The same order the clinic works in: an injection before an ablation, a decompression before a fusion, and an open approach only where the anatomy needs one. Each procedure has an animation showing what actually happens, and a page going a level deeper.
No incision. Done through a needle or a narrow probe, often as much to confirm the source of the pain as to treat it.
Lumbar epidural steroid injection. Needle trajectory into the epidural space under fluoroscopic guidance, and the spread of injectate around the inflamed root.
Calms an inflamed nerve root, and tells us whether we have found the right level. No incision, and often the step that makes surgery unnecessary.
Read the full procedure →Radiofrequency ablation. Cannula placement along the medial branch under fluoroscopy, sensory and motor testing, and the lesion forming along the active tip.
Interrupts the nerves carrying pain from worn facet joints. Only offered after a diagnostic block has confirmed those joints are the source — a scan alone cannot tell you.
Read the full procedure →Basivertebral nerve ablation. Transpedicular probe placement into the vertebral body and the ablation zone around the basivertebral nerve.
Treats vertebrogenic back pain — the kind that comes from the vertebral body itself — without removing bone or fusing anything.
Read the full procedure →Muscle parted along its fibres and held open by a tube, rather than stripped off the spine and retracted. Roughly a one-inch incision.
Tubular discectomy & laminectomy. Sequential dilation to the lamina, the tube seated, and the decompression with the facet joint left intact.
Through a tube about the width of a dime. Takes pressure off the nerve and leaves the joint intact.
Read the full procedure →MIS TLIF. Interbody cage placement through the tubular corridor and percutaneous pedicle screw fixation.
When a segment has to be stabilised, the fusion still goes through the same small corridor rather than a long open exposure.
Read the full procedure →MIS SI joint fusion. Lateral trajectory across the sacroiliac joint and implant placement, with the diagnostic injection that precedes it.
For pain that sits below the lumbar spine entirely. Confirmed by injection first, then stabilised through a small lateral incision.
Read the full procedure →Tubular cervical foraminotomy. Docking the tube on the lamina-facet junction, unroofing the foramen, and the exiting root freed with the disc space left untouched.
Frees a pinched nerve root in the neck through the same tubular corridor, leaving the disc in place. For arm-dominant pain where the compression sits out to the side.
Read the full procedure →Reached through a dedicated corridor rather than down a tube — the front of the neck, the front of the abdomen, the flank, or the back of the neck. Broader access than a tube allows, which is what reconstructions, disc replacements and revisions need. Several of these disturb less muscle than a tubular approach does, because they never cross the back muscles at all.
Cervical disc replacement. Discectomy and decompression, then the artificial disc seated in the prepared space, with the level still articulating.
The same decompression that relieves arm pain, but the level is rebuilt to keep moving rather than fused solid. Candidacy is narrower than for ACDF and is decided on imaging.
Read the full procedure →Cervical spine surgery & ACDF. Anterior approach, discectomy, and the interbody graft and plate that fuse the level.
Decompression and fusion for cervical radiculopathy, stenosis and myelopathy — a particular focus of this practice.
Read the full procedure →Lumbar disc arthroplasty. Discectomy through the anterior corridor, endplate preparation, and the implant seated with the level still articulating through flexion and extension.
An alternative to lumbar fusion for a single worn level. The selection criteria are very narrow — most patients asking about it are not candidates, and that is decided on imaging.
Read the full procedure →Open-door laminoplasty. The hinge trough, the opposite-side cut, the laminae easing open as a unit, and the cord drifting back into the enlarged canal.
Enlarges the canal across several levels for cervical myelopathy by hinging each lamina open rather than removing it — no fusion, and the neck keeps moving. Needs a preserved forward curve.
Read the full procedure →Lateral lumbar interbody fusion. The retroperitoneal corridor, transpsoas docking under neuromonitoring, and the cage seated across the rim with the foramen opening as height is restored.
Reaches the disc from the side, so the back muscles are never touched. Restoring height opens the nerve exits without the canal being entered — but it cannot reach L5–S1.
Read the full procedure →Anterior lumbar interbody fusion. The retroperitoneal corridor, the great vessels mobilised, complete discectomy, and a lordotic implant seated at the front of the disc space.
The largest interbody graft of any approach, and the best at restoring disc height and the curve of the lower back. Particularly suited to L5–S1, which the lateral corridor cannot reach.
Read the full procedure →Where the problem spans more of the spine than a small corridor can cover. Past a certain number of levels the cumulative access stops being smaller and the view stops being better — so the corridor is opened to match the work, not the other way round.
Multilevel lumbar decompression. Laminae removed across several levels, ligamentum flavum lifted off the thecal sac, and each root followed out through an undercut facet.
Open decompression for stenosis running across several levels. Where the spine is stable, nothing is fused — adding a fusion is not the thorough version of this operation.
Read the full procedure →Posterior cervical decompression and fusion. Lateral mass screw trajectories, laminae removed with the cord decompressed, and the neck brought to its intended lordosis against contoured rods.
Decompresses and stabilises the neck from behind across several levels. The operation for multilevel myelopathy, instability, lost curve, or a fusion from the front that did not unite.
Read the full procedure →Multilevel instrumented fusion. Navigated screw placement across a rotated segment, interbody cages restoring height and lordosis, and the correction brought about against contoured rods.
The largest operation described here. For degenerative scoliosis, multilevel instability and revision — and the aim is not simply to fuse the spine but to fuse it in the right shape.
Read the full procedure →Not another rung on the scale — the corridor and the instruments that make the tubular procedures above possible.
The MIS tubular corridor. Sequential dilation between muscle fibres, contrasted with the subperiosteal stripping an open approach needs.
Why the corridor matters more than the incision length, what it changes about recovery, and when an open exposure is the better operation.
Read more →Navigation, robotics & monitoring. O-Arm intraoperative CT registration, robotic screw trajectory planning, and live neuromonitoring traces.
O-Arm CT-guided navigation, Globus robotic assistance, the ultrasonic bone scalpel, and continuous neuromonitoring.
Read more →The conditions list names what comes through the clinic most often, and the approach page explains how the choice between a tube and an open exposure actually gets made.