Spinal fusion in Germany

Degenerative disease of the spine is on the rise and many individuals are resorting to various treatment strategies to get relief. Age related degeneration is the major cause; however a variety of life style factors are also known to play spoilsport.

Various treatment modes have been developed to correct the degenerative disease of the spine. Germany is the finest place for getting treated for the same. It has world class surgeons who have specialized in spine treatment. Spine treatment in Germany is done using the most sophisticated and state-of-the-art technologies.

Spinal fusion is considered to be a gold standard in the treatment of spine. This method involves joining of two or more vertebrae. This method also known as spondylodesis or spondylosyndesis makes use of bone tissue either of the patient or from the donor to join the two vertebrae.

Spinal fusion is advised in one of the following conditions:
  • Degenerative spine disease
  • Scoliosis
  • Herniated discs
  • Spondylosis
  • Tumour in the spinal column
  • Discogenic pain
  • Spinal injury
  • Kyphosis
  • Fractures of the vertebrae
  • Spondylolisthesis
  • Posterior rami syndrome
Individuals with scoliosis have a spine curved towards the end. When such individuals are viewed from the back, their spine appears to be curved and not straight as in case of normal individuals. Scoliosis treatment in Germany is done by spinal fusion which is carried out by expert surgeons. In cases of congenital scoliosis in infants, surgery may not be required and use of plastic jackets can permanently treat the condition in them. Whatever may be the case; spine treatment in Germany is exhaustive and explores all the possible treatment options, and churns out the best for you.

Symptoms of degenerative spine disease:


Degenerative disease of the spine is a cause of severe discomfort for the individuals and gives rise to the following symptoms:
  • Pain in the lower back region that gets worse in the sitting position.
  • Back ache that gets severe during activities of lifting, bending and twisting.
  • Individuals often tend to change positions to avoid the pain caused by long sitting hours.
  • Individuals are unable to sit for longer periods and may feel better by walking in between.

Types of spinal fusion:


There are two types of spinal fusion and in many cases are often used together.
  • Posterolateral fusion:
  • In this type, the bone graft is placed in the back region of the spine.
  • Interbody fusion:
  • In interbody fusion, the bone graft is placed in between the vertebrae that need to be fused. With this type, the rate of fusion is higher as compared to posterolateral fusion.
When both these types of fusion are used it is known as 360 degrees fusion.

Spinal fusion – Procedure in detail


Spinal fusion is a surgical procedure lasting for several hours. General anaesthesia is administered and the patient is put to sleep. Once the anaesthesia has shown effect, the following steps are undertaken:
  • The surgeons make an incision in the back region to see the spine. The muscles and tissues are carefully separated to have a clearer view.
  • Next, by using refractors the surgeons hold the tissues and blood vessels apart so that they get sufficient area to work.
  • A bone graft is often used for fusing the two vertebrae together. It needs special mention here that, in case the condition of the individual demands additional surgical procedures such as discectomy, laminectomy to be done then these are first carried out followed by spine fusion.
  • The vertebrae are fused together by any one of the following ways: i. The bone graft may be placed on the back side of the vertebrae.
    ii. The graft may be placed in between the vertebrae for holding them in place.
    iii. Cages containing the graft may be placed in between the vertebrae.
Once the grafting is completed, the vertebrae are fused together by means of screws, rods, plates or cages. These help the vertebrae to be in one place during the healing process.

The bone grafts is generally taken from the pelvic region either from the patient’s body or from a donor. Bone grafts act as a bridge in between two vertebrae and they also help new bone to grow.

The complete fusion takes about 6 – 12 months. During this period, external support in the form of belts or braces is required to protect the spinal column from undue strain or injury. In cases, when fusion does not occur, the individuals might have to undergo the surgery again.

Spine surgery is a major operation and one can certainly expect some risks. These are:
  • Pain in the region where the bone graft was implanted.
  • Fusion was a failure due to breakage of metal implants that were used to hold the vertebrae in place.
  • Injury to the neighbouring nerves.
  • Infection.
  • The body rejects the graft.
  • Blood clots that may cause pulmonary embolism.
Spine treatment in Germany is carried out by world class surgeons who have hands on expertise in their respective fields. If one wishes to get the best treatment for spine fusion, then certainly Germany is the best option, we can always help you by arranging for an appointment with a specialist in Germany.

Total disc arthroplasty in Germany

Total disc arthroplasty also known as TDA functional disc replacement is a procedure wherein the painful disc is replaced by artificial implants. The artificial disc or implants has properties similar to the normal disc that facilitates normal movement of the spine. Total disc arthroplasty has a major advantage over spine fusion; the former one promotes better mobility of the spine as against spine fusion surgeries which do not allow mobility.

Spine treatment in Germany is carried out by world class surgeons who have hands on expertise in carrying out total disc arthroplasty. In addition to this, the laboratories and operation theaters are well equipped with modern facilities and all the latest equipment required for carrying out TDA. Individuals with chronic back ache should consider Germany for getting their treatment done. Treatment of spine in Germany is done with latest innovations in total disc arthroplasty and with quality implants for disc replacement.

Total disc arthroplasty has been here for around 20 years for now. However, more options in artificial implants are available today due to the constant research and innovations being made in developing artificial implants to meet the quality standards.

Criteria for conducting total disc arthroplasty:


Total disc arthroplasty is required in patients who are suffering from degenerative disease of the lumbar disc. The operative procedure is the last resort that is considered when the patients fail to respond to conservative treatment options. Also, the patients need to undergo the disc replacement when severe neurological symptoms set in. These symptoms consist of loss of control over bladder movement, loss of control over bowel movement, weakness and loss of sensation in hands and legs.

Procedure:


Chronic lower back pain is making life worse for many individuals and they are on the lookout for various methods to treat the condition. Several clinical trials and research conducted state that surgical procedures for treating lower back pain have a better outcome when compared to physiotherapy and exercises. Total disc arthroplasty is a procedure, wherein the entire disc except the posterior part of the annulus is removed and replaced with artificial disc. The device used in TDA consists of the following parts:
  • Two metal end plates
  • These are made of cobalt and molybdenum that have a special coating making them favorable for the fusion process. Yet another set of metal end plates contain spikes that promote stability and allow better fusion during the surgical procedure.
  • A central core
  • This is responsible for the mobility and is made up of high molecular weight polyethylene or metal. Post surgery, the patients should regain mobility within a day or two. Some of them may experience abdominal distention that should usually clear off within 2 days. Back ache can get so severe for some patients that they often adjust their body movements to soothe the pain. The doctors can recognize this and address the problem to the physiotherapists. They would then help the patients post surgery to correct the faulty body postures.
Post operation, the patients are not given any braces or belts to wear. They are made to walk with the help of walker and carry out certain physical exercises that would help to ease off the pain post surgery. The following is a list of do’s and don’ts for patients undergoing total disc arthroplasty.
  • Restoration of movement as early as possible.
  • No lumbar rotation is allowed for the first 3 – 6 weeks.
  • Bending sideways is allowed only after 3 weeks.
  • Right and correct posture is made mandatory and the patients should avoid weight lifting as far as possible.
  • Over extension is prohibited and should be avoided.
  • Abdominal exercises are not allowed for 6 weeks post operation.
  • High level activity is allowed only after 6 months depending on the type of physical activity.
The success rates of total disc arthroplasty have so far been encouraging with very few reported complications.

The following is a list of complications that may accompany total disc arthroplasty:
  • Bleeding post surgery
  • Deep vein thrombosis
  • Infection
  • Pulmonary embolism
  • Injuries related to the ureters
  • Leg pain post surgery which should get corrected within 2 weeks
  • Retrograde ejaculation
  • Placement of the artificial disc is not proper and does not match the axis of rotation.
  • The artificial disc implanted collapses causing severe back ache. This is then corrected with another revision surgery that needs to be done within 2 weeks to avoid further damage to the spine. To avoid subsidence of the artificial disc, it is necessary that the bone mineral density be checked prior to the surgery and osteoporosis be ruled out.
  • Scoliosis may occur due to arthritis of the facet joints. It is therefore recommended that the doctors conduct a thorough check up for all these spine related diseases prior to the surgery.
If you are having a painful disc and considering having a TDA in Germany, we will assist you in choosing the best medical care facility for your spine treatment in Germany.

Treatment of herniated discs in Germany

The spinal column is made up of 26 bones that are called vertebrae. These vertebrae have soft discs in between them that are packed with jelly like substances. When these discs bulge out from their original place, a condition known as herniated discs is created. Due to this, the jelly-like substance also leaks out from its place causing discomfort and back ache. This majorly occurs due to age related factors that cause the disks to undergo degeneration. In addition, some other factors such as undue strain in the spine, lifting of heavy weight and trauma also are responsible for herniated discs. Individuals with this condition often complain of sciatica pain.

Herniated discs can also exert pressure on the neighboring nerves causing pain and weakness in the legs. However, in some cases, individuals may not experience any symptoms. Surgery is often not indicated in the treatment of herniated discs.

Individuals often do not experience any symptoms of herniated discs. However, in certain cases, the condition can give rise to painful symptoms, which include:
  • Weakness in the arms and legs
  • Decrease in ability to lift substances
  • Occurrence of numbness and tingling sensation in the legs

Treatment:


Treatment of herniated discs is aimed at alleviating the pain and its associated symptoms. Treatment of herniated discs in Germany is carried out by surgeons who have vast years of experience in this field. The following treatment options are considered:
    • Conservative treatment:
    • In this type of treatment, the individuals are given medications for relieving the pain, muscle relaxants, narcotics and corticosteroid injections. Individuals are also prescribed nerve pain medications to relieve the pain that is caused due to the nerves under pressure.
    • Physiotherapy:
    • A physiotherapist will carry out a variety of procedures for relieving the pain due to herniated discs. These consist of application of ice or hot packs in the affected area, traction to relieve the nerves under pressure, ultrasound for relieving the pain, electrical stimulation and short – term braces also known as belt for the lower back. The physiotherapist may also suggest some exercises to relieve back ache and to strengthen the muscles of the back and legs. Spine treatment in Germany is done through both conservative methods and surgery. Surgery is carried out using the latest and most modern technologies.
    • Surgery:
    • Surgery is the treatment of choice under the following conditions:
      • Conservative treatments and physiotherapy fail to work.
      • Nerves are under great pressure and might worsen if immediate action is not taken.
      • Numbness and weakness in the legs and back have increased and is getting severe.
      • There is no decrease in pain even after taking medications for 4 weeks.
    The following types of surgery are considered for treating herniated discs:
    • Discectomy:
    • This type of surgery is also known as open discectomy in which the herniated disc that is compressing the nerves is removed. This surgical procedure is indicated in cases of ruptured herniated discs or bulging discs. A surgery of this type helps cure the severe pain experienced due to herniated discs.
    • Percutaneous discectomy :
    • This type of surgery is less effective when compared to discectomy. It is used in individuals in whom the herniated discs have not ruptured. This is a minimal invasive technique that requires insertion of special tools through a small incision in the back. With the special tools, the herniated disc tissue is removed and the size of the disc is decreased. It is recommended that future studies and clinical trials be carried out for further modification of this technique to increase its efficacy.
    • Laminotomy and laminectomy:
    • These two types of surgeries are done to relive pressure on the spinal nerve roots caused due to age related factors. Laminotomy is the surgical removal of lamina which is the thin part of the vertebrae forming a protective covering on the spinal column. The procedure of laminectomy, consists of removing all parts of the lamina from the selected vertebrae. It also removes any thickened tissue that is causing the spinal canal to narrow down. These two procedures may be done at the same time or separately as the situation demands.
    • Intradiscal electrothermal annuloplasty:
    • In this type of surgical procedure, a hollow needle is inserted through a minimal invasion in the area of affected disc. A wire is passed through the needle and heated up to 90 degree Celsius for about 15 minutes. The heat at this high temperature burns the nerve ending and also seal ruptures in the discs.
    • Artificial disc replacement:
    • This type of surgical procedure is widely done in the European countries. In this procedure, the degenerated or ruptured discs in the vertebrae are replaced by artificial ones.
    Treatment of spine in Germany is carried out by world class surgeons who have hands on expertise in their respective fields. If one wishes to get the best treatment for spine related disease, then certainly Germany is the best option, we can always help you by arranging for an appointment with a specialist in Germany.