By far the most back pain occurs in the lowest section of the spine. The lumbar spine bears the torso’s entire weight. The vertebrae bearing this weight are rather small when compared to other areas of the spine. Walking upright puts great strain on the joints in the lumbar spine.
Every day some of the fluid in the discs which cushion and absorb is lost and they shrink. Although this fluid is restored overnight and when lying down, this process of restoration slows as we age and the discs shrink permanently.
This shrinkage causes a decline in muscle tension. The lumbar spine bulges forward and this can result in increasing hollow back which puts further strain on the back itself. The result is deep-seated back pain that can radiate in a belt-like pattern. Additionally, the movements that pass from the torso to the legs take place in the area of the lumbar spine. This involves muscular traction such as the hip flexor or the so-called adductors. This is why the back specialist must also take a close look at the pelvis and legs during the examination.
"Due to the vast differences between patients, treating the spine requires a great deal of treatment experience. The specific factors and the wishes of patients often determine the course of treatment, not the x-rays or MRI images"
My interest in medicine goes all the way back to my early childhood and comes from my father, who was an internist. I frequently visited my father in his office, where I learned both the technical and the human aspect of being a physician. I was particularly fascinated by the skilled way in which people in need were treated and by the ways they were shown compassion and given constructive support. In my opinion there is no other job which combines the technical and human aspects this well.
As the uppermost part of the spine, the cervical spine supports the head. It has a total of seven cervical vertebrae (C1 to C7). The first cervical vertebra (atlas) is situated directly below the foramen magnum (large opening), an opening through which the spinal cord passes into the vertebral canal. The second cervical vertebra (axis) is responsible for skull rotation. It has a tooth-like structure (dens axis) which the atlas rests on. The main purpose of the cervical spine is to stabilise and move the head and protect the spinal cord.
Cervical spine pain or injuries are therefore serious events which should be examined by a specialist.
Pain in the back, neck or arm can be signs of cervical spine syndrome, or C-spine syndrome for short. A distinction is usually made between acute cervical spine syndromes and chronic cervical spine syndromes. Acute cervical spine syndromes are typically caused by injuries caused by sudden overstraining. This includes e.g. injury to the cervical spine in traffic accidents, the so-called whiplash injury of the cervical spine. However, acute cervical spine syndromes can also arise due to unusual strain from heavy physical activity or by exposure to draughts. Another trigger for pain in the cervical spine is acute spinal disc herniation (disc prolapse), where the inside of the disc emerges from the nucleus and compresses the spinal cord nerves.
The spine is the central axis of the human body. It holds us upright, gives us mobility and protects the sensitive spinal cord. Despite its remarkable properties, however, more than 40% of all adults suffer from spinal disorders and lower back pain is one of the leading causes of work disability in the industrialized countries of the world. Moreover, the incidence of spinal disorders in individuals below twenty years of age continues to grow. Whether you suffer from temporary lumbago, chronic back pain, or a gradually worsening wear-related condition, it is essential to regard backpain as an important alarm signal.
Chronic back pain is often diagnosed by specialists from different fields and different areas of knowledge.
Depending on whether you consult a general practitioner, a doctor with a background in psychosomatic medicine, an
orthopaedic surgeon, a neurosurgeon or a rehabilitation physician, the explanation for your problem and the
treatment recommendations you receive, may vary greatly. Many patients relate the experience of having to search
for an effective diagnosis of and plan of action for their back pain for a very long time.
Disc-FX is a technique in the field of minimally invasive spine surgery. Disc-FX only requires an endoscopic working access through a hollow needle with a diameter of only 2 mm. This approach allows treatment and removal of disc tissue inside and outside of the spinal canal (extra-and intraspinal) to remove. The fiber ring of the spinal disc can be stabilized.
Degenerative Disc disease is a chronic and often painful condition. This condition happens when one or more of the vertebral discs (cushions between the vertebrae) become damaged and weakened and no longer work as shock absorbers for the movement of the spine.
The PASHA®-catheter is a minimally invasive pain therapy. It is performed by an electromagnetic effect on the pain signal conduction inside the nerve fibres in the spinal cord (neuromodulation). Pain therapy with the PASHA® catheter is a minimally invasive treatment that is performed through an epidural needle: The electromagnetic treatment with a duration of 4-7 min results in a lasting moderation of the physiological pain signal transduction in the spina. The effect of the neuromodulation treatment with the PASHA®-electrode lasts for up to 2 years. The electrode is fixed at the end of a flexible plastic tube (catheter). This electrode can be navigated through the spine while controlling the position with x-ray vision. This initially invasive pain therapy is also called "Epidural pulsed radio frequency therapy" (EPRF). The popular name for this EPRF therapy (PASHA®-catheter) is after the inventor of this procedure, the German neurosurgeon Dr Omar Pasha.
RACZ Epidural Neurolysis is an injection (or series of injections) into the spine as therapy for chronic back pain. This injection procedure is a very effective way to relieve pain in the lower back and also pain radiating into the leg.
Racz Epidural Neurolysis can avoid the need for spinal surgery for many patients with chronic back and sciatic pain. This injection treatment has the potential to provide immediate and significant relief of chronic back pain and discomfort.
Vertebral discs are usually only mentioned in connection with herniated discs and back pain: our spinal discs tend to have a bad reputation. Most people start to consider the existence of vertebral discs only after a painful discus prolapse causes extreme pain. Other symptoms such as tingling, numbness and weak reflexes indicate loss of nerve function in the spine.
A herniated cervical disc occurs when a disc in the neck region of the spine becomes ruptured or bursts as a result of damage to the surface. The soft material inside the disc comes out, hardens and can press on the nerves which run through the spinal column.
Thanks to endoscopically guided spinal decompression, the herniated material of spinal discs, can be effectively removed via endoscopic vision. The process is gentle and supports rapid recovery of mobility.
Spine surgery should always be the last resort when it comes to treating chronic back pain. What does this mean? Only after failed physiotherapy and pain therapy, should surgery of any kind, be considered at all. The spinal cord is part of the central nervous system. The density of important nerves in the area around the spine makes this area particularly vulnerable to the possible complications of open spine surgery. The results of open spine surgery are not always successful in reducing chronic back pain. One of the reasons for failed back surgery is the formation of irritating scar tissue in the area of the spine following open spine surgery.
What is minimally invasive or endoscopic back surgery?
Endoscopic surgery takes place through a tubular device that avoids incisions into skin, muscles, nerves and bones.
Kyphoplasty or Vertebroplasty is a method of repairing a spine damaged by osteoporotic fracture of a vertebral body. In advanced spinal centres the repair of osteoporotic vertebral fracture is performed via a percutaneous (minimally invasive) surgical procedure.
The osteoporotic fracture of the vertebral spine is very painful. It has the potential to alter the height of the spinal column and the function of spinal cord and nerve roots permanently if left untreated. Kyphoplasty aims to achieve pain relief for the patient and restore the height of the collapsed vertebral bone.
Percutaneous Disc Nucleoplasty is surgery to reduce the volume of a protruded (bulging) or herniated disc. In both cases the spinal disc puts pressure on a nerve root, or the spinal cord and causes back pain or sciatic pain.
Nucleoplasty is a minimally invasive procedure to treat lumbar disc-related back pain and leg pain.
Spinal stenosis is a narrowing of the spinal canal. Every nerve connecting the brain with the body passes through this spinal canal. Spinal stenosis consequently affects the function central nervous system. Every nerve of the peripheral nervous system providing control and feeling for muscles and limbs passes through the spinal canal. Pressure and narrowing of this passage can result in severe functional deficits and pain.
This is surgery to alleviate pressure and pain caused by a damaged cervical disc in the neck.
When a disc in the neck region of the spine becomes ruptured or bursts as a result of damage to the surface, the soft material inside the disc comes out, hardens and can press on the nerves which run through the spinal column.
Pain is often felt as burning and may be accompanied by tingling, numbness, or muscle weakness in the neck, shoulders arms and hands.
Spinal Fusion (Sypondylodesis) is surgery to relieve backpain caused by hypermobility of vertebrae in your spine (Spondylolisthesis). The surgical fusion of vertebrae is called Spondylodesis. Spondylodesis also treatsspinal deformities such as scoliosis and kyphosis.
Spondlylolisthesis is the name given to the condition when a vertebrae (single bone of the spine) slips forward and pinches the spinal cord and sensitive nerve roots in this area.
Posterior Lumbar Interbody Fusion (PLIF) is a highly specialised and innovative surgical procedure to alleviate pressure and pain in the back and legs. Back pain and pain radiating from the spine into the legs and arms results from damage to the nerve roots caused by degenerative disc disease.