Spire Healthcare Group Plc · LSE:SPI
Spire Healthcare — Investor Presentation (February 2011)
63 slides from Spire Healthcare's investor presentation, Feb 12, 2011
Slide 1: Clinical Cases
CLINICAL CASES Arif Khan FRCS.MSc orth,FRCS orth Consultant Orthopaedic/Spinal Surgeon Whipps Cross University Hospital Spire Roding Hospital
Slide 2: Cervical Spine Trauma
CERVICAL SPINE TRAUMA B.M 73 yr old male Fell backwards at home. Patient complained of pain in back of neck and inability to fully move his neck. There were no neurological symptoms. He did not lose consciousness or other complains. His cervical spine was immobilised in a hard collar and blocks by A
Slide 3: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 4: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 5: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 6: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 7: Back Pain with Claudication
BACK PAIN WITH CLAUDICATION C.I 68 Yr old female This lady was seen in clinic with c/o increasing lower back and bilateral leg pain She also complained that she had lost almost 3 inches in hieght Back pain was aggravated with movement Was getting severe pain and numbness in both legs and was also ge
Slide 8: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 9: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 10: Cervical Radiculopathy
CERVICAL RADICULOPATHY C.M 43 yr old male Presented with complain of pain in left shoulder and arm with pins /needles since last 5 mths Was initially seen in shoulder clinic and intrinsic shoulder problem was ruled out after mri of shoulder and c spine. EMG showed severe C7 and C8 root compression o
Slide 11: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 12: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 13: Spinal Infection
SPINAL INFECTION G.N 67 yr old asian male Presented with c/o paraparesis of 4 weeks duration He developed vague pain around thoraco-lumbar region about 3 mths prior to development of weakness There was h/o of recent wt loss and night sweats . He noticed some weakness and pain in his lower limbs a mo
Slide 14: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 15: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 16: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 17: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 18: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 19: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 20: Spinal Infection
SPINAL INFECTION Culture confirmed Tuberculosis and anti-tuberculos therapy was started. Patient was apparently taking tablets but nurses found tablets few days later in the waste bin next to his bed. He then refused to take any medicine orally. He was assessed by Psychiatrists and was sectioned and
Slide 21: Spinal Infection
SPINAL INFECTION M.T 54 yr old female Presented with c/o increasing low back pain since last 3 mths At presentation was unable to stand up b/c of severe pain She had no leg symptoms and was walking without any problem except severe low back pain There was no h/o fever ,wt loss, or any other focus of
Slide 22: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 23: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 24: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 25: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 26: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME N.G 34 Yr old male Presented with c/o inability to pass urine and peri-anal numbness x24hrs No complain of any back or leg pain at all No history of trauma He was mobile independently There was no motor weakness but there was peri- anal numbness PR examination: no tone and no v
Slide 27: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 28: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME Despite undergoing emergency discectomy wihtin 5 hrs of admission he did not recover sphincter functions fully Repeat MRI did not show any residual compression Now after 12 mths he self catheterises once a day but and has some control. Has now control on his bowl movements but
Slide 29: Sciatica
SCIATICA S.M 46 yr old male Mild pain left leg 2/3 mths He developed severe shooting pain with pins and needles in L5/1 distribution about 10 mths ago which gradually got better over next few months MRI scan was organised when his leg pain was quite manageable Clinically he had mild root tension sig
Slide 30: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 31: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 32: Spinal Infection
SPINAL INFECTION J.G 69 yr old female overseas visitor Presented with c/o Para-paresis x 1 mth She developed vague low back pain 3 moths prior to presentation. There was h/o fever and night sweats with some wt. loss. There was no complain of any cough PMx Diabetes and Hypertension On Examination: Te
Slide 33: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 34: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 35: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 36: Upper Back Pain
UPPER BACK PAIN C.H 71 yr old female Presented with c/o pain upper back x 2 mths No h/o of any significant trauma Constant pain, increased with activity and there was night pain but no h/o any wt. loss Pain killers were not very helpful There was h/o lymphoma 10 yrs ago On examination: No obvious de
Slide 37: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 38: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 39: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 40: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 41: Thoracic Spine Pain
THORACIC SPINE PAIN M.C 71 yr old female C/o Pain lower thoracic spine for last 2 mths There was h/o low energy fall at home, did not seek any medical advice initially but when pain did not subside came to A&E and xr showed T10 and T8 wedge fractures Examination did not reveal any deformity but was
Slide 42: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 43: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 44: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 45: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 46: Lower Limb Trauma
LOWER LIMB TRAUMA N.S 29 yr old male Assaulted with a hammer in a road rage incident A hammer was used by the assailant and lateral aspect of his left knee was hit and the knee was forced into a valgus position and he fell Brought to A&E with severe pain and swelling left knee Examination showed ski
Slide 47: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 48: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 49: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 50: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 51: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 52: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME 6 mths later saw a very grateful patient in clinic with a large box of chocolate and 2 shirts. He informed us his attacker was now serving a 3 yr sentence
Slide 53: Degenerative Lumbar Disc Disease
DEGENERATIVE LUMBAR DISC DISEASE A.C 68 yr old female C/o Longstanding low back pain, with some pain going down towards both knees but not beyond it. Had physiotherapy and epidurals and facet joint injections in the past without much relief. MRI showed worn out discs at L4/5 and 5/1 levels without a
Slide 54: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 55: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 56: Trauma
TRAUMA A.J 38 yr old male Fell off a fork-lift truck at work, landing on his feet He was complaining of pain and swelling left heel. There was no c/o back or neck pain Secondary survey did not reveal any other injury Left heel was swollen and tender to touch. X Rays of axial skeleton were requested
Slide 57: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 58: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 59: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 60: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 61: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 62: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Slide 63: Cauda Equina Syndrome
CAUDA EQUINA SYNDROME
Spire Healthcare Group — Investor Presentation (February 2011) on 6ix