Concierge spinal surgery · UK
Private lumbar spine microsurgery in the UK, through a smaller corridor.
The operating microscope and tubular retractors let a surgeon do the same decompression through a two-centimetre window instead of stripping muscle off the spine. It is a technique rather than an operation - and it applies across discectomy, decompression and foraminotomy.
Why patients choose us
- 01
Technique matched to anatomy, not to marketing
Minimally invasive is a means, not an end. Where an open approach would decompress better, that is the right operation and we will say so.
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Surgeons past the learning curve
Tubular and endoscopic techniques are genuinely harder to learn. Outcomes depend on volume, so we introduce surgeons who do this weekly.
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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 lumbar microsurgery costs in the UK.
Indicative ranges across our partner spinal units. Send the MRI report and a description of your symptoms and we quote firm figures for the operation proposed.
In short
A tubular microdiscectomy: £7,500–£13,000, usually a day case.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Spinal surgeon consultation | £250–£450 | 45 min | Same visit |
| Lumbar MRI | £400–£800 | 30 min | 24–48 hours |
| Microdiscectomy (tubular) | £7,500–£13,000 | 45–90 min | Day case |
| Tubular decompression (single level) | £9,000–£14,000 | 60–90 min | 0–1 night |
| Tubular decompression (two levels) | £12,000–£19,000 | 2 hours | 1–2 nights |
| Minimally invasive interbody fusion | £20,000–£32,000 | 3–4 hours | 2–4 nights |
Minimally invasive techniques often cost slightly more than the open equivalent because of the disposable instrumentation, though the shorter stay can offset that. What matters more than the price difference is whether the approach genuinely suits your anatomy. NHS spinal units increasingly offer these techniques, though availability varies. We come back with a firm quote within one working day.
The problem
A smaller wound is not automatically a better operation.
Minimally invasive spinal surgery reliably reduces muscle damage, blood loss and early post-operative pain. What it does not do is improve the long-term result, and in the wrong anatomy a restricted view can compromise the decompression that actually matters.
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Offered keyhole spinal surgery?
Ask specifically whether the same decompression can be achieved through the smaller corridor in your anatomy - that is the only question that matters.
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Worried about muscle damage?
Dilating rather than stripping muscle genuinely reduces early pain and speeds mobilisation. The benefit is real, and it is largely in the first few weeks.
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Severe multi-level stenosis?
This is where a wider open approach often serves better. A technique chosen for its name rather than the anatomy is the wrong reason to operate.
The journey
From enquiry to recovery - what happens, in order.
One spinal surgeon who chooses the approach after examining you and reviewing the imaging - not before.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
Admission and theatre
Phase 3 · After
Concierge, back on
- 01
Before
You send us the imaging
A short, confidential form and your lumbar MRI report, plus what your symptoms are, how long they have lasted, and any previous spinal surgery.
- 02
Before
We come back with a recommendation
Within one working day: whether a microsurgical approach is realistic for your anatomy, and which spinal surgeon does it regularly.
- 03
Before
We arrange the consultation
Usually within one to two weeks. Examination, imaging review, and a frank discussion of whether the smaller approach would compromise the decompression.
- 04
On the day
Admission and anaesthetic
Admission, consent - including consent to convert to an open approach if needed - and a discussion with the surgeon and anaesthetist.
- 05
On the day
The operation itself
45 minutes to two hours depending on what is being done. Muscle dilated rather than stripped, tubular retractor docked, and the work done under the microscope.
- 06
On the day
Home the same day or next
Walking within hours. Many microsurgical discectomies and single-level decompressions go home the same day, with less wound pain than an open approach.
- 07
After
Recovery and physiotherapy
Office work at two to four weeks, six-week lifting restrictions where a disc was operated on, and physiotherapy from around four to six weeks.
Typical end-to-end: 2–4 weeks from enquiry to surgery. Full recovery: 4–8 weeks.
When it helps
When a microsurgical approach fits.
The operations it suits well, the anatomy where an open approach serves better, and the emergency that overrides technique entirely.
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Lumbar disc herniation
The classic microsurgical indication. A tubular microdiscectomy removes the fragment through a two-centimetre corridor, usually as a day case.
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Lateral recess stenosis
Focal narrowing where the nerve root turns to leave the canal. Well suited to a targeted tubular laminotomy under the microscope.
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Single or two-level central stenosis
A unilateral approach with bilateral undercutting achieves a full decompression while leaving the opposite side's muscles and ligaments untouched.
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Foraminal and far lateral pathology
Fragments and narrowing outside the canal, reached through a muscle-splitting lateral corridor that avoids destabilising the facet joint.
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Synovial cysts
Facet joint cysts compressing a nerve root can be excised through a tubular retractor with minimal bone removal, preserving stability.
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Selected interbody fusions
Minimally invasive TLIF and lateral approaches use the same principles with longer instruments, reducing blood loss and muscle damage in fusion surgery.
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When open surgery is better
Severe multi-level stenosis, significant deformity, extensive revision through scar tissue, tumour and infection generally need the wider exposure.
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Red flag: cauda equina syndrome
Saddle numbness, difficulty passing or controlling urine, loss of bowel control or rapid bilateral leg weakness - A&E immediately, and the approach becomes secondary.
Technique options
What "minimally invasive" actually covers.
The techniques grouped under the term - and what each one changes.
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Microscopic open surgery
A conventional small midline incision with the operating microscope for magnification and light. The established UK standard for discectomy, and minimally invasive in every meaningful sense.
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Tubular retractor surgery
Sequential dilators split the muscle and a tube is docked on the bone, so muscle is pushed aside rather than stripped. The defining feature of MISS.
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Unilateral approach, bilateral decompression
Working down one tube and angling across the midline under the microscope to decompress both sides, leaving the opposite side entirely undisturbed.
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Full endoscopic surgery
A working-channel endoscope with continuous irrigation, sometimes performed under sedation. The smallest corridor of all, with the steepest learning curve.
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Minimally invasive TLIF
Interbody fusion through tubular retractors with percutaneous pedicle screws. Less blood loss and muscle damage than open fusion, with comparable fusion rates.
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Percutaneous pedicle screw fixation
Screws placed through stab incisions under fluoroscopic or navigation guidance, avoiding the extensive muscle stripping open instrumentation requires.
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Navigation and robotic assistance
Intraoperative CT navigation or robotic guidance improves screw accuracy and reduces radiation exposure, increasingly used alongside minimally invasive approaches.
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Conventional open surgery
Still the right answer for severe multi-level stenosis, deformity, tumour, infection and complex revision. A wider view is sometimes exactly what is needed.
Our vetted UK network
A small panel of spinal surgeons, we picked them.
Consultant spinal surgeons across UK units with genuine minimally invasive practice. Not listed publicly, and introductions are made privately once we understand your imaging.
Selection criteria
How we choose every spinal surgeon in our network.
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Surgeons performing tubular and microscopic techniques weekly, well past the learning curve
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Willingness to recommend an open approach where the anatomy calls for it
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Intraoperative fluoroscopy or navigation as standard, with attention to radiation dose
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Audited outcomes and reoperation rates, shared honestly at consultation
Safety and recovery
What to expect afterwards - honestly.
The complication profile is broadly the same as open surgery, with less wound pain and faster early mobilisation. The specific risks of the technique are the learning curve, wrong-level surgery, and an inadequate decompression through a restricted view.
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Conversion to an open approach
Sometimes the view is inadequate or bleeding obscures the field, and the safest thing is to open up. This is a judgement rather than a failure, and consent should cover it.
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The learning curve is real
Complication rates for tubular and endoscopic techniques fall substantially with surgeon experience. Volume matters more here than for conventional open surgery.
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Wrong-level surgery
Working through a small corridor without a wide anatomical view raises the importance of fluoroscopic level checking. Good practice makes it rare, but the risk is inherent to the approach.
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Incomplete decompression
A restricted view can leave residual stenosis, particularly in severe multi-level disease. This is the main reason open surgery is still preferred in some anatomy.
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Dural tear
Occurs at similar rates to open surgery, but is harder to repair down a narrow tube. Surgeons often use sealants or a period of bed rest rather than direct suturing.
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Radiation exposure
Minimally invasive approaches rely more on fluoroscopy, so radiation dose to patient and staff is higher unless navigation is used. Worth asking about.
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Long-term outcomes converge
By six to twelve months, results generally match open surgery. The benefit is concentrated in the first weeks - real, but worth understanding accurately.
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A smaller scar is not the point
The aim is less muscle damage and faster mobilisation. Choosing an approach for the appearance of the scar rather than the quality of the decompression is the wrong priority.
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Red flags after surgery
New or worsening leg weakness, difficulty passing urine, saddle numbness, fever, or clear fluid leaking from the wound - A&E or the spinal unit the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whether the surgery was microscopic, tubular or endoscopic, the note your surgeon writes 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
Indication and level
The diagnosis, which level and side were operated on, the MRI findings, and how they correlated with your examination.
- 02 Technique
Corridor and instrumentation
Incision size, whether dilators and a tubular retractor were used, microscope or endoscope, fluoroscopy or navigation, and whether conversion to open was needed.
- 03 Findings
Intraoperative findings
What was found through the corridor - fragment size, degree of stenosis, ligament thickness - any dural tear, and nerve root mobility at the end.
- 04 Impression
Recovery, restrictions and review
Read this first: when to walk, drive and return to work, what lifting restrictions apply, when physiotherapy starts, and which symptoms mean calling.
Recognised by major UK insurers
Cover for spinal surgery is usually funded when medically indicated and supported by imaging, but insurers commonly require evidence that conservative treatment has been tried first, and several exclude spinal fusion and disc replacement or require pre-authorisation. Chronic back pain management and long courses of physiotherapy are often capped. We check your policy wording before booking.
Frequently asked
Everything we get asked about lumbar spine microsurgery.
Quick answers on whether keyhole is better, recovery time, which operations it covers, and how to judge a surgeon.
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Is minimally invasive spine surgery better than open surgery?
Better in the short term, equivalent in the long term. Tubular techniques reliably reduce muscle damage, blood loss, wound pain and length of stay, and get people moving sooner. By six to twelve months, outcomes converge with open surgery. The important caveat is that in severe multi-level stenosis or complex revision, a wider open approach may achieve a better decompression - and the decompression is what determines the result.
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What is the difference between microsurgery and minimally invasive surgery?
Microsurgery refers to using the operating microscope for magnification and illumination, which has been standard in UK lumbar discectomy for decades. Minimally invasive surgery usually implies tubular retractors that split rather than strip muscle. The two are often combined, and the terms are used loosely - which is why it is worth asking exactly what is planned.
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How much does lumbar microsurgery cost in the UK?
A tubular microdiscectomy runs £7,500–£13,000, single-level tubular decompression £9,000–£14,000, two levels £12,000–£19,000, and minimally invasive interbody fusion £20,000–£32,000. Disposable instrumentation makes these slightly more than the open equivalents, offset somewhat by shorter stays. We confirm firm figures within one working day.
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How long is recovery?
Faster than open surgery in the early weeks. Many microdiscectomies and single-level decompressions are day cases, with walking within hours. Office work usually resumes at two to four weeks. Where a disc has been operated on, the same six-week bending and lifting restrictions apply, because the annulus heals at its own pace regardless of incision size.
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Which operations can be done this way?
Discectomy, laminotomy, unilateral approach with bilateral decompression, foraminotomy, far lateral discectomy, synovial cyst excision, and selected interbody fusions with percutaneous screws. What it suits less well is severe multi-level stenosis, significant deformity, extensive revision through scar tissue, and tumour or infection needing wide exposure.
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Does a smaller scar mean a better result?
No, and this is worth being clear about. The scar is the least important part. The benefit of a minimally invasive approach comes from less muscle disruption, which reduces early pain and speeds mobilisation. If a smaller corridor compromises the decompression, the cosmetic gain is worthless.
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How do I judge whether a surgeon is good at this?
Ask how many they perform a year, what proportion they convert to open, what their reoperation rate is, and - most usefully - in what circumstances they would advise an open approach instead. A surgeon who says minimally invasive is always better is telling you about their marketing rather than their judgement.
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Is there more radiation involved?
Generally yes, because working through a small corridor relies more on fluoroscopy to confirm the level and instrument position. Intraoperative navigation and modern low-dose protocols reduce this substantially, and it is a fair question to ask, particularly for younger patients.
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What if the surgeon has to convert to open surgery?
It happens, and it is a sign of good judgement rather than failure. If the view is inadequate, bleeding obscures the field, or the decompression cannot be completed safely through the tube, opening up is the correct decision. Consent should cover this possibility explicitly before the operation.
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When should I go to A&E rather than call the clinic?
New or worsening leg weakness, difficulty passing urine, numbness in the saddle area, fever, or clear fluid leaking from the wound. Before surgery, that same combination suggests cauda equina syndrome and needs assessment within hours regardless of what is planned.
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