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E-Diagnosis

E-Diagnosis Form

Please complete the sections below.

A patient manager will contact you the next working day.

Please note a lumbar MRI scan less than six months old is mandatory for E-Diagnosis.

Depending on your condition, a lumbar CT scan may also be required. SpinePro is unable to progress cases without the above.

SpinePro is currently only able to assist patients who can self fund the treatment.

Personal Details

Sex
cm
kg
Contact preference

Patient Criteria

  • Have you been diagnosed with acute herniated or slipped discs?
  • Are you suffering with (chronic) back pain and sciatica?
  • How long have you been suffering?
    Years
    Months
  • Do you have a recent Lumbar MRI scan?
  • Are you ready for surgery to permanently relieve your symptoms?
  • Are you willing to travel to Montpellier, France? Your stay would typically be 9 days in total.
  • Are you able to self-fund the treatment? (Typically, £32K+)

Your Symptoms

  • Do you have pain in your arms or legs (sciatica, cruralgia, neuralgia)?
    If yes, please tick the relevant limbs in the diagram below:
    Body outline diagram Right Left
  • Is the main pain...
  • Do you have tingling or numbness in any of your limbs?
  • Do you have a significant loss of strength in any of your limbs?

Your Treatment History

Physiotherapy or osteopathy
Discectomy
Brace or lumbar belt
Inpatient stay
Infiltration or thermocoagulation
Rheumatology or specialist medical check-up

Your Diagnostic Images

A lumbar MRI scan and a lumbar CT scan, both less than six months old, are required to assess patient suitability for Prodisc-L lumbar disc replacement.

Please paste your login details:

SpinePro is unable to progress cases without diagnostic images.

By clicking submit, you consent to SpinePro sharing your personal data with CCV for diagnostic purposes based on information herein this website. Please see our Privacy Policy for further details of how we manage & use your personal data.

For your information

Your data will remain strictly confidential and secure. Only the CCV Montpellier surgical team and the SpinePro service team will have access.

Medical opinion is governed by Article R.4127-53 of the Public Health Code of France. It is not comparable to a consultation and does not give rise to fees. Fees are only charged if a medical act has been carried out, for which the doctor is responsible, including an act relating to teleconsultation (see E-Diagnosis). Free medical advice is not a "medical act", does not engage the responsibility of its author and is not adapted in the event of an emergency.