Treatments

Basivertebral nerve ablation (BVNA): is a minimally invasive procedure aimed at relieving vertebrogenic pain, a type of chronic lower back pain caused by damage to the vertebral endplates.

Dr McKean performed the first BVNA in the UK in 2021 and performed the first Intracept procedure in Europe in 2025. The Buckinghamshire Healthcare NHS Trust press release can be found here.

Spinal injections: Dr McKean performs all spinal injection procedures at all spinal levels, including nerve root injections, caudal epidural injections, facet joint injections, medial branch blocks, sacroiliac joint injections, ganglion impar injections discography and radiofrequency ablation.

Bone biopsy: is a procedure to collect a small sample of bone tissue from a bone for examination. It’s typically done to diagnose conditions like infections or cancer.

Radiofrequency ablation (RFA): for spinal metastasis is a minimally invasive procedure used to treat cancerous tumors that have spread to the spine. It uses heat generated by high-frequency radio waves to destroy tumor cells, often providing pain relief and local tumor control. Dr McKean was an expert advisor on the recent NICE guidelines.

Electrochemotherapy (ECT): is an innovative minimally invasive, image-guided procedure that combines chemotherapy with electric pulses to treat spinal tumours that don’t respond to radiation, particularly those causing metastatic epidural spinal cord compression (MSCC). It can help treat pain and prevent tumour progression at the treated level. Dr McKean performed the first case of electrochemotherapy for spinal metastases in the UK.

Joints and bursae: Dr McKean performs all image-guided injections of joints and bursae from head-to-toe including steroid injections, hyulronic acid injections and platelet-rich plasma (PRP) injections. 

Spine: Dr McKean performs all spinal injection procedures at all spinal levels, including nerve root injections, caudal epidural injections, facet joint injections, medial branch blocks, sacroiliac joint injections, ganglion impar injections discography and radiofrequency ablation.

Dr McKean reports all radiography, fluoroscopy, ultrasound, computed tomography, and magnetic resonance imaging of the musculoskeletal system. 

Sports: Dr McKean is involved in the care of athletes ranging from the weekend-warriors to the elite professional. David is a keen amateur athlete regularly taking part in Ironman, ultramarathon and Otillo Swimrun races.

Oncology:  We use the full range of imaging techniques to guide the diagnosis of bone and soft-tissue tumours.

Rheumatology and Infectious Diseases: Dr McKean works closely with his local rheumatology and microbiology colleagues to aid in the diagnosis of rheumatological and infectious disease.

Spine: Dr McKean is an expert in the diagnosis of spinal pathology and identifying the cause of neck and back pain.

Tenotomy: Dr McKean performs a range image guided tenotomy techniques for chronic tendon pain. This includes dry needling of tendons to stimulate healing, or ultrasound guided tendon release, typically for patients who wish to avoid surgery. 

Botulinum toxin injections: Dr McKean provides ultrasound-guided injections of botulinum toxin. This may be a used as treatment for spasticity, cervical dystonia, chronic myofascial pain or thoracic outlet syndrome.

Aspirations: Joints, bursae, and soft tissue collections can be aspirated to diagnose infection and other causes of inflammation.

Frozen shoulder: Dr McKean has pioneered combining steroid injections into the rotator interval (an area at the front of the front of the shoulder) with shoulder manipulation as a treatment for frozen shoulder. This technique results very significant improvement in both pain and range of movement. 

McKean et al. Skeletal Radiol. 2019 Aug.
McKean et al. J Ultrason. 2021.
Yoong et al. Skeletal Radiol. 2015 May.