Mr Martin Knight
MD FRCS MBBS
Consultant Spinal Surgeon
Speciality: Orthopaedic Surgery, Spinal Surgery,
Location: Weymouth Street Hospital, 9 Harley Street
Martin Knight trained at St Bartholomew’s and St Thomas’ and his research training was established at the Royal Postgraduate Medical School.
After a short-term commission in the Royal Navy to support Orthopaedic staff deficits following the Falklands War, he embarked upon a Consultant Orthopaedic post in Rochdale with an interest in the treatment of degenerative disc disease. Following in the footsteps of predecessors prosecuting conventional surgery there was an expected incidence of ‘Failed Back Surgery’. Rather than pursue the same course of treatment he introduced keyhole percutaneous discectomy for revision treatment. Evaluation of outcomes after a year led him to introduce the KTP 532 laser disc decompression into the UK with prospective evaluation.
After two years having pushed out the envelope of this application the team defined the limitations of the technique. They introduced biportal flexible endoscopic intradiscal discectomy with laser assistance.
This expanded the application of keyhole surgery for the treatment of 1„a treatment and Failed Back Surgery. However, whilst the technique allowed larger or extruded discs to be addressed, this needed to be developed to address the problems of facet joint arthritis, instability, backward and forward slippage of vertebrae, sequestra. This led to the development of the uniportal technique of Endoscopic Laser Foraminoplasty for the treatment of chronic lumbar spondylosis, lateral recess stenosis, instability, spondylolitic spondylolisthesis, failed back surgery.
This research has warranted the initiation of a NHS supported a National Randomised Controlled Trial of Endoscopic Laser Foraminoplasty versus Pain Management at The Spinal Foundation.
This research in the lumbar spine has been paralleled by similar laser and endoscopic developments in the cervical spine and the development of a keyhole disc replacement.
Endoscopic “keyhole” Transforaminal surgery (Transforaminal Endoscopic Lumbar Decompression and Foraminoplasty and associated techniques) conducted under Total Intravenous Venous Anaesthesia (TIVA) provide real time feedback from the patient thus guiding the surgeon to the true and specific source of their pain. This provides greater diagnostic accuracy than that offered by MRI scans, X-rays and Discography. This in turn has driven forwards our understanding of the mechanisms of degenerative disc disease and its presenting symptoms and allowed the development of new minimally invasive techniques. These interventions target the pain source accurately; avoiding multiple disc level surgery and limiting collateral tissue damage whilst providing encouraging low risk beneficial outcomes. The results have been Peer reviewed in studies over 20 years. Mr Knight’s expertise in minimal invasive spine surgery is considerable. Because the nerve and to a lesser extent the disc are the major causes of symptoms, these techniques address disc protrusions, extrusions, sequestration, lateral recess stenosis (narrowing), axial stenosis, “instability”, spondylolisthesis (slippage), spondylolytic spondylolisthesis, facet joint cysts, radial tears and High Intensity Zones, degenerative scoliosis and failed back surgery and can be performed at any age including the elderly and infirm. Consequently their encouraging outcomes and low complication rates offer an attractive alternative to open spinal surgery, microdiscectomy, open decompression, interspinous spacers, open or “Less invasive” fusion or total disc replacement.
Endoscopic Spine Surgery
Minimally Invasive Spine Surgery
British Orthopaedic Spine Society
British Orthopaedic Association (Fellow)
Royal Society of Medicine
British Orthopaedic Research Society
British Back Pain Research Society
British Laser Medical Society
European Laser Medical Society (Executive)
Arthroscopy Society of New York
Military Medical Society
Surgical Research Society
ISTHMUS – Founder member and British Representative
American Academy of Minimally Invasive Spinal Medicine and Surgery
North American Spine Society
European Society of Spine
International Musculoskeletal Laser Society – Founder member and British Representative