These are some of the most commonly asked questions. If you require further information please contact us.
Please make sure you have been given precise instructions about where to go at least the day before your appointment. Your procedure may be carried out in several possible locations so this is very important. If you have any doubts please call +44 (0)20 7486 0808, or email office@kellow.com to check.
If you are having sedation or a general anaesthetic you must not have anything to eat for at least 6 hours beforehand. You are allowed to drink clear fluids (squash, water) until 2 hours beforehand. Avoid milky drinks including tea and coffee for 6 hours beforehand.
Please get to the hospital at least an hour before the expected time of your procedure. This is important as it can take some time to get through the hospital’s administration procedures.
For minor procedures where you will not be sedated you should be able to leave hospital within an hour and a half of your procedure. If you are sedated you should still be able to leave within three hours of your procedure.
Sedation is a personal choice in most situations. Some people want to be sedated for simple procedures such as facet joint injections but it is not essential. Most people tolerate these simple procedures very well. All you will feel is a small jab as local anaesthetic is injected into the skin over the area to be treated. Some procedures, such as nucleoplasty require sedation, but only major procedures such as Kyphoplasty require general anaesthesia.
You will only need someone to take you home if you have been sedated or if you have had a general anaesthetic.
For most back procedures you will be asked to lie on your stomach. For most neck procedures you will be lying on your side or sitting up. If you are being sedated this will be given to you in small increments during the procedure. All procedures are carried out under constant x-ray screening so the image intensifier (fluoroscopic x-ray machine) will be positioned around your body. The area to be treated will be cleaned with antiseptic and then surrounded by sterile drapes. Local anaesthetic will then in injected into your skin, and the treatment will start. Most treatments take between 10 and 60 minutes to do. You will be told beforehand how long your particular procedure is likely to take.
All the procedures we do are extremely safe. All interventional procedures will be carried out under constant x-ray screening, so the position of the needles or instruments can be followed at all times. There are always some risks whenever you have a medical procedure, whether from the drugs used or the procedure itself, but the chances of any complication are of the order of one in a hundred for most procedures, and the chances of any serious complications are much less. You should consider these risks in comparison with the risks of the alternative treatments. Often the alternative treatment will be surgery, for which the risks are usually much greater.
Steroids are often used as a component in the injections you will have. Generally these are considered to be safe so long as the number of times you have such an injection is limited. Generally it is considered safe to have up to 3 steroid injections in a six-month period. Ideally you should not have any more for at least a year.
Steroids are potent anti-inflammatory agents. Inflammation is often caused by an underlying structural problem such as a herniated disc, degenerative disc disease, or spinal stenosis, which can lead to facet syndrome, lumbar radiculopathy or cervical radiculopathy. Steroids can be very effective at reducing localised inflammation when delivered to the area either by lumbar epidural injection, cervical epidural injection, facet joint injection, or transforaminal epidural injection.
For most people the risks of steroids given in this manner, and limited to 3 doses in 6 months, are very small indeed.
We would not give you a particular treatment unless we felt there was a good chance of it working. Pain and nerve dysfunction can be very difficult to treat but generally we would be reluctant to perform an interventional treatment on you unless our personal experience and the available medical evidence suggested that at least 3 out of 4 patients could expect to improve their symptoms by at least 50%.
When the treatment has finished you will either walk or be taken on a trolley to the recovery area. If you have not been sedated you will be allowed to have something to eat and drink straight away. You will be allowed to go home after about half an hour if you have not been sedated. If you have been sedated or have had a general anaesthetic you will have to stay for at least two hours. If you have had a more major procedure you will need to stay longer, but rarely for more than 4 hours after the procedure.
Please make an appointment to see us 3-4 weeks after your treatment. Phone either the London Clinic appointments on +44 (0)20 7616 7693 for Thursday morning appointments, or +44 (0)20 7486 0808 for a Thursday afternoon appointment.