Complex spinal surgery
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Complex spinal surgery is the insertion of metalwork to stabilize and fuse parts of the spine. This may be necessary for spinal fractures, metastatic spinal tumours, spinal instability and sometimes for back pain. A relatively new development is minimally invasive spinal surgery, a type of ‘key-hole’ surgery. Our surgeons use the latest techniques in complex spinal surgery including minimally invasive procedures.
There are weekly multi-disciplinary team meetings attended by neurosurgeons, spinal orthopaedic surgeons, pain specialists and neuroradiologists to discuss complex spinal cases.
Our neurosurgery complex spine specialists are Vino Siva, Pawan Minhas and Marios Papadopoulos. Our Orthopaedic spinal specialists are Timothy Bishop, Jason Bernard and Darren Lui.
Our paediatric complex spine specialists are Jason Bernard, Darren Lui, Timothy Bishop, Samantha Hettige, Simon Stapleton, and Navneet Singh.
Referrals
Elective referrals can be made by letter or the e-Referrals Service.The address for non-urgent referrals is:
Department of Neurosurgery
Atkinson Morley Wing
St George’s Hospital
Blackshaw Road
London SW17 0QT
Fax – 020 8725 4452
Complex Spine Referrals
Patients with a complex spinal condition must be referred to the Spinal MDT via the Spinal MDT Referral Form. More referral forms available here.
This needs to then be emailed to Sayfur.Rahman@stgeorges.nhs.uk
Please ensure all relevant imaging is sent via Image Exchange Portal (IEP).
The Spine MDT is on Friday mornings and the outcome of each referred patient will be emailed to the address on the MDT form by 5pm on the Friday.
Please send all relevant imaging via the IEP and the referral form by 12:00hrs on Thursday. The images and information need to be reviewed by a Consultant Radiologist before the Neuro-oncology MDT which starts at 08:00hrs on Friday mornings. It may not be possible to provide management/ advice if a referral form and imaging are unavailable at the time of the meeting.
The MDT coordinator is available during office hours on 020 8725 4533.
Emergency referrals
Neurosurgical On-Call Referrals
All emergency neurosurgery referrals to St George’s Hospital are to be made electronically via a secure on-line web systemwww.referapatient.org
Please access this webpage and select the ‘make a referral’ button and fill out the necessary information and clinical details. Once submitted, the on-call neurosurgery doctor will be informed of the referral by text and will review and respond at the earliest opportunity. The response will be received as a pdf letter which will be emailed to the (secure) address provided by the referrer.
If you have trouble opening the PDF document click here for troubleshooting advice.
If you wish to speak to a doctor whilst completing a referral, please contact St George’s Hospital switchboard on 020 8672 1255 and ask for the ‘On Call Neurosurgery Registrar’ or access their bleep (7242) via the automated bleep desk. They may be unable to answer immediately if they are taking another call so please wait for a reply.
It is our experience that the transfer of scans for review can take some time. We therefore recommend contacting PACS transfer teams or radiographers depending on local policy to send any relevant imaging at the earliest opportunity via the Image Exchange Portal (IEP). If your case is urgent then please specify that these scans should be transferred as a ‘Blue Light Transfer‘.
Metastatic Spinal Cord Compression (MSCC)
St George’s Hospital provides a 24 hour advisory service and surgical management for the patients with MSCC. We serve South West London (part of the London Cancer Alliance (LCA)) and the Surrey, West Sussex and Hampshire Cancer Network (SWSHCN).
MSCC is defined as spinal cord or cauda equina compression by direct pressure and/or induction of vertebral collapse or instability by metastatic spread or direct extension of malignancy that threatens or causes neurological disability.
The 24 hour contact number for the Lead MSCC Co-ordinator at St George’s Hospital is 020 8672 1255 and Bleep 6027
Referring clinicians/local MSCC Co-ordinators will be signposted by the Lead MSCC Co-ordinator/On-call Neurosurgical Registrar to access the South West London MSCC Service Referral Form. This is available here.
This form must be completed electronically and returned to the South West London MSCC Service. The fully completed form should then be e-mailed to stgh-tr.mscc@nhs.net
In the event of server/system disruption or failure, this form should be printed off, completed manually and faxed back to 020 8725 4613.
A copy of the form should also be sent to the Cancer Centre at the same time to provide patient details to allow the Clinical Oncologist to initiate emergency radiotherapy if/once surgery has been excluded.
- Royal Marsden Hospital
Email rmh-tr.MSCC@nhs.net
Fax 020 7811 8436 - Royal Surrey County Hospital
rsc-tr.MSCC@nhs.net
Fax 01483 464 876
Please contact the Lead MSCC coordinator and the Clinical Oncologist (or AOS administrator at the local trust) to confirm how the form has been sent (i.e. fax or e-mail)
Mortality data
Consultant outcome publication (COP) is an NHS England initiative to increase transparency within the NHS and to provide the public with information on surgical outcomes. The Neurosurgical National Audit Programme (NNAP) has been mandated by NHS England to publish activity and mortality data for all neurosurgery units and consultant neurosurgeons practising in England.
The newly published mortality data shows that the St George’s Hospital neurosurgery unit has a lower than expected mortality rate. You can read the NNAP report on St George’s and compare our performance with other neurosurgery units on the Neurosurgical National Audit Programme website.
Consultant Outcome Publication 2014
Read the mortality data and outcome report for each of our consultant neurosurgeons: