Your physician will carry out a targeted diagnostic investigation in order to firmly establish the underlying causes that result in the pain you are experiencing.The clinician will then work out a treatment regimen that is based on your clinical picture. If your disease is due to wear and tear, treatment will always start with conservative measures, such as injections or physiotherapy. However, if these therapies do not exert a permanent effect, interventional measures or surgical procedures will need to be considered. In some cases, the extreme nature of the symptoms (e.g. signs of paralysis) may render an immediate surgical intervention necessary since long-term damage needs to be avoided.
Your physician will carry out a targeted diagnostic investigation in order to firmly establish the underlying causes that result in the pain you are experiencing.The clinician will then work out a treatment regimen that is based on your clinical picture. If your disease is due to wear and tear, treatment will always start with conservative measures, such as injections or physiotherapy. However, if these therapies do not exert a permanent effect, interventional measures or surgical procedures will need to be considered. In some cases, the extreme nature of the symptoms (e.g. signs of paralysis) may render an Over recent years, new technologies have also led to a trend toward minimally invasive treatment methods. These technologies are available as a result of the development of instruments and devices for medical technology. Particularly for the treatment of diseases of the spinal column brought on by wear and tear, we are aware that it is not possible to stop the process of aging entirely, and slow down wear and tear. Even major surgical interventions do not provide a definitive solution for these diseases, but frequently entail a series of additional problems, such as scarring or impairment of the biomechanics of the spine. This can in turn result in generating new pain. When using minimally invasive techniques, which are also designated as keyhole surgery, the access port to the spine and the associated structures are largely undamaged. This allows the surgeon to carry out the intervention at the actual site of the problem using specialist instruments. After the operation has been performed, you will scarcely see any scarring on your skin and you will therefore also have less pain than would have been associated with a larger access port.
Treatment methods in disk herniation
Many instances of disk herniation, which initially cause a large amount of pain and possibly also neurological deficits in the arms or legs, correct themselves and an operation is not required, unless they generate symptoms of paralysis which may have other results such as long-term damage. They require patience and painkillers in order to achieve a positive outcome. Some hospitals will also offer you a phased plan for treatment. If painkillers do not prove to be effective, therapy known as PRT (periradicular therapy) may be helpful. This procedure involves a thin cannula being guided directly to the affected nerve root and an anesthetic and anti-inflammatory drug is then injected.
If the interventional pain therapy proves to be ineffective, an operation has to be carried, and this should be minimally invasive.
Minimally invasive – Full-endoscopic spine surgery with VERTEBRIS
Over recent years, medical technology company Richard Wolf has joined forces with leading spine surgeons to develop methods of operating on disk herniations that can be performed even less invasively than existing operations. An endoscope can be guided directly to the disk herniation through an incision in the skin of only 8 mm without damaging any of the adjacent structures. Special instruments are used to remove the disk herniation and the release of pressure on the nerve can be directly monitored. These operations can be carried out under local or general anesthetic. Most patients are free of pain immediately after the operation and they are then able to return quickly to their everyday routine and the world of work.
These methods are now available in many hospitals. You should therefore ask your attending physician about full-endoscopic spine operations. The attached patient information tells you more about these procedures.
We will be delighted to help you find hospitals in your area which offer these minimally invasive methods.
Treatment methods for spinal canal stenosis
The following also applies in this case: An operation should only be carried out if all conservative and interventional measures (as described in disk herniation) have not proved effective over a long period of time.
When an operation is performed, all bony parts which are directly pressing on nerve and vessel structures must be removed. If extensive spinal canal stenoses are present, the intervention must frequently be performed by carrying out an open operation. However, there are many cases in which the stenoses are limited locally. Full-endoscopic procedures can then be applied there with the advantages described above. This is because the technology has now been developed in order to remove bones through the endoscope. You should ask your attending physician about these methods.
Treatment methods in a facet joint syndrome
Wear and tear, and aging mean that you have arthrosis in the little spine joints and this generates radiating back pain. Since there is no replacement joint available here (as in the case of the knee or hip), there is only the option of ameliorating the symptoms (by means of joint infiltrations with anesthetic and anti-inflammatory drugs) or excluding the conduction of pain emerging from the joint. You will then no longer experience any pain radiating from the facet joint.
When facet joint denervation is carried out, a thin cannula inserted through the skin (percutaneously) is used to identify under X-ray control the specific nerves which conduct the pain from the facet joint. A small probe is used to deactivate these nerves using ultra high-frequency electricity (radio frequency). This intervention can be carried out under local anesthetic. Your surgeon can also use an endoscope here in order to identify and deactivate the nerves reliably.