Don’t get lost in the jungle of the neck, upper back and shoulder - Get me out of here! - Mr Bob Chatterjee, Consultant Spinal Surgeon

One of the challenges of the spine is the upper back region. The symptoms can develop from a number of areas. Is it the neck, the thoracic spine, the shoulder, the heart or the lungs? Mr Chatterjee will utilise 2 decades worth of experience to demonstrate how to tackle this region. Describing key points to pick up in the history and clinical examination to help you distinguish between symptoms. What clinical tests can you do ? How accurate are they? What imaging choices do we have? Covering common complaints such as disc prolapses of the neck and thoracic spine, concurrent shoulder and forearm pathologies as well as how to determine if your patient might have more serious conditions such as cord compression, cancer or an underlying cardiac or respiratory disorder that may masquerade as a spinal issue. The session will close with a perspective on surgery. Knowing what really happens in theatre, what to expect for your patient as well as how to rehabilitate them will ensure confidence from start to finish for those requiring surgery.

Unusual, Unique and Missed Diagnoses in the Spine - Mr Caspar Aylott, Consultant Spine Surgeon

A good clinician knows the next patient is never the same as the last. Could the demands of a modern practice sometimes lead us to drop our guard? When we are busy, distracted, tired or rushed is it possible to stop thinking, to stop questioning, to miss some unusual signs and symptoms? A missed diagnosis can sometimes have major consequences for both the patient and clinician alike. Mr Aylott is uniquely dual qualified in the UK as a Consultant Spine Surgeon and mechanical engineer and also has a Doctorate in dynamic stabilisation in the spine and will share some examples of the more unusual, unique and sometimes missed spinal cases in spine which he has observed in his practice.

Neurology of the Spine – Non-Compressive Pathology of the Spine - Dr Ben Turner, Consultant Neurologist

Compression of the spinal cord is a surgical emergency. It usually presents with severe back pain due to the compression and mass effect, therefore understanding the condition, the signs and symptoms and prompt MRI imaging will lead to an effective diagnosis. However, there are many medical conditions that can mimic compression - myelitis is recognised to occur in several conditions such as Multiple Sclerosis, Systemic Lupus Erythematous or Sarcoid. In addition, there are conditions that can look like spinal cord disease but are in fact due to different pathology such as Guillain-Barre-Strohl or myopathy. This talk will cover the medical differential to spinal cord disease, how to identify these and the management.

Holistic Principles of Spinal Pain Management - Dr Deepak Ravindran, Pain Management Consultant

This session will focus on the various aspects of spinal pain, the mechanisms and the structures and will provide an understanding of the latest neuroscience of pain as well as they physiology behind the occurrence of chronic spinal pain. Discussing the new NICE guidelines for chronic pain which includes spinal pain as well as new international guidelines for pain in terms of understanding the various treatment pathways available locally, nationally and internationally. Lastly, a focus on existing techniques for spinal pain management and the evidence base behind them and what would be a holistic, sustainable approach to supporting patients with spinal pain.

Primary and Secondary Osteoporosis in the Spine: Causes, Diagnosis, Imaging and Treatment - Dr Taher Mahmud, Consultant Rheumatologist

There are over 500,000 osteoporosis related fractures in the UK per year - in the UK circa 1,100 individuals die every month following a hip fracture alone. This is unacceptable when many of these fractures could be prevented by effective screening, diagnosis and treatment. Secondary osteoporosis is caused by certain medical conditions, inflammatory spinal arthropathies or treatments that interfere with the attainment of peak bone mass and may cause bone loss. In secondary osteoporosis there is change in bone re-modelling with overall increase in the rate of bone loss. This event will give an overview as to helping to define the signs and symptoms of osteoporosis including the diagnostic imaging pathway including DEXA scanning. The talk will also discuss the effective treatment of osteoporosis and will also cover the important roles of nutrition and exercise. The event will conclude with a discussion as to the next steps for osteoporosis, case studies and a question and answer session.

The Role of Neck Injections in Neck and Back Pain - Dr Serge Nikolic, Consultant in Spinal and Pain Medicine

Dr Serge Nikolic will discuss the role of injections in neck and back pain. Corticosteroid and and Epidural steroid injections are considered an integral part of non-surgical management of neck and back pain. They are often the next steps following conservative treatments bringing no relief to pain. 

Dr Nikolic specialises in minimally invasive spinal procedures and will begin his talk with an overview of the use of injections to deal with back and neck pain. This will include the NICE guidelines, most common types of injections and the rationale behind their use. It is also important to discuss the benefits and limits to these injections so that you can be accurately informed when considering their use. There are numerous types of neck and back injections to which is reflected by their most appropriate and effective uses. What is the difference between diagnostic and therapeutic injections? When should you use each one? The talk will also cover the use of specific types of injections. For example, Dr Serge Nikolic will discuss the use of epidural injections to address nerve root blocks. Penultimately, the topics of facet joint/medial branch injections will be discussed. 

The talk will conclude by Dr Nikolic covering other minimally invasive treatments, such as radiofrequency and pulsed radiofrequency treatment, the side effects of each and their role in rehabilitation. 

Learning Outcomes: 

• Improve your understanding of the upper back, neck and shoulder anatomy 
• Learn about unique and easily missed spinal conditions 
• Understand the medical differentiation to spinal cord disease 
• Have a greater depth of knowledge on spinal pain management 
• Be more informed about the new NICE guidelines for chronic pain 
• Have a better understanding of primary and secondary Osteoporosis in the spine 

Check out the attendee pack for the 12th Spinal Symposium to get more information on what to expect from the day.

Recording of 7.5 hour webinar, speaker's slides (if permitted) and CPD certificate.

Chiropractors, Osteopaths, Physiotherapists, Podiatrists, Sports Therapists, Hand Therapists, Radiographers, Occupational Therapists, GP, Public, Other Health Professionals, Trainee Health Professionals, Students