Spinal surgery - Clinic for Trauma Surgery, Orthopaedics and Plastic Surgery

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Clinic for Trauma Surgery, Orthopaedics and
Plastic Surgery

Spinal surgery

At the Clinic for Trauma Surgery, Orthopaedics and Plastic Surgery’s spinal surgery department, our highly specialised team treats any and all diseases and injuries, be they congenital, accident-related, or degenerative.

We perform both conventional and minimally-invasive procedures, and all of our operations use state-of-the-art methods and are of the highest standard. In addition to the indispensable surgical microscope, we also use modern 3D navigation when necessary and, in special cases, monitor nerve function intraoperatively (neuromonitoring). By using these methods, we can guarantee the highest possible degree of safety for the patient during their operation.

The spine is a human being’s bony centrum and is located centrally within the body. In combination with the spinal discs and their associated ligaments, it plays a crucial role not just for the stability and static equilibrium of the skeleton, but also for the spinal cord and the nerves that arise from it. Almost every person suffers from back pain at some point during their lifetime. The causes of back pain are manifold, and we will discuss them in more detail below. 

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Degeneration

The term “degeneration of the spine” encapsulates all changes to the spinal column caused by age and wear. These changes can take the form of herniated intervertebral discs (nucleus pulposus prolapse), narrowing of the spinal canal (spinal stenosis) or curving of the spine due to wear (de novo scoliosis). Surgery is advisable in only a few cases. In many cases, we will be able to alleviate your symptoms through adequate conservative therapy, e.g., with an injection administered under X-ray guidance (PRT, periradicular therapy).

If an operation is necessary, we are able to make use of any and all modern procedures – from minimally invasive microsurgical decompression, to minimally invasive stabilisation and artificial intervertebral disc replacement (intervertebral disc prosthesis), right through to major corrective surgery. 

The image below shows a painful herniated disc to the left side at L4-L5:

Bandscheibenvorfall L4/5 links

Injuries

Here at our clinic, we treat cervical, thoracic and lumbar spine injuries of all degrees of severity using both conservative and surgical methods. Whether surgery is advisable depends on the severity of the injury and the patient’s circumstances, which is why we work together with you to determine what therapy will be best.

If an operation is necessary, all dorsal and ventral surgical procedures will be at our disposal. Which procedure we opt for will be dependent on the case at hand. The goal of any procedure is always to reconstruct the injured spinal segments in an optimal way and to preserve neurological functions.

As elderly people can often suffer vertebral body fractures even in the absence of an accident (pathological fractures), our clinical focus, aside from optimal surgical therapy, is on the treatment of the underlying osteoporosis in order to prevent further fractures.

Even patients experiencing negative after-affects after a spinal injury, such as pseudarthrosis and post-traumatic malposition, are in the right place with us. The image below shows an L3/L4 fracture-dislocation before and after surgical treatment:

Luxationsfraktur L3/4 vor und nach operativer Versorgung

Revision surgery

The chosen therapy will not always achieve a satisfactory result for the patient. As is the case when treating any other fracture, pseudarthrosis (failure to achieve bony fusion), implant failure and malpositioning may occur when treating spinal fractures as well. Our team of doctors has many years of experience in treating these sequelae. The following X-ray on the left shows the preoperative CT of a case of connection instability caused by inflammation, while on the right, you can see the postoperative X-ray after infection treatment and renewed stabilisation:

Anschlussinstabilität durch Entzuendung

False statics and structural disorders

Curvatures of the spine (scoliosis) and sliding discs (spondylolisthesis) can be congenital, but can also occur in older people as a result of wear. Careful and thorough anamnesis, examination and diagnostics in a team made up of different disciplines are important in these cases as well. Without them, we would be unable to provide you with recommendations on whether conservative or surgical therapy would be best for you.

The following image shows an MRI of a disc that has slipped by 1 degree, which increases visibly in the standing X-ray:

Wirbelgleiten im MRT

Inflammations

Inflammations of the intervertebral discs (spondylodiscitis) and the vertebral body (spondylitis) are very rare, but often very serious diseases that are caused by fungi or bacteria. They often affect immunocompromised patients who have diabetes mellitus or have had cancer in the past. In addition to differentiated determination of indications for surgical or conservative therapy, cooperation with the other specialist disciplines at the UMG is essential for this patient group. Thus, when it comes to determining the right antibiotic therapy, there is a weekly joint conference with colleagues from the microbiology department – this collaborative effort ensures that, in addition to providing the best surgical therapy, we can also determine what drug therapy will be best for you.

The following 3 pictures show a case of intervertebral disc inflammation in the same patient on an X-ray, a CT and an MRI.

Bandscheibenentzündung im Roenten, CT und MRT

Tumour diseases

Primary spinal tumours are very rare. By contrast, malignant metastasis of other tumour diseases to this region of the body occurs relatively frequently. This causes both severe pain and instability. In some cases, pressure on the spinal cord or outgoing nerves can cause neurological complications. To enable us to provide our patients with the treatment that is optimal for them, we have the possibility of individually discussing our cases together with all colleagues involved in the patient’s treatment at the UMG’s tumour boards.

The MRI scans below show a tumour growing on the cervical spine and pressing against the spinal cord, followed by the situation after successful stabilisation and decompression.

Tumor Halswirbelsäule