Harley Street spinal consultation

Clear, specialist guidance for patients considering spinal fusion.

Spinal fusion and lumbar fusion can be discussed when back pain, nerve symptoms or spinal instability need careful specialist review. This site explains the procedure, the different fusion approaches and what patients can expect from consultation through recovery planning.

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  • Consultant-led assessment
  • Careful discussion of options
  • Information on TLIF, PLIF, ALIF, LLIF and XLIF
Specialist spine focus Information centred on lumbar fusion, stabilisation and related spinal surgery pathways.
Consultant team access Patients can explore consultant profiles, educational material and the wider specialist service.
Balanced information Benefits, limitations, risks and recovery considerations are explained in a medically appropriate way.
London location Harley Street contact details and booking routes remain available throughout the page.
About spinal fusion

What spinal fusion surgery is designed to do.

Spinal fusion is intended to stabilise a painful or unstable part of the spine by joining two or more vertebrae together. It is usually considered only after symptoms, imaging findings and the likely source of pain or nerve compression have been carefully reviewed.

In selected patients, lumbar fusion can form part of treatment for instability, spondylolisthesis, certain degenerative conditions, deformity or symptoms that relate to spinal movement and nerve compression. Different approaches are used depending on the spinal level, anatomy and the overall treatment objective.

Because spinal surgery decisions need care, patients often benefit from an explanation that covers what fusion may help with, what it may not address, and how recovery is typically planned around the individual rather than a template.

Stabilisation of a painful spinal segment
Assessment of nerve compression and alignment
Use of implants to support fusion while healing develops
Discussion of surgical and non-surgical pathways
Professor Hilali Noordeen
Specialist spinal review Patients often need more than a yes-or-no answer about surgery. Good consultation usually means understanding the diagnosis, reviewing scans carefully and discussing the reasoning behind each option.
Why patients seek advice

Common reasons patients ask about lumbar fusion.

Patients may be referred for specialist opinion when symptoms persist, function is reduced, or spinal imaging raises questions about stability, nerve pressure or structural change.

01

Persistent pain or reduced function

Back pain, leg pain or nerve symptoms that continue despite time, physiotherapy, medication or injections may prompt further review.

02

Possible spinal instability

Spondylolisthesis, degenerative change or movement-related pain can raise the question of whether stabilisation may need to be discussed.

03

Need for a clearer treatment plan

Some patients seek reassurance, a second opinion or a consultant explanation of whether surgery is likely to be appropriate at all.

Conditions discussed

Conditions that may be reviewed in relation to spinal fusion.

The decision for surgery depends on the whole clinical picture. Conditions commonly discussed on this site include:

Fusion types

Different fusion techniques for different anatomical problems.

Terminology can feel technical at first. These are some of the approaches patients most often encounter when discussing lumbar fusion.

TLIF

TLIF

Transforaminal lumbar interbody fusion is commonly discussed when access from the back and side of the spine helps address instability and nerve compression together.

PLIF

PLIF

Posterior lumbar interbody fusion approaches the spine from the back and may be considered when decompression and fusion are performed in the same operative field.

ALIF

ALIF

Anterior lumbar interbody fusion reaches the spine from the front and may allow disc work and restoration of disc height without direct dissection through the back muscles.

LLIF

LLIF / XLIF

Lateral approaches reach the spine from the side and may be useful in selected cases involving alignment, disc height and indirect decompression goals.

Consultation process

What patients can usually expect at consultation.

The first consultation is often about clarity rather than commitment. The aim is usually to understand symptoms properly, review investigations and explain the next sensible step.

1

Symptom review

Your consultation usually starts with the pattern of pain, leg symptoms, weakness, numbness, walking tolerance and previous treatments.

2

Scan and diagnosis discussion

Imaging findings are considered alongside the symptoms, because surgery decisions should not be based on scans alone.

3

Treatment options explained

Where appropriate, discussion may include non-surgical measures, decompression alone, fusion options and the reasons for or against each route.

Surgical approaches

Approach planning depends on the level, anatomy and surgical objective.

Approach choice is individual. The descriptions below are general summaries rather than promises of suitability for every patient.

Anterior approach

In an anterior lumbar approach, the spine is reached from the front. This can create access for disc removal and cage placement while avoiding direct dissection through the back muscles.

Front of spine access Disc removal and cage placement Selected according to anatomy

Posterior approach

Posterior approaches reach the spine from the back and may be used when decompression, instrumentation and fusion need to be carried out through the same pathway.

Back of spine access Decompression and fusion planning General anaesthetic surgery
Recovery and support

Recovery is usually a staged process, not a single moment.

Patients often want a realistic idea of the early recovery period, return to activity and the need for follow-up. Recovery varies, so the most useful framing is usually what support and milestones are typically discussed rather than exact timelines.

Early recovery

Initial recovery usually focuses on wound care, mobilising safely, pain control and recognising what is expected after surgery.

Rehabilitation

Movement, activity progression and rehabilitation advice are generally tailored to the procedure and the patient’s starting point.

Ongoing review

Follow-up helps assess symptom change, functional progress and whether imaging or further support is needed.

Specialist team

Meet some of the specialists behind the service.

The wider service includes consultant spinal surgeons, deformity expertise, neurosurgical spine input and pain management support.

Mr Mo Akmal
Medical Director

Mr Mo Akmal

Consultant spinal surgeon associated with spinal surgery pathways and minimally invasive thinking.

View profile
Professor Hilali Noordeen
Professor of Spinal Surgery

Professor Hilali Noordeen

Senior spinal expertise with recognised depth in scoliosis, deformity and complex spinal review.

View profile
Dr Anthony Hammond
Pain Management

Dr Anthony Hammond

Pain management expertise that helps patients consider the broader treatment pathway around surgery decisions.

View profile
Next step

Arrange a consultation to understand your options.

Patients considering lumbar fusion often want an informed conversation first: whether surgery is appropriate, what the realistic goals are and how the pathway would usually be organised if an operation is advised.

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Also explore

Lumbar fusion videos

Publications and educational content

Patient reviews and experiences

Contact

Harley Street contact information.

Use the existing booking route for appointments. For urgent medical concerns outside office hours, patients should seek appropriate local urgent care.

Location

19 Harley Street
London, W1G 9QJ
United Kingdom

Phone

+44 (0)203 973 8810

Hours

Monday to Friday: 8am - 6pm
Saturday: 9am - 1pm
Sunday: Closed

Urgent concerns

For urgent concerns outside office hours, please contact your GP or visit A&E.