Concierge spinal oncology · UK
Excision of spinal tumour, by a consultant spinal neurosurgeon.
A proper spinal oncology pathway — MDT review, the right imaging, and the honest choice between stereotactic radiotherapy, separation surgery and full resection. Whichever route fits your tumour, not the surgeon’s preference.
Why patients choose us
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A consultant spinal neurosurgeon, in a real theatre
Not a general list. A named SBNS/BASS spinal oncology surgeon working inside a multidisciplinary spinal tumour MDT, with intraoperative neuromonitoring on the table.
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NOMS framework, not surgery by default
For metastatic disease we run the Neurologic–Oncologic–Mechanical–Systemic decision — SBRT, separation surgery, en-bloc resection or stabilisation, chosen for your tumour, not the surgeon’s preference.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private spinal tumour treatment costs in the UK.
Indicative ranges across our partner spinal oncology centres. Every case is different — we return a firm quote across two or three routes once the MDT has seen your imaging.
In short
Intradural tumour resection in our network: £28,000–£55,000, with a 5–10 day stay.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Contrast MRI whole spine (workup) | £800–£1,400 | 45–60 min | 24–72 h |
| CT-guided spinal biopsy | £2,200–£3,800 | Day case | 3–7 days |
| Stereotactic spinal radiotherapy (SBRT) | £12,000–£25,000 | 1–5 fractions | 1–2 weeks |
| Intradural extramedullary tumour resection | £28,000–£55,000 | 3–5 h | 5–10 day stay |
| Intramedullary cord tumour resection | £40,000–£80,000 | 5–8 h | 7–14 day stay |
| Separation surgery + instrumented fusion | £35,000–£70,000 | 4–6 h | 7–14 day stay |
| En-bloc spondylectomy (primary bone tumour) | £60,000–£120,000 | 6–12 h | 10–21 day stay |
| Consultation and imaging review | £300–£600 | 45 min | Same visit |
Prices vary by the surgeon, the hospital, whether instrumentation and neuromonitoring are needed, whether a stay in ITU is planned, and by the adjuvant plan afterwards. We come back with a firm quote once the MDT has reviewed your case.
The problem
The right MDT, the right framework, the right operation.
Spinal tumour surgery is one of the highest-stakes decisions in neurosurgery — and one where the wrong operation is worse than none at all. We put you in front of an SBNS/BASS spinal oncology MDT before anyone books a theatre.
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Not sure surgery is right?
For many radiosensitive metastases, SBRT controls the disease without opening the spine. We use the NOMS framework to say so honestly.
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Worried about the neurology?
Intraoperative neuromonitoring with SSEP, MEP and D-wave signals — mandatory in our network for every intradural case.
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Want it done properly?
A named consultant spinal neurosurgeon, a spinal oncology MDT, and imaging reviewed against NICE NG234 for metastatic disease.
The journey
From enquiry to rehabilitation — what happens, in order.
One coordinator from first message to post-operative review, alongside a named spinal oncology surgeon.
Phase 1 · Before surgery
MDT, imaging and consent
Phase 2 · Admission and theatre
Day of, and overnight
Phase 3 · After
Rehab and adjuvant care
- 01
Before
You send us the imaging
A short confidential form and any recent MRI, CT or PET. Symptoms, timeline, primary cancer history if any, and how quickly things are changing.
- 02
Before
MDT review and recommendation
Within one to three working days: a spinal oncology surgeon reviews the scans, we discuss SINS, Bilsky grade and NOMS, and come back with a recommendation — SBRT, surgery, or biopsy first.
- 03
Before
Pre-operative workup
Contrast MRI whole spine, CT for bony architecture and stability, PET-CT if the primary is unknown, CT-guided biopsy where histology is needed. Anaesthetic assessment and cross-match.
- 04
On the day
Admission and theatre
Admission the day before or the morning of surgery. General anaesthetic, prone positioning, intraoperative neuromonitoring (SSEP, MEP, and D-wave for intramedullary cases) and image-guided navigation.
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On the day
The resection itself
Two to eight hours depending on tumour location and approach — laminectomy or laminoplasty, microneurosurgical dissection with CUSA aspirator and intraoperative ultrasound, pedicle screws if the spine is unstable.
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On the day
ITU or HDU overnight
A planned night in intensive care or the high-dependency unit for neurological observation, pain control and drain management. Step-down to the ward the following morning if all is well.
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After
Rehabilitation and adjuvant care
Five to fourteen days in hospital for open cases, physiotherapy from day one, adjuvant radiotherapy or chemotherapy planned with oncology, DVLA notified before you drive again.
Typical end-to-end: 1–3 weeks from enquiry to surgery for elective cases. Full rehabilitation: 3–6 months.
When it helps
When excision of a spinal tumour is the right step.
The presentations we see most, and the one red flag that means A&E rather than a clinic booking.
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Extradural metastasis
Spread from breast, lung, prostate, renal or myeloma — the commonest spinal tumour, often presenting with mechanical back pain worse at night.
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Intradural extramedullary tumour
Meningioma, schwannoma or neurofibroma sitting inside the dura but outside the cord — usually benign and surgically curable.
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Intramedullary cord tumour
Ependymoma, astrocytoma or haemangioblastoma arising within the spinal cord itself — the highest-stakes resection, monitored with SSEP, MEP and D-wave.
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Progressive myelopathy
Weakness, numbness or clumsiness in the legs, brisk reflexes, or new bladder symptoms — a cord under pressure needs urgent imaging.
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Radiculopathy from a nerve-root tumour
Persistent unilateral limb pain in a dermatomal pattern, sometimes with wasting — schwannomas classically present this way.
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Mechanical back pain, worse at rest
Night pain, pain lying flat, pain that wakes you — different from mechanical wear-and-tear and a red flag for a tumour.
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Spinal instability (high SINS score)
A Spinal Instability Neoplastic Score above 12, or a Bilsky grade with epidural cord compression, usually needs stabilisation as well as decompression.
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Red flag: cauda equina syndrome
Saddle numbness, new incontinence or acute leg weakness is a same-day A&E emergency — do not wait for a clinic appointment.
Procedure options
Open resection is not the only option.
The routes on the table for spinal tumours — from stereotactic radiotherapy to en-bloc spondylectomy — and where each one fits.
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Stereotactic spinal radiotherapy (SBRT)
Highly focused radiation in one to five fractions — increasingly first-line for radioresistant metastases where the cord is not compressed.
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Separation surgery + SBRT
A minimal decompression to create a safe margin around the cord, then post-operative SBRT — the modern standard for many symptomatic metastases.
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Laminectomy and tumour resection
The classical open approach — the posterior bony arch is removed to reach and excise the tumour, with instrumented fusion if the spine is destabilised.
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Laminoplasty (paediatric and select adult)
The lamina is lifted, the tumour resected, and the bone reconstructed to preserve posterior stability — preferred in younger patients and long-segment intradural tumours.
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Microneurosurgical intramedullary resection
Microscopic dissection of a tumour within the cord itself, with CUSA aspirator, intraoperative ultrasound, and SSEP, MEP and D-wave monitoring throughout.
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En-bloc spondylectomy
Whole-vertebra removal for primary bone tumours — chordoma, chondrosarcoma or aggressive benign lesions — where wide margins change survival.
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Pedicle screw stabilisation
Instrumented fusion above and below the affected level when SINS shows instability, or when tumour resection has removed load-bearing bone.
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CT-guided biopsy
Where the primary is unknown, a percutaneous needle biopsy under CT guidance confirms histology before any major decision is made.
Our vetted UK network
A small panel of spinal oncology surgeons, we picked them.
Consultant spinal neurosurgeons in London, Oxford, Cambridge and Manchester, each operating inside a spinal oncology MDT. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every spinal surgeon in our network.
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Consultant spinal neurosurgeons on the SBNS or BASS specialist register
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Weekly spinal oncology MDT with radiation and medical oncology input
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Intraoperative neuromonitoring (SSEP, MEP, D-wave) available for every intradural case
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Access to stereotactic spinal radiotherapy and interventional radiology on the same site
Safety and recovery
What to expect afterwards — honestly.
Spinal tumour surgery is high-stakes but well-trodden ground when it is done by a specialist team. The risks worth understanding in advance are the neurological ones, the wound-healing ones, and the long-term surveillance plan.
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Neurological worsening is the main risk
Any spinal tumour surgery can temporarily or permanently worsen weakness, numbness or bladder function. The rate is highest for intramedullary tumours (10–30%) and much lower for extradural metastases and meningiomas.
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CSF leak and pseudomeningocoele
Opening the dura carries a small risk of cerebrospinal fluid leak, sometimes needing bed rest, a lumbar drain, or a return to theatre. Modern closure techniques keep the rate low.
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Wound complications and infection
Deep infection rates are around 1–3% and higher after radiotherapy. Careful skin closure, antibiotics and early physiotherapy reduce the risk.
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DVT and pulmonary embolus
Cancer, surgery and reduced mobility together raise the clot risk — chemical and mechanical prophylaxis start the day of surgery unless the surgeon advises otherwise.
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Instrumentation loosening and adjacent segment disease
Pedicle screws can loosen, particularly in irradiated or osteoporotic bone, and the segments above and below a fusion carry extra load over time.
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Recurrence and further treatment
Even after complete resection, some tumours recur and need repeat surgery, SBRT or systemic therapy. Long-term MRI surveillance is standard.
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Radiation-induced myelopathy is rare with modern SBRT
Stereotactic planning keeps cord dose within safe constraints — clinically significant radiation myelopathy is now uncommon.
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Mortality is low for elective, higher for emergency
Perioperative death is rare in planned surgery and considerably higher in emergency cauda equina or high-grade cord compression — one reason not to delay imaging.
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Red flags after surgery
New weakness, loss of bladder or bowel control, spreading redness, a clear fluid leak from the wound, or a fever above 38 °C — call the ward or attend A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever approach was used, the note the neurosurgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Diagnosis, level and approach
The tumour type, spinal level, Bilsky grade if metastatic, SINS score, and the surgical approach — posterior, anterior or combined.
- 02 Technique
Resection, monitoring and instrumentation
What was removed, whether the resection was gross-total or subtotal, the neuromonitoring signals throughout, and any pedicle screws or cages used.
- 03 Findings
Histology and margins
The pathologist’s report — tumour type, grade, molecular markers where relevant, and whether the margins are clear. This drives the adjuvant plan.
- 04 Impression
Rehab, adjuvant plan and surveillance MRI
Read this first: physiotherapy plan, whether radiotherapy or chemotherapy is coming next, when to drive, and the schedule for follow-up MRI.
Recognised by major UK insurers
Cover for spinal tumour surgery varies by insurer and by tumour type — most oncological indications are covered under standard policies with pre-authorisation. We confirm cover before booking.
Frequently asked
Everything we get asked about spinal tumour surgery.
Straight answers on diagnosis, decisions, surgery and recovery — written for patients and families, not clinicians.
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What is a spinal tumour and how are they classified?
A spinal tumour is any growth in or around the spinal cord and its coverings. They are grouped by where they sit: extradural (outside the dura, mostly metastases from breast, lung, prostate, renal or myeloma), intradural extramedullary (inside the dura but outside the cord — meningioma, schwannoma, neurofibroma), and intramedullary (within the cord itself — ependymoma, astrocytoma, haemangioblastoma). The category drives almost every treatment decision.
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What symptoms suggest a spinal tumour rather than ordinary back pain?
Mechanical back pain that is worse at rest or at night, radicular pain in a dermatomal pattern, progressive weakness or numbness in the legs, clumsy hands, or new bladder or bowel disturbance. Cauda equina symptoms — saddle numbness and acute incontinence — are an emergency.
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How is the diagnosis confirmed?
Contrast MRI of the whole spine is the primary investigation. CT clarifies bony architecture and stability, PET-CT looks for a primary or other sites of disease, and CT-guided biopsy is used when the histology is not already known from another site.
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What are SINS, Bilsky and NOMS?
They are the three frameworks used in modern spinal oncology. SINS (Spinal Instability Neoplastic Score) grades mechanical stability. Bilsky grades epidural spinal cord compression from 0 to 3. NOMS (Neurologic, Oncologic, Mechanical, Systemic) is the decision tool that combines cord compression, tumour radiosensitivity, spinal stability and how well you are systemically to choose between SBRT, surgery, or combined treatment.
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Is surgery always needed, or can radiotherapy alone work?
No — modern stereotactic spinal radiotherapy (SBRT) can control many metastases without open surgery, particularly where the cord is not compressed. Where compression exists and the tumour is radioresistant, separation surgery followed by SBRT is often preferred over aggressive resection.
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What happens during the operation?
You are under general anaesthetic, usually prone, with intraoperative neuromonitoring throughout. Depending on the tumour, the surgeon uses laminectomy or laminoplasty to reach it, then microsurgical resection with a CUSA aspirator, intraoperative ultrasound, and image-guided navigation. Pedicle screws are added if the spine is unstable.
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How long is the recovery, and when can I drive?
Most patients stay five to fourteen days after open surgery. Physiotherapy starts on day one. Driving is not permitted until you meet DVLA criteria for a neurosurgical procedure — usually four to six weeks minimum, and you must inform the DVLA.
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What are the main risks I should know about?
The most important is neurological worsening, which ranges from a few per cent for extradural metastases to 10–30% for intramedullary tumours. Other risks include CSF leak, wound infection, DVT or PE, instrumentation loosening, tumour recurrence, and rarely radiation-induced myelopathy. Perioperative mortality is very low in elective work and higher in emergency cases.
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