Frequently Asked Questions

Spine surgeon's hands over a spine model - Spine Care.

Where can I see Mr Karpe for a consultation?

Mr Karpe works in a private setup at:
Woodland’s Hospital, Darlington.
Nuffield Health Tees Hospital, Stockton on Tees.

For all appointments and queries, please call 07771112322 or click here for an online query. This referral can be done by patients, general practitioners, physiotherapists, osteopaths, or chiropractors.

Mr Karpe also works in the NHS setting at James Cook University Hospital in Middlesborough and the University Hospital of North Tees, Stockton on Tees. These appointments are usually done through GPs or Extended Scope Physiotherapists.

What items must I bring along when I arrive for my scheduled appointment?

It is recommended to show up 10-15 minutes before your appointment to complete a health questionnaire and the registration process. Please remember to bring:
• Driver’s License or a valid ID
• Insurance information
• Referral Letter (if required)
• Reports, X-rays, MRIs, CT scans etc. and any other relevant information
• List of medications (if any)

Do I need a referral if I need to see Mr Karpe?

Self-funding patients don’t need to. It is generally recommended to have a referral letter from your family doctor. They may provide relevant medical information to help with your diagnosis and save time.Insured patients will need a referral letter. You are welcome to refer patients to us if you are a physiotherapist, chiropractor, osteopath, or other specialists such as neurologists or rheumatologists.

What should I expect at my first appointment?

When you come in for your appointment, I will ask you questions about your illness. This will be followed by an examination to make a diagnosis.Additional investigations may be needed, like X-rays, MRI, CT or blood investigations.
‍On occasions, it may be possible to accomplish these tasks in a single visit, but there are instances where more than one appointment may be necessary.

How do I prepare for the appointment?

Prior to meeting with a specialist, it is beneficial to prepare by jotting down the following details:
• Nature and duration of any symptoms you have been experiencing.
• Pertinent personal information, such as recent changes or events in your life
• Any other health conditions that you are undergoing.
• Any questions that you may have regarding your condition?
• If you have undergone any tests in the past for your symptoms, please remember to bring the results to your appointment.

Do all spinal conditions need surgery?

No, not all spinal conditions require surgery. Treatment options for spinal conditions vary depending on the specific condition and its severity. Non-surgical options such as physical therapy, medication, and lifestyle modifications are often considered before surgery is recommended. Surgery may be necessary in cases where conservative treatments have failed to alleviate symptoms or if there is a risk of further damage or injury to the spine or spinal cord. Like, in cases of sciatica, emergency surgery may be necessary if bladder or bowel control is lost. Another reason to consider prompt intervention is if leg weakness accompanies the pain.

What options are available for funding my treatment?

Patients often choose to use their private or company health insurance to have more control over the timing and location of their consultation or surgery. It is possible to arrange a private consultation directly, but it is recommended to have a referral letter from your family doctor. It is also important to inform your family doctor about any planned treatment, as they may have relevant medical information that could save time and help with investigations. If you are considering private treatment, it is recommended to discuss it with your private healthcare insurer to clarify any financial limits or exclusions on your policy. Any balances not covered by your private health insurance will be discussed, and a quote or invoice will be provided.Before any treatment or procedure, you will need to provide the private hospital with your insurance company details and policy number for pre-authorization for your private treatment. Sometimes, your insurer may provide an authorisation number for you to quote.For patients who are funding their treatment themselves, cost estimates will be provided in advance, and payment is required before any procedure is undertaken. If you have any questions about payments, please contact 07771112322 or email

Does Mr Karpe see patients with private health insurance?

Yes, Mr Karpe works with BUPA, AVIVA, AXA PPP, Alliance,Vitality, and many other major insurance companies and works within their practice guidelines. Please call on 07771112322 to confirm your insurance cover. 

How much are Mr Karpe’s consultation fees?

New patient consultation is £250. Follow-up consultation is billed £150.

I have had my investigations elsewhere. Can I still see Mr Karpe?

Yes. But investigations like MRI, X-rays or CT scans will need to be brought on a CD to be transferred to private/NHS system.

Does Mr Karpe do Telemedicine consultations?

Yes. Telemedicine has its advantages, as it enables one to receive healthcare services from the comfort of their home, eliminating the need to travel long distances. One can schedule an appointment at a convenient time and provide specialised care that may not be available locally. However, on occasions, a face-to-face appointment will be arranged if there are further queries or an in-person examination is needed.

What are spinal injections, and how do they work?

Spinal injections refer to the administration of medication into the spine to alleviate pain, inflammation, or other symptoms related to spinal conditions. There are several types of spinal injections, including epidural injections, facet joint injections, and sacroiliac joint injections, among others. Please refer to procedure lists for details about specific injections.

What conditions are treated with spinal injections?

Spinal injections are used to treat a variety of conditions that cause pain or inflammation in the spine or surrounding areas. Some of the most common conditions that may be treated with spinal injections include:
• Herniated or bulging discs: These conditions occur when the soft tissue inside the spinal disc bulges or ruptures, causing pressure on the nerves in the spine and resulting in pain or weakness in the affected area.
• Spinal stenosis: This condition refers to the narrowing of the spinal canal, which can put pressure on the spinal cord and nerves and cause pain, numbness, or weakness in the arms, legs, or back.
• Arthritis: Arthritis is a chronic condition that causes inflammation in the joints, including those in the spine. This inflammation can cause pain, stiffness, and limited mobility.
• Sciatica: Sciatica is a condition characterised by pain that radiates from the lower back into the legs and is often caused by pressure on the sciatic nerve.
• Spondylolisthesis: This condition occurs when one vertebra in the spine slips out of place, putting pressure on the nerves in the surrounding area and causing pain or weakness.
Please refer to the conditions and procedure lists for more details about specific injections.

How long does a spinal injection take?

The duration of a spinal injection procedure can vary depending on the type of injection being performed, the complexity of the procedure, and the individual patient's needs. In general, however, most spinal injections take anywhere from 10 to 30 minutes to complete.

Will I need to have more than one injection?

Whether or not a patient will need more than one spinal injection depends on a variety of factors, including the underlying condition being treated, the severity of the symptoms, and the individual patient's response to the initial injection.In many cases, a single spinal injection can provide significant relief from pain or inflammation for several weeks or even months. However, in some cases, the effects of the injection may wear off over time, or the patient may experience a recurrence of symptoms.If this occurs, the surgeon may recommend additional injections as part of an ongoing treatment plan.It's important to note that while spinal injections can provide significant relief from pain and inflammation, they are not typically considered a cure for the underlying condition.

Is sedation or anaesthesia used during the injection procedure?

In most cases, sedation or general anaesthesia is not necessary for spinal injection procedures. These procedures are typically performed using local anaesthesia, which numbs the area around the injection site to minimise discomfort.
In some cases, however, sedation or light anaesthesia is offered to patients who are particularly anxious or uncomfortable during the procedure. This may involve the administration of a mild sedative medication to help the patient relax.Patients who have concerns about discomfort during the procedure or who have a history of anxiety may wish to discuss their options and whether, prior to the injection, sedation may be appropriate.

How soon can I resume my normal activities after a spinal injection?

The timing for resuming normal activities after a spinal injection can vary depending on the individual patient's response to the injection, the type of injection performed, and the surgeon's recommendations. In general, however, most patients can resume their normal activities relatively quickly after the injection.Patients may be advised to take it easy for the remainder of the day after the injection, avoiding any strenuous activities or heavy lifting. They may also be advised to avoid driving for a few hours after the injection, as the medication may cause drowsiness or temporary weakness in the affected area.After the first day, patients can typically resume their normal activities, including work, exercise, and other daily tasks. However, it's important to listen to the body and avoid any activities that cause discomfort or pain.

How do I know if spinal injections are right for me?

The decision to undergo spinal injections as a treatment for spinal conditions should be made in consultation with your surgeon, who can evaluate your individual situation and determine whether this treatment is appropriate for you.To determine if spinal injections are right for you, your surgeon will likely conduct an evaluation, which may include a physical exam, medical history review, imaging studies, and other tests as needed. They will then discuss the potential risks and benefits of the procedure with you, including the potential for pain relief, the risks of complications, and the likelihood of needing other treatments.

If I do need surgery, what is the process?

You will be explained the conditions, the natural history and available treatment options.You will also be explained the risks and benefits of available options.
If you agree with surgery, you will be taken through the consent process.

What is the consent process?

Consent for surgery/intervention refers to the process by which a patient gives permission to undergo a surgical procedure after being fully informed about the risks, benefits, and alternatives of the procedure. This process involves a discussion between the patient and their healthcare provider, during which the surgeon explains the details of the procedure, the potential risks and complications, the expected benefits and outcomes, and any alternative treatment options. The patient is also given an opportunity to ask questions and clarify any concerns before making an informed decision about whether to proceed with the surgery.

What is minimally invasive spinal surgery?

Minimally invasive spinal surgery (MISS) is a surgical technique used to treat spinal conditions with less disruption to the surrounding muscles and tissues. This technique uses smaller incisions and specialised instruments that allow the surgeon to access the spine with minimal damage to the surrounding structures.Minimally invasive spinal surgery has several advantages over traditional open surgery, including smaller incisions, less blood loss, reduced risk of infection, shorter hospital stays, and faster recovery times.Although minimally invasive spinal surgery is suitable for many spinal conditions, it is not always an option for all spinal procedures. The appropriateness of this surgical technique depends on the individual patient's situation and the specific condition being treated. Traditional open surgery may be necessary to achieve the best outcome for certain spinal conditions, such as spinal fractures, complex spinal deformities, or advanced spinal tumours. It may be required to perform adequate decompression, stabilisation, or tumour removal.

Does Mr Karpe use surgical loupes or a microscope?

Mr Karpe believes that magnification (surgical loupes or microscope) is vital for spinal surgery.
Magnification allows visualisation of the surgical site in greater detail, providing a clearer and more precise view of the structures being operated on. This can help surgeons identify small or delicate structures, such as nerves or blood vessels, and avoid damaging them during surgery. Magnification can help reduce the risk of complications during surgery, as it allows surgeons to see the surgical site more clearly and avoid damaging surrounding tissues or structures. As one can perform spinal surgery with smaller incisions, resulting in less tissue damage and a shorter recovery time for the patient.

What should I expect on the day of spine surgery?

On the day of spine surgery, you should expect to arrive at the hospital or surgical centre several hours before your scheduled procedure. You will likely be asked to change into a hospital gown and may have to provide a urine sample for testing. Your vital signs, such as blood pressure, heart rate, and oxygen saturation, will be monitored by a nurse.You will meet with your anaesthesiologist to rediscuss the type of anaesthesia that will be used during the procedure. You may be given medication to help you relax before being taken to the operating room.Once in the operating room, you will be positioned on the operating table and given anaesthesia to put you to sleep. The surgical team will then prepare the area of your spine that will be operated on by cleaning and sterilising the skin.The surgical team will use specialised tools and techniques to perform the surgery on your spine during the procedure. Depending on the type of procedure you are having, the surgery may take several hours.After the surgery is complete, you will be taken to a recovery room, where you will be monitored closely as you wake up from the anaesthesia. You will likely feel groggy and disoriented for several hours after the procedure.Once you are stable, you will be transferred to a hospital room where you will stay for a few days to recover before being discharged. Your surgical team will provide you with detailed instructions for post-surgery care and rehabilitation, which may include physical therapy and medication management.

How do I prepare for spine surgery?

Preparing for spine surgery is an important part of ensuring a successful outcome. Here are some general steps to prepare for spine surgery:
• Follow pre-surgery instructions: We will provide you with detailed instructions on how to prepare for the surgery, including what medications to stop taking and when to stop eating and drinking. Be sure to follow these instructions carefully.
• Arrange for help at home: You may need assistance with daily activities after the surgery, such as cooking, cleaning, and getting dressed. Arrange for a family member or friend to stay with you or help you at home during your recovery.
• Prepare your home: Make your home safe and comfortable for your recovery. Remove clutter, secure loose rugs or carpets, and install handrails or grab bars as needed. You may also need to rearrange furniture to make it easier to move around.
• Prepare for transportation: Arrange for someone to drive you to and from the hospital on the day of the surgery. You may also need to schedule transportation for follow-up appointments with your surgeon.
• Stop smoking: Smoking can interfere with healing and increase the risk of complications after surgery. If you smoke, try quitting or reducing your smoking before the surgery.
• Build your strength: Strengthening your body before the surgery can help you recover faster. Your surgeon may recommend exercises or physical therapy to improve your strength and flexibility.
• Manage your medications: Talk to your surgeon about which medications you should stop taking before the surgery and which ones you should continue taking. Make sure you have enough medication on hand for after the surgery.
• Prepare mentally and emotionally: Spine surgery can be a stressful experience, so it's important to prepare yourself mentally and emotionally. Talk to your surgeon and loved ones about any concerns you have and ask questions to alleviate any fears or anxiety you may have.

How long will I need to stay in the hospital after spine surgery?

The length of hospital stay after spine surgery will depend on several factors, including the type of surgery performed, your overall health, and your individual recovery progress. Some patients may be able to go home on the same day as the surgery, while others may need to stay in the hospital for several days or even a week.For example, patients who undergo minimally invasive spine surgery (MISS) may be able to go home the same day or the next day after the surgery, while patients who undergo more complex surgeries or spinal fusion may need to stay in the hospital for several days.Our team will monitor your progress after the surgery and determine when it's safe for you to leave the hospital. They will evaluate your pain level, ability to move, and other factors to determine if you are ready for discharge.

Will I be awake during spine surgery?

In most cases, patients are put under general anaesthesia during spine surgery, which means that they will be asleep and not feel any pain or discomfort during the procedure.
However, in some cases, surgeons may use local anaesthesia or conscious sedation to perform certain types of minimally invasive spine surgery procedures. In these cases, the patient may be awake but sedated and will not feel any pain during the surgery. The surgeon will also numb the area around the surgery site to minimise any discomfort.Mr Karpe will discuss with you the type of anaesthesia that will be used during your surgery and explain what to expect. It's important to follow instructions for preparing for the surgery, which may include avoiding eating or drinking for a certain period before the surgery.It's also important to discuss any concerns or questions you may have about the anaesthesia before the surgery to help alleviate any anxiety you may have about the procedure.

What kind of follow-up care will I need after spine surgery?

The type of follow-up care you will need after spine surgery depends on the type of surgery you had and your individual recovery progress. In general, we will want to monitor your progress after the surgery to ensure that your incision is healing properly and that you are recovering as expected.Mr Karpe may schedule follow-up appointments with you after the surgery to check your progress and monitor any potential complications. During these appointments, your surgeon may perform imaging tests such as X-rays to evaluate your progress after the surgery.Depending on the type of surgery you had, we may recommend physical therapy or other forms of rehabilitation to help you regain strength, mobility, and function after the surgery. Your surgeon may also provide you with specific exercises or stretches to perform at home to aid in your recovery.

Can I drive after spine surgery?

In general, it is not recommended to drive immediately after spine surgery, as you may be still recovering or also be taking medications that can affect your reaction time, alertness, and coordination, which can also impair your ability to drive safely.In general, you will need to wait until you have regained sufficient strength, mobility, and coordination to control a vehicle safely. You may also need to have your pain medication dosage reduced or eliminated before you can safely resume driving.Whether you can drive after spine surgery will depend on several factors, including the type of surgery you had, the location of the surgical site, and your individual recovery progress. Like in lumbar decompression, most people feel ready to drive after 2 to 6 weeks, depending on the size of the operation.Some insurance companies don't insure drivers for several weeks after surgery, so check what your policy says before you start to drive.

When can I return to work after spine surgery?

The timing of your return to work after spine surgery will depend on several factors, including the type of surgery you had, your job requirements, and your individual recovery progress. In general, you should plan to take some time off from work after spine surgery to allow your body to heal and recover.We will likely provide you with specific instructions regarding when you can safely return to work based on your individual recovery progress. In general, the amount of time you will need to take off from work will vary depending on the type of surgery you had and the physical demands of your job.
For example, suppose you have a sedentary desk job that does not require lifting or physical exertion. In that case, you may be able to return to work sooner than if you have a job that involves heavy lifting, bending, or physical activity. Your surgeon may recommend that you take several weeks off from work after spine surgery to allow your body to heal and recover.
Like in lumbar decompression, most people return to work after 4 to 8 weeks if their job isn't too strenuous.If your job involves much driving, lifting heavy items or other strenuous activities, you may need to be off work for up to 3 to 6 months.

I have paediatric scoliosis that needs surgery. Where will the surgery be done?

While Mr Karpe does see paediatric spinal patients in private, the surgeries for paediatric scoliosis are done only in an NHS setup.He performs these surgeries at James Cook University Hospital, where there is a High Dependency backup and other equipment needed during the procedure.Other simple procedures can be done in a private setup.

What set of principles does Mr Karpe base his practice upon?

Mr Karpe relies on patient-centred care placing their safety and comfort above all else. He believes in evidence-based practice, wherein only treatment options based on the best available scientific evidence will be offered. He believes in a team-based approach involving a range of healthcare providers, including physical therapists, pain specialists, and other surgical specialists.Mr Karpe recognises the importance of effective communication with their patients, explaining treatment options, risks, and benefits in a clear and understandable way.