Services Offered
Mr Nicholas Finnis provides consultative and operative services for all cranial, spinal and peripheral nerve problems.
Cranial Surgery
All aspects of the management of cranial (brain) surgery are offered. This includes all malignant and benign brain tumours, and collaboration with other surgeons and cancer specialists is done to optimise the treatment. Mr Finnis will consult and operate on vascular problems such as intracranial aneurysms, and assess suitability for non-operative management with the endovascular team. Mr Finnis is experienced in the operations available for trigeminal neuralgia, a severe facial pain problem, and offers both open and percutaneous techniques. Brain fluid (CSF) flow problems can lead to pressure problems in the head and headaches and Mr Finnis can offer all the management strategies for this.
In the Private sector, Mr Finnis operates at St Georges Hospital for cranial cases. St Georges Hospital is fully equipped with the necessary and latest equipment for comprehensive brain surgery. There is available for post-operative management an intensive care unit (ICU) and high dependency unit (HDU) for those that require this for specialist care and close observation with “one to one” nursing.
Spine Surgery
Mr Finnis is a neurosurgeon with subspecialty practice in Complex Spine Surgery. Mr Finnis is able to evaluate and manage all aspects of spinal problems and offers a broad spectrum of surgical options to best manage a patient’s problem.
Spinal problems commonly dealt with are those related to injuries (trauma) such as a disc prolapse or bone fracture, including osteoporosis. Mr Finnis commonly deals with age-related (degenerative) problems where problems with a pinched nerve (spinal stenosis, foraminal stenosis) and back pain (disc or facet joint related) are common. These problems also lead to deformity of the spine which aggravates the problem and often complex techniques are needed which Mr Finnis offers to correct these. Rheumatoid arthritis is an example of an arthritic problem that commonly involves the spine creating neurological and deformity problems for which special techniques are necessary to correct.
Mr Finnis also manages all tumours of the spine. Neurosurgical spine surgeons are specifically trained to manage these problems around and within the spinal cord. Other problems with the spinal cord are due to spinal fluid (CSF) problems that cause cysts around and within the spinal cord (syrinx, syringomyelia) and Mr Finnis is experienced at dealing with these. These are common after spinal cord injury and Mr Finnis with his involvement with the Burwood Spinal Injuries Unit has built up an extensive experience with the management of this problem. A specific condition leading to syringomyelias is from the congenital (born with it) problem of “Chiari” malformation where the fluid is blocked at the junction between the head and spine.
Mr Finnis is experienced and can offer management in all aspects of spine surgery in the cervical, thoracic, lumbar and sacral areas. In all areas, this involves decompression (un-pinching nerve structures), stabilisation (fusion), motion preservation (disc replacement and dynamic stabilisation) and deformity correction.
In the neck (cervical area) Mr Finnis can offer surgery from the front (Anterior Cervical Discectomy and Fusion or Disc Replacement) and from the back (foraminotomy/discectomy and laminectomy) with or without fusion from behind. Instead of a fusion procedure, a movement preservation “laminoplasty” can be offered.
In the lower back (lumbar region), surgery can be from the front or behind, but also sometimes from the side. From the front, Mr Finnis can offer an Anterior Lumbar Discectomy and Fusion or Disc Replacement (arthroplasty). From the back, surgery can be for decompression alone such as discectomy or laminectomy which is to free up the nerve by removing the disc or the abnormal bone. Patients may also need a fusion to correct their problem after decompression and various techniques are available (postero-lateral, PLIF, TLIF) to best manage the problem.
Approaches from the side to establish a fusion (DLIF, XLIF) are a powerful way to establish a fusion and correct deformity which Mr Finnis can offer for suitable cases.
Mr Finnis has extensive experience in disc replacement surgery in both the neck and lower back. He is one of the most experienced surgeons in disc replacement surgery in the neck in the world. Preserving motion in the spine can be beneficial for selected patients undergoing spine surgery and Mr Finnis can advise on this.
Mr Finnis also offers in the lower back motion preservation surgery in the way of “dynamic stabilisation” (for example “interspinous stabilisers”)which are techniques to help back pain without fusion. He was one of the first to introduce this surgery into New Zealand.
Mr Finnis will offer where appropriate “keyhole” or “Minimal Invasive Surgery” (MIS). These are techniques encompassing a broad range of spine surgery where the approach is designed to minimally affect the tissues and this has advantages in a more rapid recovery. Mr Finnis offers MIS fusions such as PLIF, TLIF, XLIF, and DLIF. To achieve this fixation screws can be placed through small incisions in the skin (percutaneous pedicle screw) or via minimal tissue disturbance through a small central incision (MIDLF approach). Both St Georges Hospital and Southern Cross Hospital where Mr Finnis works has special 3D x-ray machines (O-arm, Zeego) that are used for computer guidance (“image guidance) improving accuracy and reducing radiation exposure and complications.
Peripheral Nerve Surgery
Mr Finnis will assess and manage problems related to the full spectrum of peripheral nerve problems. The commonest conditions are related to pinched nerves from surrounding structures, but other problems can arise from nerve injury or the development of nerve tumours.
The common pinched nerve problems cause numbness/tingling and pain in the region of the nerve as well as commonly weakness. The commonest problem of this nature is the carpal tunnel syndrome causing problems in the hand. The other common hand problem is the cubital tunnel problem from pinching of a different nerve. Less common arm “entrapment syndromes” are the radial tunnel syndrome, posterior interosseous nerve syndrome, and the thoracic outlet syndrome.
In the leg, a number of less common problems can cause pain and neurological symptoms. The lateral cutaneous nerve of the thigh entrapment can cause numbness and pain in the front of the thigh. Other less common areas are the tarsal tunnel syndrome in the foot and the common peroneal entrapment in the knee region. Mr Finnis is one of a few surgeons that evaluate and operate for the “piriformis syndrome” or pinching of the sciatic nerve in the gluteal region. Pelvic pain is very common and a cause of this can be entrapment of the perineal nerve in the pelvis (Alcock Canal) and Mr Finnis is one of a few surgeons offering surgery for this condition.
Neurosurgery is the surgical management of neurological diseases and is broad in its extent. Mr Finnis is a senior neurosurgeon in Christchurch and has acquired an extensive experience and is happy to consult on all aspects of the speciality.
