Consultant spinal surgeon
Mr Tomasz Wren
FRCS (Tr & Orth). Lumbar and cervical surgery, and second opinions before an operation.
Tab. I · The human spine · 33 vertebrae
Your spine, explained.
A private spine clinic in Marylebone. Scroll, and travel down a spine the way we will travel down yours: level by level, before anyone mentions surgery.
AC1–C7 · The neck
Seven bones carry your head.
About five kilograms, balanced all day. When a neck disc presses on a nerve, the pain can travel into the shoulder and down the arm.
BC7–T1 · Where the neck meets the back
The hinge you never notice.
Run a finger down the back of your neck: the bump where it stops is C7. Hours at a screen load this joint more than most people expect.
CT1–T12 · Between the shoulders
Twelve hold your ribs.
Seen from behind, every bone shows its spine, the ridge you can feel under the skin. Pain here usually comes from muscles and joints, and most of it settles with movement.
DL1–L5 · The lower back
Five bones take the weight.
The biggest vertebrae in the body, and the discs between them work the hardest. This is where most back pain begins.
Tab. VI · Where does it hurt?
Point to where it hurts.
Choose an area. The spine lights the levels involved, and the plate tells you what usually causes it.
- What it often is
- Stiff joints or a worn disc in the neck. When a disc presses a nerve, pain can run into the shoulder and arm.
- What we try first
- Gentle movement, changes at your desk and short-term pain relief.
- When surgery comes up
- If weakness or numbness in the arm grows, or pain lasts after months of good care.
- Go to A&E now if
- Both arms or legs suddenly feel weak, walking becomes hard, or you lose bladder control.
- What it often is
- Muscles and the small joints where the ribs meet the spine. Rarely a disc.
- What we try first
- Movement and strengthening. Most of it settles within weeks.
- When surgery comes up
- Almost never for this area.
- Go to A&E now if
- You have chest pain or breathlessness, or the pain began after a fall or a crash.
- What it often is
- A strained muscle, ligament or joint. Discs change with age, and that is usually normal.
- What we try first
- Staying active, a guided exercise plan and short-term pain relief.
- When surgery comes up
- Rarely for back pain alone; more often when a nerve is trapped.
- Go to A&E now if
- You feel numb between your legs, lose bladder or bowel control, or both legs feel weak.
- What it often is
- A disc between L4 and S1 pressing on the nerve that runs to the leg. This is sciatica.
- What we try first
- Activity, physiotherapy and pain relief. Most people improve within weeks.
- When surgery comes up
- If pain has not settled after several weeks of good care, or the leg is getting weaker.
- Go to A&E now if
- You feel numb between your legs, lose bladder or bowel control, or both legs feel weak.
EL4–L5 · The disc that hurts
Where it hurts, we take it apart.
When a disc bulges onto a nerve, the pain can run down one leg. On your first visit we open your own scan in 3D and show you which disc, and which nerve.
EThe care path
Surgery is the last chapter.
- ConsultationAn hour with a consultant, your MRI open in 3D.
- MovementA plan with our physiotherapists, usually 6–12 weeks.
- InjectionOnly when your scan and your symptoms agree.
- SurgeryOnly if it will help, and never on the first visit.
Tab. IX · What your first visit includes
Four things in the first hour.
A full hour with a consultant. No eight-minute slots, and no rushing to the next patient.
We load your MRI into the 3D viewer and turn it with you, level by level.
Movement, injection, surgery or simply waiting, each with honest odds for someone like you.
You leave with a written one-page plan, and we send it to your GP if you want.
Your care team: a spinal surgeon, a pain specialist and a physiotherapist.
Next free · Mon 19 Oct
Tab. X · Clinicians
The people who read your scan.
Consultant in pain medicine
Dr Amara Okafor
FRCA, FFPMRCA. Image-guided injections and pain that has outlasted its cause.
Lead physiotherapist
Leah Marsh
MSc Musculoskeletal Physiotherapy. Builds every movement plan around the level that hurts.
Tab. XI · Fees, self-pay or insured
Fees, in plain sight.
First look
£250per visit
- A 60-minute consultation
- Your existing scan opened in 3D
- A one-page written plan
Full picture
£650all included
- A 60-minute consultation
- A new MRI scan
- Your scan reviewed together in 3D
- A follow-up within two weeks
Recovery
£690six sessions
- Six physiotherapy sessions
- A movement plan built on your scan
- A consultant review at week six
Your visit
Book this visit£250
Paid on the day. No referral needed.
Tab. XII · Guides for patients
Read before you come.
Tab. XIII · Fabrica · Marylebone, London W1
See it before you decide.
Named after Vesalius’ De humani corporis fabrica, 1543, the book that first drew the body so anyone could see it. His first skeleton stands behind the spine.