Our Specialties

What is a herniated disc?

Our intervertebral discs are located between the individual vertebral bodies and serve as elastic buffers. Each intervertebral disc has a solid outer fibrous ring (Anulus fibrosus) and a softer, gelatinous core (Nucleus pulposus).

Over time, the intervertebral disc can lose elasticity. This allows the outer fibrous ring to initially bulge - this is called a Disc protrusion. If the fibrous ring tears and the intervertebral disc tissue protrudes outwards, this is the cause Herniated disc (Prolaps) before.

A herniated disc does not necessarily have to cause problems. However, if the protruding disc tissue presses or irritates a nerve root or other nerve structures, neck or back pain as well as radiating pain into the arms or legs can occur. Tingling, numbness or reduced muscle strength are also possible.

Which symptoms occur and how severe they are depends, among other things, on where the herniated disc is located and which nerve structures are affected.

Does a herniated disc require surgery?

No. Many herniated discs are initially treated conservatively. Surgery may be necessary or advisable if significant neurological deficits occur, there is evidence of a relevant disorder of bladder or bowel function, or severe symptoms consistent with the findings persist despite appropriate non-surgical treatment.

How is the decision made?

The course of the complaint, neurological examination and imaging are evaluated together to make the decision. The aim of an operation is usually to relieve the affected nerve structure. Which technique is used depends on the location and type of finding.

Typical procedure for a disc operation

What is spinal canal stenosis?

Spinal canal stenosis results in a narrowing of the spinal canal and thus a narrowing of the nerve structures running within it. This change often occurs as a result of increasing wear and tear on the spine.

Over time, for example, the small vertebral joints and ligaments can thicken. At the same time, the intervertebral discs can bulge. The interaction of these changes means that there is increasingly less space available for the nerves in the spinal canal.

Spinal canal stenosis of the lumbar spine can be particularly noticeable as pain in the legs, which increases when standing or walking for long periods of time. In addition, tingling, numbness or a reduction in muscle strength may occur. The symptoms often improve when you sit or bend your upper body forward. The resulting restriction in walking distance is referred to as: Spinal claudication designated.

Whether and what treatment is necessary depends on the symptoms, the neurological findings and the extent of the changes in the imaging.

Treatment

Treatment depends on the extent and duration of the symptoms, neurological findings, imaging and personal goals. If the symptoms are less severe, conservative measures may initially be considered.

Surgical decompression

If the symptoms remain significant despite appropriate conservative treatment or if relevant neurological problems exist, surgical relief can be considered. Restrictive structures are removed as much as necessary. Whether additional stabilization is necessary is assessed individually.

What is facet joint osteoarthritis?

The small vertebral joints, also called facet joints, connect neighboring vertebrae and, together with the intervertebral discs, enable the mobility of the spine. Wear-related changes therefore often affect both the intervertebral discs and the facet joints.

With facet joint arthrosis, the joint increasingly changes. This can include, among other things, an enlargement of the joint structures, joint effusions or changes in the position of the joints.

Local back or neck pain is typical, which can worsen with certain movements or stress. The pain can also radiate to the arms or legs. In contrast to direct irritation of a nerve root, these symptoms often extend less far into the extremities and are usually not accompanied by typical neurological deficits. Then you talk about pseudoradikulären Beschwerden.

What is a facet joint cyst?

Wear-related changes to a facet joint can cause a fluid-filled joint cyst (synovial cyst) to form. If such a cyst protrudes into the spinal canal, it can constrict a nerve root. This can result in radiating pain, tingling, numbness or reduced strength – similar to a herniated disc.

Which treatment is suitable depends on the size and location of the cyst, the symptoms, the neurological findings and the imaging.

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.

What is carpal tunnel syndrome?

In carpal tunnel syndrome, the median nerve at the wrist is narrowed. Typical symptoms include tingling, numbness and pain in the thumb, index and middle fingers - often more pronounced at night or when holding objects. Long-term damage can lead to a loss of strength.

The diagnosis results from complaints and clinical examination and can be supplemented by neurophysiological measurements.

Carpal tunnel surgery

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.

Ulnar sulcus syndrome

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.

Other bottleneck syndromes

Nerves can also be compressed at the elbow and other anatomical narrow areas. Whether conservative or surgical treatment is indicated depends on the symptoms, clinical findings and, if necessary, neurophysiological results.

Treat chronic pain individually

Chronic pain can have different causes and effects. This is why a graduated treatment concept often makes sense. In addition to treating an underlying disease, medicinal, physical, interventional and psychosomatic approaches can be taken into account.

Persistent back or neck pain that persists for three months or longer is called chronic. They require a careful clarification of the cause and an individually tailored therapy concept.

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.

Before an implantation

Before an implantation, the diagnosis, previous therapies, individual risks and realistic therapy goals are examined and discussed in detail.

What is SIJ syndrome?

The sacroiliac joint (SIJ) connects the sacrum, the lower section of the spine, with the pelvis. It is stabilized by strong ligaments and has little mobility.

If there is irritation or dysfunction of the SI joint, pain can occur in the lower back and pelvic area. Possible triggers include incorrect or excessive strain, wear-related changes or previous injuries.

Local pain over the affected sacroiliac joint is typical. The symptoms can also radiate to the buttocks, hip region or thigh.

Diagnostics and therapy

Since similar complaints can also be caused by diseases of the lumbar spine, hips or other structures, it is important to carefully examine and differentiate other causes.

Which treatment is suitable depends on the cause, the duration and severity of the symptoms as well as the individual examination findings. Conservative pain therapy or – if appropriate, individual indication – surgical SIJ arthrodesis.

What is a vertebral fracture?

A vertebral fracture is a fracture of a vertebral body. A basic distinction is made between stable and unstable fractures. The cause of the break is also crucial for the assessment.

Vertebral fractures can occur, for example, after accidents or falls, when bone strength is reduced due to osteoporosis or in connection with tumor-related changes.

Typical symptoms are often clear, localized back pain that can persist for a long period of time. Depending on the type and extent of the fracture, structures of the spinal canal can also be affected. This can cause radiating nerve pain, numbness, tingling or a reduction in muscle strength.

Which treatment 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.

Minimally invasive stabilization / kyphoplasty

In selected cases, cement augmentation such as kyphoplasty may be considered to stabilize an affected vertebral body. Whether the procedure is suitable must be checked individually. Not every vertebral fracture requires surgery.

Tumors and metastases of the spine

In the case of tumor-related changes, interdisciplinary treatment planning is particularly important. Depending on the situation, surgical, radiotherapy, medication and, in selected cases, ablative procedures can be combined. Radiofrequency ablation should therefore be seen as a possible option for certain conditions, not as a general standard therapy.

Nerve compression – what happens?

Peripheral nerves can come under pressure at various anatomical constrictions. This leads to impaired nerve function, which can manifest as tingling, numbness, pain or reduced strength.

The symptoms are often intermittent at first and worsen with certain postures or stress. If the damage is prolonged or more severe, failures can become permanent.

Diagnosis and treatment

The diagnosis is confirmed through clinical examination and – if necessary – through electrophysiological measurements (nerve conduction velocity, EMG). Imaging can be used additionally.

Whether conservative or surgical treatment is indicated depends on the symptoms, the clinical findings, the extent of the nerve damage and the cause of the compression.

What is neuropathic pain?

Neuropathic pain develops when nerves are damaged or persistently irritated. It differs from ordinary pain caused, for example, by an injury or inflammation.

Typical symptoms include burning, stabbing, or electric-like pain. Additionally, tingling, numbness, or an uncomfortable hypersensitivity of the skin may occur. Such complaints can also persist or newly arise after an operation. Depending on cause and duration, this is referred to as postoperative neuropathic or chronic postoperative pain syndrome. A special form is phantom pain, which can occur after the loss or amputation of a body part. Although the affected body part no longer exists, the nervous system continues to process pain signals that are perceived as very real.

Treatment of neuropathic pain is guided by the individual cause. In addition to specific medications, physiotherapy, psychological, and interventional procedures may be used. In selected patients, neuromodulation techniques – such as spinal cord stimulation – may also be considered. A thorough examination is essential to identify the cause of the symptoms and together develop an individually appropriate treatment strategy.

Chronic pain – more than a physical problem

Chronic pain affects not just the body. Long-lasting complaints can also impair sleep, mood, concentration, performance and quality of life. At the same time, stress, anxiety, depressive symptoms or persistent emotional strain can influence the perception and processing of pain.

This does not mean that the pain is "only psychological" or imagined. Rather, physical, psychological and social factors in chronic pain are often closely interrelated.

That is why we approach chronic pain as holistically as possible. In addition to physical and neurological diagnostics, we also take psychosomatic accompanying factors and individual life circumstances into account.

Depending on the findings, psychosomatic or psychotherapeutic treatment approaches may also be beneficial alongside medication, physiotherapy or interventional procedures.

Our goal is not only to treat the pain itself, but also to reduce its impact on daily life, improve physical and psychological resilience, and thus support quality of life in the long term.

What is Tarsal Tunnel Syndrome?

Tingling, burning, or numbness in the sole of the foot can be caused by nerve compression at the inner ankle. In tarsal tunnel syndrome, the tibial nerve or one of its branches is compressed or irritated within the tarsal tunnel, impairing normal nerve function.

Typical complaints include tingling, burning sensations, numbness, or pain in the sole of the foot and toes. These symptoms frequently arise or worsen during weight-bearing activities or after prolonged standing and walking.

Diagnostics and Treatment

Accurate diagnosis relies on a thorough medical history and neurological examination. Depending on findings, electrophysiological examinations (such as nerve conduction tests) and imaging techniques may be utilized to pinpoint the cause and rule out conditions with similar symptoms.

Treatment is guided by the underlying cause and the severity of symptoms. Conservative measures are usually considered first. In cases of pronounced nerve compression and persistent discomfort, surgical decompression of the nerve may be indicated. Together with you, we discuss and determine the most appropriate individual treatment path.

Complex and Chronic Pain Syndromes

Chronic pain can have very diverse causes and significantly impair quality of life. As specialized neurosurgical pain therapists, we focus particularly on complex and chronic pain syndromes of the nervous system, spine, and musculoskeletal system.

These include neuropathic pain, phantom limb pain, and chronic postoperative and post-interventional pain syndromes. Even with persistent pain following spinal surgery or other interventions, we perform targeted diagnostics and therapy planning.

Individualized & Multimodal Therapy Planning

Following comprehensive diagnostics, we develop a personalized treatment concept. Depending on the underlying cause, pharmacological, physical, physiotherapeutic, psychosomatic, and interventional procedures may be combined. For selected patients, modern neuromodulation techniques are also considered.

Holistic Approach – Outpatient and Inpatient

Depending on the nature and severity of the symptoms, treatment can be carried out on an outpatient basis. For complex chronic pain syndromes, multimodal inpatient pain therapy may also be appropriate where medically indicated.

Our goal is not merely treating isolated symptoms. We consider physical, neurological, and psychosomatic factors together to formulate the most effective and tailored therapy.