherapy, pain relief or lifestyle changes, Mr Bell may consider surgery to be your best option, and he’ll talk you through the surgical approach he recommends.
Before your procedure, Mr Bell will talk to you in detail about your post-surgery goals around pain and activity. He’ll make sure you’re informed, prepared and realistic about returning to work or your usual exercise routine.
Your procedure will require a general anaesthetic, so you’ll need to stop eating and drinking for at least six hours before you go into theatre.
You’ll be taken to a comfortable private room to recover from your anaesthetic, and our team will look after you. The next day, you should be able to get up and walk around.
Full recovery usually takes between two and four weeks, depending on the extent of your surgery. Most people experience up to a 90 percent improvement in their pain levels as they recover, but there’s a risk your pain may remain, and you may also still experience some leg numbness. There’s also always a chance that sciatica might return and affect another of your vertebrae.
Mr Bell will talk you through your specific surgery and recovery timeline in detail.
ARTIFICIAL DISC REPLACEMENT (ADR) SURGERY
If you have a degenerative disc disease that’s causing you pain and hasn’t responded to non-surgical treatment, we understand how difficult it can be to live with. Mr Bell is a skilled, experienced neurosurgeon, and he can use this surgical technique as an alternative to spinal fusion.
If you’d like to discuss your condition or symptoms with our team, please get in touch, and we’d be happy to help.
Your discs are soft cushions that sit between each of your vertebrae, which are the bones that make up your spinal column, and these cushions can naturally experience wear and tear as you age.
Artificial disc replacement, known as ADR, uses discs made of metal, plastic or a combination of both. They replace your damaged discs and mimic their supportive and decompressive properties. This may help you get back to normal movement and prevent nearby discs from worsening.
Mr Bell will make an incision near your belly button to gain access to your spine. He’ll remove the diseased or damaged disc and tap the metal endplates of the implant into place, before sliding the plastic core between the endplates and safely closing your wound.
Mr Bell and his team will use an MRI, CT scan, X-ray or discography to determine which disc in your spine is causing the pain. A special dye is injected into that disc, then images are taken to verify its location in your spine.
You’ll need to be under a general anaesthetic for this exploratory phase. This will give Mr Bell a clear view of the disc that needs to be replaced, so you can both discuss the risks associated with any spinal surgery.
After your procedure, another X-ray is taken to make sure that your new disc is in the right place and that it fits properly. You’ll usually need to stay in hospital for two to four days afterwards, and you should be able to walk and stand the day after your surgery. You may also need to wear a brace or corset to support your spine while it heals.
Mr Bell and his team will talk you through the basic exercises you need to help your recovery, such as walking, but you should avoid over-stretching after the procedure.
COMPLEX REVISION SPINAL SURGERY
If you have previously had unsuccessful spinal surgery, it sometimes creates more problems than it solves, leaving you with chronic pain and other complications. This kind of persistent back pain following back surgery is sometimes called failed back surgery syndrome.
Mr Bell uses minimally invasive techniques (wherever possible) to reduce your pain and help you get back to doing the things you love. This surgery, however, isn’t recommended for all patients.
It’s a minimally invasive procedure, where Mr Bell uses small incisions to limit any further damage to your muscles and the connective tissue surrounding your spine.
The complexity of this surgery is always increased because Mr Bell needs to work carefully around any scar tissue that’s close to sensitive structures, such as your spinal nerves. It’s riskier than primary spinal surgery, so Mr Bell will work especially slowly and carefully. This can lead to a lengthy time in theatre.
It’s important to try to get to a healthy weight and to stop smoking beforehand, if possible, because these can both aid your recovery. It’s a complicated procedure that can be made more difficult by previous unsuccessful surgeries, so unfortunately, there’s a 2 percent chance you’ll feel no difference in your pain levels.
Mr Bell will explain this complex surgical process, including the potential risks and benefits, and offer advice on the best way forward.
We’ll take you to your comfortable private room after your surgery. You’ll need plenty of time to recover, and will stay in hospital for up to four days. We’ll give you advice about starting to move around again as soon as you’re ready, and how to manage your recovery after you get home.
In the longer term, it’s vital to work on your core strength and maintain a healthy body weight, as these will both help to prevent your disc problems from returning.
LUMBAR DIScECTOMY SURGERY
Mr Bell performs lumbar discectomy surgery to treat pinched nerves in the lower region of your spine. There is strong evidence that this decompression surgery is effective for pain relief and may improve your function and quality of life.
You’ll be able to discuss your symptoms and preferences in detail with Mr Bell and decide together whether this procedure is the right one for you.
You’ll be taken to your comfortable private room to recover and after three or four hours, you should be able to sit up in bed or lie on your side. The following day, you’ll be able to get out of bed and move about with the aid of your dedicated rehabilitation team, which will include a nurse and physiotherapist.
You’ll probably need to spend another one or two nights in hospital, and Mr Bell’s team will gradually introduce more movement into your routine. They’ll encourage you to do more activities for yourself, such as washing and dressing, when you return home. We’ll make sure you have all the information and advice you need to manage your long-term recovery.
kyphoplasty
This is a relatively new, minimally invasive procedure that can help to relieve your pain if you’ve cracked or broken your spinal bone, and it can also reduce unwelcome curvature in your spine. Kyphoplasty may also lower the risk of any of your adjacent vertebrae suffering similar compression fractures.
The procedure, which is also known as ‘balloon kyphoplasty’, generally needs to be carried out within four months of your fracture occurring.
Mr Bell will make a small incision in your back and insert either one or two balloon devices into your damaged vertebra. He will then fill the balloon or balloons with a high-contrast liquid so he can see them on an X-ray.
Then those balloons are slowly inflated to restore as much of your vertebra's initial height as possible. That leaves a cavity that can be filled with bone cement, which helps to stabilise your fracture. The balloons are then deflated and removed.
The pain relief you receive as part of this procedure is usually immediate, and you don’t need a general anaesthetic, so you should be able to get up and walk about straight after your surgery.
Long-term, this procedure should reduce your spinal curvature, take pressure off the adjacent vertebrae and help you regain lost height.
MINIMALLY INVASIVE SPINAL SURGERY
Minimally invasive spinal surgery (MISS) is an alternative surgical procedure to open spinal surgery. It’s keyhole surgery, which often requires an incision of just two to five centimetres in your back. This smaller incision reduces any pain as you recover from surgery and helps speed your recovery.
Mr Bell will carry out your surgery using advanced surgical techniques and technology to help minimise damage to your muscles, ligaments and soft tissues. Depending on your condition, he will use one of these three methods:
- Thoracoscopy: This uses a thin tube with a small video camera inside called a thoracoscope, which enters through a small incision in the lower end of your shoulder blade, between your ribs.
- Laparoscopy uses a thin tube with a small camera inside called a laparoscope, which enters through a small incision in your tummy or pelvis.
- Endoscopy is conducted using a thin tube with a small camera inside called an endoscope, which enters your body through a natural opening, such as your mouth.
SPINAL FUSION SURGERY
This surgical intervention connects two or more bones in any part of your spine to prevent any movement between them. This helps to stabilise your spine and relieve your back pain, including peripheral nerve pain.
In younger patients, it can also help to ensure that your spine grows in the right way.
Mr Bell also recommends this procedure if you have a degenerative disease of the spine, such as a vertebral fracture, spondylolisthesis, scoliosis or spinal stenosis.
Mr Bell will place some bone or bone-like material in the space between two of your spinal bones. He may also use titanium plates, rods or screws to hold those bones together. Over time, these two bones will permanently fuse together to become one.
It’s likely that you’ll need a bone graft as part of this procedure, so Mr Bell will use a piece of your own pelvic bone or one taken from a donor. In some cases, he may be able to use a synthetic bone-like material instead.
If it’s possible, Mr Bell will perform your spinal fusion using minimally invasive techniques, meaning that you’ll only have a small surgical incision. That should reduce the risk of any potential complications and help you recover more quickly.
You’ll need to stay in hospital for a few days and rest before gradually reintroducing physical activity into your routine. This will help you make your recovery as smooth as possible.
You’ll be given a bespoke physiotherapy program about six weeks after your operation, to help you regain strength and mobility. You’ll also be given painkillers to manage your immediate symptoms and advice on complications to watch out for.
SPINE FRACTURE SURGERY
Your spinal cord connects your brain to your lower back through your nervous system, and controls how you move, sense and react.
A spinal fracture, when the small bones in your spine break or dislocate, can have a number of causes, including traumatic events like a car crash, fall or sports injury, but also age-related osteoporosis or cancer, which can weaken the spine over time.
These fractures can affect the function of your spinal cord and have serious consequences.
Mr Bell has extensive experience treating these kinds of injuries and conditions, and he understands how limiting and painful they can be. He may be able to treat you without surgery or if your pain persists, carry out the precise procedure you need.
He and his team will do their very best to get you back to living your life with the freedom and movement you want.
If Mr Bell considers surgery to be the best course of action for either your stable or unstable fracture, he can provide an accurate diagnosis, expert advice and the right surgical approach for your case.
The spine is a delicate and complex structure, so Mr Bell and his team will devise a specific treatment plan for your case and talk through every step with you.
There are two common approaches to spinal fractures: vertebroplasty and kyphoplasty. These are both minimally invasive surgeries that will help reduce tissue damage, blood loss and operating time.
They should also help you to recover more quickly than from open surgery.
All spinal surgery is complex and comes with risks, including infection, bleeding and blood clots. Before your operation, Mr Bell will discuss your surgical options and any specific risks in detail, and you can ask any questions. He’ll also explain the potential benefits of the surgery.
Your procedure will be performed under a general anaesthetic, so you should avoid eating and drinking for at least six hours before you go into theatre.
You’ll need to stay in hospital for at least a few days, depending on the severity of your fracture and the surgery you have, as well as your general health. You’ll be given a comfortable private room to recuperate in, and all the help and advice you need as you start to move again.
Spinal fractures are painful, so you’ll need painkillers to help manage your recovery. That pain is likely to continue for up to three months as your bones heal, but by the sixth week, you should already be feeling much better.
The team will create a bespoke physiotherapy program for you that you can start around six weeks after your operation. They’ll also book you in for any follow-up consultations you’ll need.
READY TO TAKE THE NEXT STEP?
If you have any worrying symptoms you’d like to get checked, need a second opinion or just want a free chat with one of our nurse specialists, get in touch. Our friendly team will take care of the rest.