Spinal Surgery. Medical Care
Exact diagnostics, comprehensive explanation and gentle operating methods.
Using modern diagnostic methods the underlying cause of symptoms is clarified initially in each individual case. If urgency demands, examinations take place on the day the patient comes to the outpatient department or to the ward. After an exact diagnosis, we try first of all to avoid surgery by means of conservative treatment methods. This means only 8% of patients with a slipped disc in the lumbar spine undergoes surgery. We only advise surgery if a combination of physical therapy, physiotherapy, infiltrations and medications do not look promising or are ineffective. Even progressive neurological deficits justify an operation.
Spectrum of spinal surgery.
Minimal-invasive & microsurgical procedures.
In all suitable cases, minimally invasive intervention is carried out in our Spine Centre during which there is minimal tissue injury. The advantage for the patients, especially the elderly, is mobilisation on the afternoon of the day of the operation. This means a significant reduction in risk of thrombosis or pulmonary embolism. Also the fact that minimal access techniques result in intraoperative blood loss being limited to 50 – 100 ml, contributes to a very short healing period with rapid rehabilitation.
Special microsurgical procedures.
A specialisation of our Clinic for Spinal Surgery in Hamburg is the use of minimal access techniques in the treatment of slipped discs, bony stenosis of the spinal canal and tumours in the spinal canal. Prof. Dr. Pavero, Consultant, has been involved in the introduction of special techniques and is committed to their further development including on an international level. For instance Prof. Papavero uses a specially developed expandable tube with a 15mm diameter for the removal of protruding disc tissue, with the aid of which the trapped nerve can be relieved without harming any tissue.
Microsurgical intervention the best for spinal canal stenosis.
Narrowing of the lumbar spinal canal, so-called spinal canal stenosis, causes pain and numbness in the legs and shortens walking distances. Microsurgical expansion of the narrowed spinal canal is the most frequent intervention on the lumbar spine. Patients affected are aged between the sixth and ninth decade of life. By using a microscope and a special speculum that is 2/3 the size of the traditional ones, it is possible to widen the narrowed spinal canal on both sides by access on one side via a 25-mm long incision in the skin. A recently published study proved the high level of effectiveness of this surgery and that it is well tolerated. The postoperative outpatient or inpatient treatment is organised during the patient's stay at the clinic, which usually lasts around 5 days for the most common operations.
Removal of tumours: Intraoperative monitoring.
The removal of tumours in the spinal canal, especially in the region of the neck and thoracic spine requires many years of surgical experience and sophisticated facilities in terms of surgical technology. These include high-performance surgical microscopes, intraoperative X-ray machines and the latest generation of microsurgical instruments. Monitoring electrical activity in the spinal cord during surgery - so-called intraoperative monitoring, is a complex and challenging procedure, which however considerably reduces the risk of postoperative neurological deficits. Put in simple terms it can be likened to the difference between visual flight and radar-controlled flight. In the Clinic for Spinal Surgery, intraoperative monitoring is the norm in surgery on intraspinal tumours.
During the operation permanent control ensures the therapeutic outcome.
The electric currents of the spinal cord can be monitored during surgery with a very complex procedure (intraoperative neuromonitoring). If certain waves disappear (yellow arrows) the operation is interrupted and only continued once the spinal cord recovers again. Without this control there is a danger that the spinal cord will suffer lasting damage.
We are specialised in the treatment of acute and chronic diseases and injuries of the cervical, thoracic and lumbar spine exspecially onspinal stenosis.
- Slipped discs (excision or implantation of a prosthesis)
- Bony narrowing of the spinal canal (minimal-invasive decompression)
- Slipped vertebra
- Degenerative scoliosis of the lumbar spine
- Rheumatic spine
- Ankylosing spondylitis
- Traumatic and osteoporotic fractures to the vertebrae (shot of cement)
- Tumour of the spine
- Infections of the spine
- Interventional pain therapy of the spine (CT or x-ray guided shots)
- Spinal cord tumours
- Myelocele (open back)
- Tethered cord
- Narrowing syndroms