Conditions Treated

Myelopathy occurs when pressure on the spinal cord in the neck (cervical) or mid-back (thoracic) leads to neurological symptoms such as hand clumsiness, difficulty walking, balance problems, weakness or numbness. It may result from disc herniation, bone spurs (osteophytes), thickened ligaments, ossification of ligaments (OPLL), or tumours. As spinal cord damage can become irreversible, early diagnosis and surgical decompression are critical to prevent further deterioration.

Radiculopathy refers to when a spinal nerve root is compressed or irritated, causing pain, tingling, numbness, or weakness in the arm or leg supplied by that nerve. The pattern of symptoms often helps identify the level of compression. Common causes include disc herniation, overgrowth of bone or ligaments, and spinal arthritis (spondylosis).

Progressive wear and tear of the spinal intervertebral discs can cause chronic neck or back pain, sometimes with referred or nerve-related symptoms. Treatment begins with conservative measures, though surgery can be considered in appropriate cases where symptoms remain severe or disabling.

A herniated or “slipped” disc occurs when the soft inner core of a disc pushes out, irritating nearby nerves or the spinal cord. Depending on the extent and level affected, this can cause pain, numbness, tingling, or weakness in the arms or legs. While many improve without surgery, persistent or severe cases may require surgical removal of the disc fragment.

Disc bulges, bone spurs and thickened ligaments can narrow the spinal canal in the lower back. When severe, this can gradually compress the nerves in a bundle and result in a cluster of symptoms known as neurogenic claudication — aching, heaviness, or numbness in the legs brought on by walking, which is often relieved by leaning forward. It is particularly common in older adults and can have a significant impact on quality of life.

“Sciatica” is a common term used to describe pain radiating from the lower back into the buttock and leg. It is usually due to compression or irritation of the spinal nerve roots travelling to lower limbs, most often due to a lumbar disc herniation or spinal stenosis. Symptoms can include sharp or burning pain, tingling, numbness, or weakness in the leg.

Abnormal spinal alignment (such as scoliosis, flat-back syndrome, or kyphosis) can lead to pain, posture problems, and nerve symptoms. Treatment begins with conservative approaches, with surgery considered if symptoms are worsening or debilitating. Where appropriate, spinal correction surgery aims to improve alignment, relieve nerve pressure, and stabilise the curvature using hardware like rods and screws. The ultimate goals are to reduce pain, improve mobility, restore balance, and halt any further progression of the deformity. Every case is assessed individually, often by a multidisciplinary team, to ensure a tailored treatment plan that optimises both safety and outcomes.

Fractures of the vertebrae can occur due to trauma, osteoporosis, or weakening of bones due to tumour infiltration. Stable fractures suitable for outpatient care may be managed with bracing, minimally invasive stabilisation, or fusion, depending on the severity.

Tumours of the spine may be benign, locally invasive, or malignant (cancerous).

They can occur in different locations:

• Vertebrae (arising from bone)
• Epidural (outside the dura, the lining of the spinal cord and nerves)
• Intradural extramedullary (within the spinal sac but outside the cord)
• Intramedullary (arising within the spinal cord itself)

Symptoms vary from pain to weakness, numbness, or instability. Depending on the individual circumstances, surgery may be needed in combination with other treatment modalities to decompress the spinal cord, remove tumour bulk, or stabilise the spine.

A condition where one vertebra slips forward (anterolisthesis) or backward (retrolisthesis) over the one below. This may cause instability, pain, and nerve compression. Management can include physiotherapy, injections, or surgery such as decompression and fusion if symptoms are severe.

Brain tumours are broadly divided into:

• Primary brain tumours – these arise directly from the brain tissue or its coverings. They may be benign (non-cancerous, but still capable of causing problems due to pressure on surrounding structures) or malignant (locally aggressive or able to spread).
• Secondary brain tumours (metastases) – the most common type in adults, occurring when cancers from elsewhere in the body (such as lung, breast, melanoma, kidney, or bowel) spread to the brain.

Tumours can also be described by their location. Extra-axial tumours arise outside the brain tissue but within the skull (for example, meningiomas, vestibular schwannomas, or pituitary tumours), while intra-axial tumours arise within the brain itself (such as gliomas or ependymomas).

Symptoms depend on the size and position of the tumour, and may include headaches, seizures, weakness or numbness, speech or vision difficulties, or changes in memory, mood, or personality.

Management is highly individualised. It may involve surgery to remove as much tumour as safely possible, or a small biopsy to determine a diagnosis. Treatment is often combined with radiotherapy, chemotherapy, and multidisciplinary care involving other specialties. Patients will receive careful guidance and specialist care throughout every stage of their treatment journey.

A structural condition present from birth where the back part of the brain (the cerebellum) extends down into the spinal canal. This can sometimes disrupt the normal circulation of cerebrospinal fluid around the brain, and place pressure on the brainstem or spinal cord. Symptoms may include occipital headaches (often worsened by coughing, sneezing, or straining), dizziness, neck pain, numbness, or problems with balance and coordination. In many people, a mild Chiari malformation has no adverse effect and does not require any treatment. However if symptoms are significant or progressive, surgery to decompress the area may be recommended to restore fluid flow and relieve pressure.

Common examples include carpal tunnel syndrome (median nerve compression at the wrist) and cubital tunnel syndrome at the elbow (ulnar nerve). When conservative measures fail, surgery can relieve nerve pressure and improve symptoms.

Tumours can develop along the nerves outside the brain and spinal cord. Most are benign, such as schwannomas or neurofibromas, but they can still cause pain, numbness, tingling, or weakness if they press on the nerve. Treatment may involve careful monitoring, with surgical removal if symptoms are significant or the tumour is growing. Surgery is aimed at relieving pressure while preserving nerve function as much as possible.