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Conditions

Spinal Conditions Treated

Overview

Back and neck pain are common. The conditions that need a surgeon are not.

The value of a specialist assessment lies in separating the two accurately and early.

Mr Russo assesses each referral against three questions: is there a defined anatomical cause, does it explain the symptoms and signs in front of him, and would an intervention change the natural history of the problem. Where the answer to any of these is no, the recommendation is non-operative care with a clear review point — not an open-ended course of treatment.

Each condition below has its own reference page covering symptoms, red flags, the diagnostic pathway, non-surgical management, surgical options where relevant, and expected recovery.

Principles of assessment
  • Imaging is interpreted against the examination, never on its own.
  • Degenerative change on a scan is normal with age and is not, by itself, a diagnosis.
  • Non-operative care is structured and time-limited, with defined goals.
  • Where surgery is advised, the reasoning is set out in writing.
CERVICAL CONDITIONS

Neck and cervical spine

Conditions arising between the skull base and the upper chest, where a few millimetres of narrowing can affect the nerve roots to the arm or the spinal cord itself.
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Cervical Disc Disease

Degeneration of the discs in the neck causing arm pain, numbness or weakness.

Typical symptoms
  • Neck pain radiating into the shoulder blade
  • Sharp arm pain following a defined dermatome
  • Numbness or tingling in specific fingers
LUMBAR CONDITIONS

Lower back and leg pain

The commonest reason for referral. Most of these conditions settle without an operation; the purpose of assessment is to identify the minority in whom surgery genuinely changes the outcome.
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Lumbar Spinal Stenosis

Narrowing of the spinal canal in the lower back leading to leg pain when walking.

Typical symptoms
  • Progressively reduced walking distance
  • Heaviness, burning or cramping in both legs
  • Relief on sitting or leaning forwards
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Sciatica

Pain radiating along the sciatic nerve, often from a herniated lumbar disc.

Typical symptoms
  • Sharp, electric leg pain below the knee
  • Pain aggravated by sitting, coughing or sneezing
  • Numbness or tingling in the calf, foot or toes
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Herniated Disc

Protrusion of a disc compressing a nerve root, in the cervical or lumbar spine.

Typical symptoms
  • Sudden onset pain radiating into an arm or leg
  • Pain worse on sitting, bending or straining
  • Dermatomal numbness or paraesthesia
COMPLEX SPINAL CONDITIONS

Deformity and complex pathology

Adult deformity and spinal tumours require planning across specialties, careful assessment of bone quality and comorbidity, and a surgeon who operates on these problems regularly.
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Adult Scoliosis

Progressive lateral curvature of the spine causing pain or postural change.

Typical symptoms
  • Aching back pain worse through the day
  • Visible asymmetry of the waist or shoulders
  • Leg pain from nerve compression within the curve
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Spinal Tumours

Pain radiating along the sciatic nerve, often from a herniated lumbar disc.

Typical symptoms
  • Sharp, electric leg pain below the knee
  • Pain aggravated by sitting, coughing or sneezing
  • Numbness or tingling in the calf, foot or toes
CLINICAL APPROACH

How a spinal diagnosis is reached.

The same disciplined sequence applies to every referral, whether the eventual answer is reassurance, physiotherapy, an injection or an operation.
History and examination

A structured 45-minute consultation with Mr Russo. Pain pattern, walking distance, neurology and function are recorded before any scan is discussed.

Imaging correlated to symptoms

MRI, CT or standing radiographs are requested only where they will change management, and are always read against the clinical picture rather than in isolation.

Non-surgical care first

Targeted physiotherapy, medication review and, where indicated, image-guided injection — structured, time-limited and reviewed against measurable goals.

Surgery only where it is decisive

An operation is offered when there is a clear anatomical target, a matching clinical syndrome and a realistic expectation of benefit.

FAQ

Frequently Asked Questions

A short selection of the most common enquiries received from prospective patients. If your question is not addressed here, please write to the practice.

No. If you already have recent imaging please bring it, as Mr Russo reviews the images themselves rather than only the report. If you do not, the consultation begins with history and examination and any imaging required is arranged afterwards.

In the large majority of cases, no. Most spinal conditions improve with structured non-operative care. Surgery is recommended only where there is a clear anatomical cause, a matching clinical syndrome and a realistic expectation that an operation will change the outcome.

Routine consultations at Harley Street are usually available within a few days. Cases with progressive neurological signs are triaged and seen urgently.

Yes. Many patients are referred specifically for an independent review of a proposed operation. You will receive a written summary of the assessment and the reasoning behind the recommendation.

Cervical disc disease, lumbar spinal stenosis, sciatica and lumbar disc herniation form the bulk of the caseload, alongside adult deformity and spinal tumour work referred from other specialists.

  • Imaging is interpreted against the examination, never on its own.
  • Loss of bladder or bowel control, or numbness around the saddle area
  • Rapidly progressive weakness in an arm or leg
  • Deteriorating balance, stumbling or loss of fine hand function
  • Severe unremitting night pain with fever or unexplained weight loss
These symptoms can indicate cauda equina syndrome, spinal cord compression or infection. Attend your nearest emergency department rather than waiting for an outpatient appointment.