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Martin Knight trained at St Bartholomew’s and St Thomas’ and his research training was established at the Royal Postgraduate Medical School.
After a short-term commission in the Royal Navy to support Orthopaedic staff deficits following the Falklands War, he embarked upon a Consultant Orthopaedic post in Rochdale with an interest in the treatment of degenerative disc disease. Following in the footsteps of predecessors prosecuting conventional surgery there was an expected incidence of ‘Failed Back Surgery’. Rather than pursue the same course of treatment he introduced keyhole percutaneous discectomy for revision treatment. Evaluation of outcomes after a year led him to introduce the KTP 532 laser disc decompression into the UK with prospective evaluation.
After two years having pushed out the envelope of this application the team defined the limitations of the technique. They introduced biportal flexible endoscopic intradiscal discectomy with laser assistance.
Whilst the technique allowed larger or extruded discs to be addressed, this needed to be developed to address the problems of facet joint arthritis, instability, backward and forward slippage of vertebrae, sequestra. This led to the development of the uniportal technique of Endoscopic Laser Foraminoplasty for the treatment of chronic lumbar spondylosis, lateral recess stenosis, instability, spondylolitic spondylolisthesis, failed back surgery.
This research has warranted the initiation of a NHS supported a National Randomised Controlled Trial of Endoscopic Laser Foraminoplasty versus Pain Management at The Spinal Foundation.
This research in the lumbar spine has been paralleled by similar laser and endoscopic developments in the cervical spine and the development of a keyhole disc replacement.