Q&A with Mr Jonathan Lucas

Consultant Orthopaedic Paediatric Spinal Surgeon at The Portland Hospital, part of HCA Healthcare UK

When did you join the HCA UK family?

I started working within HCA UK in 2009 at London Bridge Hospital and was then asked to join the HCA UK family as an employee at The Portland Hospital in January 2020 to set up the Complex Paediatric Spine Multidisciplinary Team Meeting and to work as a Consultant Paediatric Spinal Surgeon.

I combine my role here with my NHS post as a Consultant Adult and Paediatric Spinal Surgeon at Guy’s and St Thomas’ Hospital and the Evelina London Children’s Hospital, which I have held for the last 21 years. I know HCA UK well and thoroughly enjoy working with and for them as we share the same aspirations of delivering the best and safest care for our patients.

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Why did you want to specialise in spinal surgery?

I first wanted to become a surgeon back when I was training at medical school. I was taught anatomy by a group of young surgeons who were revising for their exams for their surgical examination. They were incredibly inspiring, and I wanted to do what they did, and so I embarked on the path to becoming a surgeon.  

But why specialise in paediatric spinal surgery you might ask? Well, spinal surgery seemed an incredibly exciting, challenging and interesting area of surgery, and then when you combine that with paediatric patients whose spines are growing, it makes the surgery even more complex and challenging, and very rewarding as you’re able to correct young people’s spinal deformities.

I used to treat adults and children, but since my paediatric practice grew so exponentially, I now spend the majority of my time specialising in paediatric care.

What’s it like providing healthcare for children, teens and their family?

When providing healthcare to children and young adults, it’s so important that they feel at the centre of every decision and that everything is explained to them directly, even if they’re quite young.

There’s lots of evidence to suggest that the more you explain to a child or young adult about what they should expect with regards to the procedure and any pain they might feel, the better they do, the quicker they recover and the less pain they report. Feeling informed and prepared is key. Of course, making sure the parents feel reassured is obviously critical too.

What are the common conditions that you treat?

The commonest conditions we treat are spinal deformities, curvatures of the spine which is called a scoliosis and then children and young people who present with spinal pain for which a cause and then treatment plan needs to be determined.

The majority of our patients, however, come to us reporting some kind of childhood back pain where there’s no underlying cause. In many cases, this can be resolved with a course of physiotherapy. Other conditions that we treat at our centre include:

  • Bone dysplasia conditions 
  • Metabolic bone conditions
  • Scoliosis and kyphosis
  • Spinal infections
  • Spinal tumours
  • Spinal fractures
  • Spondylolysis and spondylolisthesis
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What is idiopathic adolescent scoliosis and how is it treated?

Idiopathic adolescent scoliosis is a curvature of the spine and often affects girls more than boys, for which we are unable to find a cause for. Whilst this spinal condition is not life-threatening or nerve-threatening, it can cause a severe deformity and can cause pain and disability. It can also have a huge psychological impact, especially as the curve often becomes more noticeable and problematic during teenage years – a period of time where even more focus is placed on body image and being able to fit in at school.

‘Idiopathic’ means that the cause is unknown – so with these patients there is no identifiable cause. We are able to predict what will happen to the curve over time, and are able to identify which curves will get worse – but unfortunately, we still do not know the cause.

Treatment pathways

With regards to treating this type of scoliosis, there are primarily four main treatment paths which a patient is likely to go down:

  1. If they have a mild curve, we would suggest a ‘watch and wait’ approach, with the understanding that not much will need to be done and that the curve will not worsen
  2. If a patient presents to us early with a curve, we might suggest that they are braced
  3. If they come to us with a severe curve or one which we think it will become significantly worse, we will recommend an operation - where we insert screws and rods in the patient’s back to correct the deformity and improve overall quality of life.
  4. A very small number of patients will come to us and we will perform growth modulation, whereby we allow the growth of the child to be modified to protect the curve. This is still very much an experimental form of treatment and would only be offered in rare cases where the patient meets very specific criteria.
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Why choose the Spinal and Scoliosis Surgery Centre for your child or young adult’s care?

At the Spinal and Scoliosis Surgery Centre, we take a holistic view of the child or young adult and their family. We want to ensure that every patient receives the most clinically appropriate care and feel at ease with the treatment plan or procedure and its risks and benefits. On-site we have all of the latest imaging to determine the most accurate diagnosis; EOS X-rays, MRI, CT and bone scans– we have them all at our disposal with trained spinal radiologists to interpret and relay the results.

The team here, which includes physiotherapists, orthotists, radiographers, anesthetists, spinal nurses and surgeons are all very experienced in providing the care for spinal problems and surgery for what is a very specialist area of medicine, and are all dedicated to giving children and young people the very best spinal care and ensuring that they get back to doing the things that they love and that their overall quality of life is improved as they grow into adulthood and for the rest of their lives.

Find out more about Mr Jonathan Lucas

Find out more about the Scoliosis and Spinal Surgery Centre