Mr Am Rai (Amarjit Singh Rai)

Profile

Experience and training
Mr Am Rai was elected President of the British Association of Spinal Surgeons by his surgical peers and has been on the BASS Executive Committee for 6 years. He has published on national best practice surgical guidelines, helped develop the British Spinal Registry (over 150,000 patients), involved in National Institute for Health and Care Excellence (NICE) guidelines and government led regional variation in surgical practice across England. Mr. Rai set up the Travelling Spinal Fellowship (administered through BASS & British Scoliosis Society) aimed at prospective new Spinal consultants.

He is fellowship trained (Australia, European Travelling Fellowship, South Africa and USA) and to date has trained over 12 spinal consultants who currently work throughout the UK. Mr. Rai has helped develop core curriculum for spinal training and was the Foundation Programme Director for junior doctors.

He has more than 20 years of consultant spinal experience and has been involved in over 10,000 surgical procedures.

He is director of a spinal charity Spine Aid which, arranges regular trips abroad for a team of spinal surgeons, medical students, neurophysiology technicians and anaesthetists to help treat under privileged children with spinal deformities. Mr Rai hopes to devote more time to this charitable work.

What Can you expect?

Surgery is always a last resort, but certain conditions and states of health may suggest it as a best option. There is good evidence in the literature that spinal surgery for nerve compression gives the best validated results as good as any other surgical procedure. Many patients are keen to get the best surgical opinion which is based on experience, training and appropriate patient selection. Surgeons in the modern era are duty bound to validate their results to ensure patients receive advise based on outcome data.

Mr Rai is an advocate of giving experienced and validated advice with outcome data to confirm treatment plans. He will allow as much time as is required to give his patients a balanced opinion. This will often involve reviewing images, discussion with other specialists and surgical colleagues.

Mr Rai appreciates the disability from spinal disease as he himself has had spinal surgery.

British Spinal Registry(BSR).

Since 2008 I have prospectively collected outcome data on all my private patients undergoing spinal surgery. This allows me to look at all my surgical results, compare them with other units and ultimately improve and monitor patient outcomes.

I have one of the largest series of outcome data from an individual consultant in Europe and our unit is in the process of publishing this.

The following is example of the data we have collected since 2008:

This data is collected on my behalf by an independent Spinal Specialist physiotherapist (Jonathan Geere) who is the main driver responsible for us to have data collection as good as anywhere in the world. This table shows, with our patients’ help, we collect 97% of the data compared to the national average of 43%. At one year after surgery the data we have collected as comprehensive as the Scandinavian (considered as gold standard in terms of data collection in healthcare in the world).

With this data we can look at various interactions and analyse and compare our results with other countries

Results of discectomy patients

Comparison group / other centres was from:

Rushton, A., et al. (2020). "Clinical course of pain and disability following primary lumbar discectomy: systematic review and meta-analysis." Eur Spine J 29(7): 1660-1670.

We can also look at how comorbidities and sex affect results of spinal surgery. This has revealed hormonal changes around the menopause may affect surgical results.

We also looked at diabetes and found greater proportion patients requiring revision surgery. This emphasises the importance of improving ones health prior to surgery.