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What is the goal of the operation?

The aim of the procedure is to remove herniated disc material using a surgical microscope or endoscope to relieve pressure on compressed nerve roots. Intervertebral disc material is removed via small accesses and with the help of special instruments. This technique aims to put as little strain on the surrounding muscles as possible.

Whether an operation is necessary depends on the course of the symptoms, neurological deficits and the results of the imaging. Many herniated discs are initially treated conservatively.

Typical procedure for a disc operation

When is decompression necessary?

If the spinal canal is narrowed (spinal canal stenosis), more space is created for the spinal cord and nerve roots by surgically removing constricting bone and ligament structures. If the symptoms remain significant despite appropriate conservative treatment or if relevant neurological problems exist, surgical relief can be considered.

Treatment depends on the extent and duration of the symptoms, neurological findings, imaging and personal goals. Whether additional stabilization is necessary is assessed individually.

Minimally invasive stabilization

In the event of instability (e.g. spondylolisthesis, spondylolisthesis), adjacent vertebral bodies can be connected to one another in a minimally invasive manner using special implant systems in order to prevent abnormal movements and permanently relieve pressure on nerve roots.

Percutaneous stabilization operations and dynamic stabilization procedures are established techniques that are used individually depending on the findings.

What is a Kyphoplasty?

In the event of a vertebral body fracture - for example due to osteoporosis, a fall or tumor infection - cement augmentation such as kyphoplasty can be considered in selected cases to stabilize the affected vertebral body. Medical bone cement is inserted into the fractured vertebral body to stabilize it and reduce fracture-related pain.

Whether the procedure is suitable depends in particular on the stability of the fracture, its cause, the symptoms, the neurological findings and the imaging. Not every vertebral fracture requires surgery.

Tumor-related changes & radiofrequency ablation

In the case of tumor-related changes to the spine, interdisciplinary treatment planning is particularly important. Depending on the situation, surgical, radiotherapy, medication and, in selected cases, ablative procedures can be combined.

Percutaneous radiofrequency thermal ablation should be seen as a possible option for certain findings (e.g. bone tumor metastases), not as a general standard therapy.

Carpal tunnel syndrome surgery

In carpal tunnel syndrome, the median nerve at the wrist is narrowed. The diagnosis results from complaints and clinical examination and can be supplemented by neurophysiological measurements.

If symptoms persist or there is significant nerve damage, surgical relief may make sense. The ligament over the carpal tunnel is cut to give the nerve more space. Open and endoscopic procedures are established; the appropriate method is selected individually.

Sulcus ulnaris syndrome & other bottleneck syndromes

In ulnar sulcus syndrome (cubital tunnel syndrome), the ulnar nerve is narrowed at the elbow. Tingling or numbness in the little finger and ring finger as well as pain on the inside of the elbow are typical. If the damage is advanced, muscle wasting and loss of strength in the hand may occur.

Nerves can also be compressed at the elbow and other anatomical narrow areas. By splitting the constricting band or tissue, the pressure on the affected nerve is relieved. Whether conservative or surgical treatment is indicated depends on the symptoms, clinical findings and, if necessary, neurophysiological results.

What is Neuromodulation?

For selected chronic pain syndromes, neuromodulation, such as spinal cord stimulation (SCS), can be considered after careful consideration. The aim is to influence pain processing through targeted electrical stimulation of nerve pathways. Complete freedom from pain cannot be guaranteed.

In chronic, treatment-refractory pain syndromes, electrodes are placed in the epidural space. Light electrical impulses superimpose the pain signals on their way to the brain.

Sequence

Diseases of the cervical spine

Changes in the cervical spine can affect nerve roots and, in certain cases, the spinal cord. Possible complaints range from neck and arm pain to numbness, reduced strength or fine motor problems.

Which operation is suitable?

Depending on the diagnosis, different procedures may be useful, including decompression, fusion or, in selected cases, a motion-preserving disc replacement.

A disc prosthesis is not suitable for every patient. Whether a prosthesis makes sense depends, among other things, on the affected segment, the extent of degenerative changes, stability, bone quality and other individual factors. The recommendation is only made after examination and image evaluation.

Arthroplasty & Arthrodesis

After removal of a degenerated intervertebral disc, under certain medical conditions, a prosthesis can be inserted (arthroplasty) with the aim of maintaining the mobility of the corresponding segment. Alternatively, neighboring vertebral bodies are permanently stabilized through a fusion (arthrodesis).