In this section...

  1. Acute Physiotherapy
  2. Cheshire and Merseyside Rehabilitation Network (CMRN)
  3. Chiari malformation and syringomyella
  4. Cognitive neurology
  5. Complex regional pain syndrome (CRPS)
  6. Dietetic Services
  7. Electroencephalogram (EEG)
  8. Endoscopic (keyhole) spinal surgery
  9. Epilepsy
  10. Epilepsy specialist nurse service
  11. Epilepsy surgery
  12. Essential tremor - Ultrasound thalamotomy
  13. Evoked potentials (EP)
  14. Facial pain
  15. Fluroscopy
  16. Functional Neurological Disorders Service (FNDS)
  17. Headache service
  18. Hydrocephalus, CSF disorders and spina bifida
  19. Infection prevention and control
  20. Integrated Neurology Nurse Service
  21. Interventional Radiology
  22. Major Trauma service
  23. Motor neurone disease
  24. Multiple sclerosis
  25. Multiple sclerosis (MS) nurse service
  26. Nerve conduction studies (NCS) and Electromyography (EMG)
  27. Neuroanaesthesia and Critical Care
  28. Neurogenetic disorders
  29. Neurological long-term conditions OT service
  30. Neurological Long Term Conditions Physiotherapy Team (LTC)
  31. Neurology
  32. Neuromodulation for Pain and Pelvic Floor Instability
  33. Neuromuscular disorders
  34. Neuromyelitis optica
  35. Neuro-Oncology Department
  36. Neuropathic pain (nerve pain)
  37. Neurophysiology Department
  38. Neuropsychiatry
  39. Neuropsychology Department
  40. Neuropsychology inpatient service
  41. Neuroradiology
  42. Neuroscience Laboratories
  43. Neurosurgery
  44. Neurovascular surgery and intervention
  45. Pain Management Programme
  46. Pain medicine
  47. Palliative care pain
  48. Parkinson's disease Nurse Specialists
  49. Pre-operative Assessment Team
  50. Physiotherapy botulinum toxin service
  51. Rehabilitation
  52. Research
  53. Respiratory Physiotherapy Team
  54. Speech and Language Therapy
  55. Spinal surgery
  56. Surgical management of chronic pain
  57. Surgical, Medical, Acute Response Team (SMART)
  58. Theatres
  59. Therapies Department
  60. Tissue viability
  61. Trauma Therapy Team

Surgical management of chronic pain

 

Techniques

Spinal cord stimulation, lesions – open cordotomy and dorsal root entry zone lesioning.

 

Indications

  • Chronic neuropathic pain; chronic non-malignant pain, including refractory low back pain 
  • Cancer pain – Treatment for the primary condition, lesions and intrathecal drug delivery systems.

Outcomes are viewed as critically important and over the years the neurosurgical service has several publications to attest to this.

 

Trigeminal neuralgia and other facial pain

There is a major interest in the management of trigeminal neuralgia, and The Walton Centre has an international reputation for this, evidenced by many publications on the subject.

Trigeminal neuralgia is managed by the neurosurgeons who will deliver microvascular decompression as first-line treatment, medical management and foramen ovale procedures. There is a further interest in other neuralgic pain due to compression syndromes, including hemifacial spasm, tinnitus, otalgia, glossopharyngeal neuralgia.

A joint facial pain clinic is run with neurology, pain medicine for cases of diagnostic difficulty; for trigeminal autonomic cephalgias, including cluster headaches, occipital nerve stimulation is provided, and for some difficult facial neuropathic pains deep brain stimulation may be appropriate. They can also be supported by a facial pain management programme in most challenging to manage facial pain.

Many of these techniques involve implanted devices – these are supported on a day-to-day basis by a team of specialist nurses and physiotherapists working for the neuromodulation service with close support and supervision from the pain and neurosurgical service. There is an intrathecal drug delivery system pump refill clinic, spinal cord stimulator clinics and deep brain stimulation clinics

 

Contact information

0151 556 3368
 

Leaflets

Cervical Cordotomy

Cervical Epidural Injection

Saddle neurolytic block

Trigger point injections

Ways to cope with reducing opioid medication

 

Consultants

Mr Jibril Osman Farah

Ms Deepti Bhargava