Integrated back unit (IBU)

The Integrated Back Unit (IBU) at the RNOH pools the skills and expertise of a multidisciplinary team specialising in the treatment of back pain.Clinics are held at our Bolsover Street site every Friday morning.

Range of Services

Surgical/Medical opinion
Investigations include MRI, CT & bone scan
Expert physiotherapy opinion on conservative management
Minimally invasive techniques e.g. epidurals, facet injections, RF
All major spinal surgery
Active Back Programme

Consultants

Mr Lester Wilson (Consultant Spinal Orthopaedic Surgeon) Lumbar spine conditions
Mr Kia Rezajooi (Consultant Spinal Neurosurgeon) Lumber and cervical spine conditions
Dr Jan Gawronski (Consultant in Rehabilitation Medicine)
Helen Nafis (Clinical Specialist Physiotherapy)
Dr Jonathan Berman (Consultant Anaesthetist)

Referrals should be made to the most appropriate specialist in the team.

Referral Criteria for Surgical Opinion (Mr. Wilson, Mr Rezajooi)

Surgical management of degenerative lumbar spine disorders is a tertiary referral service only. It is now our policy to only accept referrals which fulfil the following criteria:

1. The patient has been assessed by a consultant team at another [local] hospital, and they agree that the patient should consider surgery. This team may be orthopaedic, rheumatological or neurology/neurosurgical.
2. The patient has had appropriate imaging performed recently (ie within the last 3 months). Usually this will mean an MRI scan. The scan (CD-ROM) and all appropriate hospital correspondence must accompany the referral letter.
3. The patient is happy to accept surgical treatment for their spinal problem.

Referrals for surgical opinion should be to the named consultant - see below for contact details.

Referral Criteria for conservative or rehabilitation opinion including the Active Back Programme (Helen Nafis or Dr Gawronski)

Referrals are welcome from GPs and hospital doctors. The referral letters should include the clinical findings, review of history (including treatment) and details of any previous investigations. Referrals should be sent to the Integrated Back Coordinator at the address below.

Indications for conservative or rehabilitation opinion:

1. Patients with low back pain including chronic pain that has not responded to previous physiotherapy/conservative treatment.
2. Patients who are not back at work or struggling to stay at work due to back pain
3. Patients who are keen to maximise their recovery following back surgery

Referral criteria for opinion on minimally invasive procedures (Dr Berman)

A range of minimally invasive procedures are available including epidural, facet injections and radiofrequency ablation. Referrals should be directed to Dr Berman's secretary - see address below.

Key Contacts:

Surgical Referrals

Mr Lester Wilson
Consultant Spinal Orthopaedic Surgeon
Royal National Orthopaedic Hospital NHS Trust
Brockley Hill
Stanmore
Middlesex HA7 4LP

Mr Kia Rezajooi
Consultant Spinal Neurosurgeon
Royal National Orthopaedic Hospital NHS Trust
Brockley Hill
Stanmore
Middlesex HA7 4LP

Conservative or rehabilitation opinion including the Active Back Programme (Helen Nafis or Jan Gawronski)

Kay Kyriacos
Integrated Back Unit Coordinator
Royal National Orthopaedic Hospital NHS Trust
Brockley Hill
Stanmore
Middlesex HA7 4LP

Tel: 020 8909 5355
Fax: 020 8909 5788

Conservative or rehabilitation opinion including the Active Back Programme (Helen Nafis or JanGawronski)

Mr Jonathan Berman
Consultant in Pain Management and Anaesthesia
Pain Management Department
Royal National Orthopaedic Hospital NHS Trust
Brockley Hill
Stanmore
Middlesex HA7 4LP