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Spine Assessment Tool

Conditions and treatments

Consultant Spinal Neurosurgeon and a leading authority in UK spine care, working with physiotherapists, osteopaths, pain specialists, rheumatologists

Specialist assessment and treatment for spinal conditions affecting the back, neck and nerves.

From persistent lower back pain to complex spinal disorders, Anthony Ghosh provides specialist assessment, diagnosis and treatment for a wide range of spinal conditions. Care is tailored to the individual, whether that involves guided non-surgical management, spinal injections, or advanced minimally invasive surgery.

Every treatment plan is built around clear clinical decision-making, with an emphasis on long-term outcomes, careful diagnosis, and avoiding unnecessary intervention wherever possible.

Conditions treated

Back and nerve pain

  • General back pain
  • Sciatica / leg pain
  • Slipped or herniated disc
  • Piriformis syndrome

Neck and arm symptoms

  • General neck pain
  • Brachalgia / arm pain
  • Cervical radiculopathy

Degenerative and structural conditions

  • Spondylosis and spondylolisthesis
  • Spinal stenosis
  • Spinal fractures

Complex spinal conditions

  • Spinal cord compression
  • Spinal tumours

Downloadable guides

Download a selection of free patient guides covering some of the most common spinal conditions and treatments. These resources are designed to help patients better understand symptoms, diagnosis, and available treatment options before and after consultation.

Cervical Radiculopathy

An overview of cervical radiculopathy, including common symptoms, causes, diagnosis, and the treatment options available for nerve pain affecting the neck and arm.

Cervical Myelopathy

A guide to cervical myelopathy, explaining how spinal cord compression develops, the symptoms it may cause, and when surgical treatment may be required.

Lumbar Spinal Stenosis

Learn about lumbar spinal stenosis, including the typical symptoms, underlying causes, and the non-surgical and surgical treatments available to relieve pressure on spinal nerves.

Sciatica

Understand the causes and symptoms of sciatica, along with the treatments available to reduce nerve pain and support long-term recovery and mobility.

Slipped / Herniated Discs

A patient guide to slipped and herniated discs, covering symptoms, diagnosis, and the treatment options available for disc-related neck and back pain.

Spinal Tumours

An introduction to spinal tumours, including how they are diagnosed, the symptoms they may cause, and the specialist treatments available.

Spinal Fractures

Learn about spinal fractures, including common causes, symptoms, diagnosis, and the treatments used to stabilise the spine and support recovery.

Understanding Back Pain

An overview of chronic back pain, exploring the physical, emotional, and lifestyle factors that can contribute to ongoing symptoms and recovery.

The UK’s Rising Spine-Health Burden

An in-depth look at the growing impact of spinal conditions across the UK, and what this means for long-term health, movement, and wellbeing.

Treatments available

Injections and pain management

Targeted treatments designed to reduce inflammation, relieve nerve irritation, and support recovery without immediate surgery.
  • Epidural injections
  • Nerve root injections
  • Medial branch injections
  • Facet injections
  • Integrated pain management

Minimally invasive and decompression surgery

Advanced surgical techniques focused on relieving pressure on nerves and spinal structures while minimising tissue disruption.
  • Minimally invasive / keyhole surgery
  • Lumbar microdiscectomy
  • Lumbar decompression
  • Cervical decompression
  • Cervical foraminotomy

Disc replacement, fusion and stabilisation

Specialist procedures used to restore spinal stability, address degeneration, or replace damaged discs where appropriate.
  • Anterior cervical discectomy and fusion (ACDF)
  • Anterior cervical disc replacement (arthroplasty)
  • Minimally invasive lumbar interbody fusion (MIS-TLIF)
  • Spinal fixation
  • Vertebroplasty / kyphoplasty

Clinically directed rehabilitation and supportive therapies

Non-surgical therapies delivered under specialist clinical direction, helping ensure treatment remains coordinated, appropriate, and responsive to progress over time.
  • Physiotherapy
  • IDD therapy
  • Osteopathic manipulation
  • Integrated pain management

Clinical direction

A surgeon-led approach to non-surgical spine care

Many people who come to see me have already tried multiple treatments for their back or neck pain. They may have seen physiotherapists, osteopaths, pain specialists, or even other surgeons – often without a clear plan, joined-up decision-making, or confidence about what should happen next.

Spine problems are rarely straightforward. When care becomes fragmented, patients are often left managing complex decisions on their own.

Clinical Direction exists to address that problem.

Clinical Direction is a surgeon-led model of care used when surgery is not the immediate or obvious answer.

Under this approach, I remain actively involved in guiding treatment decisions over time, working closely with a small group of trusted clinicians involved in your care. Where appropriate, I can collaborate with a therapist local to you. The aim is to ensure treatment is coordinated, progress is reviewed, and decisions are made deliberately, rather than reactively. You are able to contact me throughout the process.

Clinical Direction is not about withholding surgery, nor is it about endless non-surgical treatment. It is about ensuring the right treatment happens at the right time, with clear clinical leadership throughout.

It is typically appropriate when:
  • There is no clear surgical target, but symptoms are ongoing
  • There is a potential surgical issue, but surgery is not required at present
  • A period of structured non-surgical treatment may help avoid or delay surgery
  • You want senior oversight rather than being discharged back into the system

If surgery is clearly indicated, it will be discussed and advised directly.

Clinical Direction does not replace surgery – it ensures sound clinical judgement around it.

Depending on your situation, care may involve:
  • Careful review of diagnosis and imaging
  • A coordinated non-surgical treatment plan
  • Close collaboration with physiotherapists, osteopaths, or pain specialists
  • Ongoing review of progress
  • Re-evaluation if symptoms change
  • Escalation to further investigation or surgery where appropriate
Throughout this process, responsibility for direction and decision-making remains under specialist oversight.

In many healthcare settings, once surgery is ruled out, patients are referred on and effectively discharged from specialist care. Clinical Direction is different.

It is designed for patients who want:

  • Continuity rather than fragmentation
  • Clear leadership rather than conflicting opinions
  • Thoughtful decision-making rather than rushed intervention
  • Ongoing specialist involvement when it matters

No. Not everyone requires ongoing surgeon-led care.

Whether this approach is appropriate is decided after consultation, once your diagnosis and circumstances are fully understood.

In Summary, Clinical Direction reflects how care is delivered in this practice when surgery is not the immediate answer:

  • Surgeon-led
  • Coordinated
  • Deliberate
  • Focused on resolution, not just treatment

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