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Lower back pain: when is conservative or surgical treatment required?

A combined session presented by Mr John Ferguson, orthopaedic spinal surgeon and Dr Giresh Kanji, MSK pain specialist, covers the influences and conservative management of spinal pain and when to refer for surgery when conservative management fails.

Dr Giresh Kanji – MSK pain specialist, will be presenting on the influences and conservative management element, including:

  • Neurophysiology - pain threshold
  • lumbosacral pathology - disc/facet/hip/SI
  • biomechanics and influences of time
  • common medications and how they are used
  • lifestyle and activity modification.

Dr John Ferguson FRACS will be presenting on the red flags and when to refer to a spinal surgeon when conservative management fails, specifically covering:

  • When to send straight to the public ED? How do I get past the registrar?
  • How to get the spine surgeon to pay attention?
  • How to manage the wait for specialist consultation.
  • Indications for appropriate surgery.


John Ferguson

Orthopaedic Spinal Surgeon

I have now been practicing in public and private practice since 2006. In this time, we have introduced the direct lateral approach to the lumbar spine to Australasia. We have also pioneered the use of the MAGEC magnetically lengthening growing rod for the treatment of early onset scoliosis and, more recently has performed the first anterior thoracoscopic tethers for idiopathic scoliosis in Australasia. Since commencing as a consultant in New Zealand, it has been my goal to provide New Zealanders with gold-standard care at a level that would be considered excellent anywhere in the world. I sit on several committees with the Scoliosis Research Society and on the programme committee for the ICEOS scoliosis subgroup. My results are regularly submitted to national and international bodies and compared with peers to ensure the outcomes are of the highest possible order.

I continue to be involved in ongoing research and product development with medical device companies in the hope that we can continue improving the care given to patients with spinal disorders.


Giresh Kanji

Honorary Associate Professor Giresh Kanji

(PhD, MBChB, PGDip Musmed, MMGT, PG Dip Businfo, FAFMM, FRNZCGP)

Dr Giresh Kanji is a Musculoskeletal Pain Specialist and Researcher. He explored the sensory amplification of pain in his PhD, including the role of the human stress response. He has presented in NZ, Australia, Tahiti, USA and Europe.

He is an honorary Associate Professor at Auckland University, the chairperson of the NZ Pain Foundation and editor of Australasian Musculoskeletal Medicine. He is the author of “Fix Your Back”, “Fix Your Neck Pain, Headache and Migraine”, “Brain Connections: How to sleep better, worry less and feel happier” and Sleep Well and Energise: A no Pills Approach. He is currently writing a book dedicated to sleep and finishing an App called Painguru for education on lower back pain.