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Spinal interventions

Spinal interventions
Centre for Spine Health

What are spinal interventions?

Special minimally invasive one-day procedures under local anesthesia with which our multidisciplinary team (vertebrate surgeon, neurosurgeon), based on many years of experience in the treatment of acute and chronic spinal pain, discovers the causes and treats cervical, thoracic, lumbar, and sacral spine pain and radicular pain in all regions. Detection procedures are called diagnostic interventions, while treatment procedures are called therapeutic interventions. Procedures are carried out in a superbly equipped operating room for interventions with the use of a digital Philips Veradius mobile X-ray device with a flat detector and an image of higher resolution and better contrast than previous devices. The radiation dose with this device is reduced 2-3 times and it is the first device of its type in the region. During the entire procedure of preparation, intervention, and observation, which lasts 2-3 hours, the patient is placed in a day hospital under the constant supervision of the medical staff. After the procedure is completed, it is possible to go home on your own.

How to treat back pain in elderly persons?

The most common cause of neck pain and back pain in the elderly is the joints of the spine. If long-term treatment with physical therapy does not reduce pain or if patients take painkillers for a long time, the recommended method of treatment is therapeutic intervention - RF neuro-ablation of the facet joints of the spine. The procedure is performed with a radiofrequency neuro-ablation device that provides maximum safety and success of the procedure, as well as comfort for the operator and the patient during the intervention. Neuroablation of the facet joints of the spine is a particularly safe and suitable treatment technique for the elderly, as it is performed under local anesthesia without skin incisions and there are no surgical risks and complications. After the procedure and a short observation, the patients are mobile and go home accompanied by another person.

How to treat back pain in younger patients?

Painful backs are increasingly a problem of young active people. Sometimes the pains are occasional and transitory, and if they last longer than 12 weeks, specific diagnostics and therapy are required. Diagnosed degenerative disc disease (DDD) can be treated with therapeutic interventions and minimally invasive surgeries.

Our Centre for Radiology & Imaging uses state-of-the-art technology in performing radiological diagnostic examinations. The approach to the patient is individual, and the choice of the radiological examination depends on the indications. Contact us with confidence!

Therapeutic intervention – disc biacuplasty

Therapeutic intervention - disc biacuplasty is a procedure of neuro-ablation of the sinuvertebral nerves of the painful disc that effectively reduces chronic low back pain. The procedure is performed under local anesthesia with mild sedation of the patient with special needles that have water cooling ("cooled" RF), which maximizes the safety of the patient and the efficiency of the procedure. After the procedure and a short observation, the patient goes home accompanied by another person. Returning to office work is allowed after 2 weeks, and to physical work and other more difficult activities after 6 weeks. If the disc changes have progressed, it is possible to carry out minimally invasive surgical treatment with the installation of an interspinous implant, dynamic stabilization, or minimally invasive fusion.

Can disc herniation be treated without surgery?

Disc herniations and spinal stenosis can cause radicular pain due to mechanical and inflammatory stimuli. Most patients recover naturally, but 15% of them have pain for longer than six weeks. In these patients, it is necessary to confirm the location of the nerve root stimulus with magnetic resonance, after which the pain can be reduced by therapeutic intervention - epidural steroid injection. Injections are performed through an interlaminar or transforaminal approach at the level of a verified hernia or stenosis. The procedure is performed in a superbly equipped operating theater for interventions. Localization of injections is determined with a Philips Veradius digital mobile X-ray device. After the procedure, it is possible to go home accompanied by another person, and the maximum therapeutic effect is expected in a few days. Pain reduction is expected in 90% of patients with a herniated disc who receive the injection within 12 weeks of the onset of symptoms, and in 50% of patients with chronic stenosis.

When and how to operate for lumbar disc herniation?

Disc herniation characterized by protrusion is effectively treated with therapeutic interventions. However, extrusion-type disc herniation often requires surgical treatment due to persistent pain and/or possible neurological damage (muscle paresis, loss of sensation). The classic surgical approach with a wide laminectomy causes unnecessary damage to the paravertebral musculature and the formation of postoperative adhesions. The microsurgical approach with interlaminectomy and discectomy, while preserving the stability of the segment, reduces the mentioned side effects of the procedure and speeds up the patient's recovery, and shortens the rehabilitation time.

Should lumbar spinal channel stenosis be operated?

Scientific evidence confirms that surgical treatment of spinal canal stenosis is more effective than any other type of treatment. The classic surgical approach is the method of long incision and decompressive laminectomy with expected prolonged rehabilitation. A minimally invasive approach to the problem of spinal stenosis is solved in two ways: by inserting an interspinous implant, microsurgical laminotomy, and foraminotomy. A part of patients with predominantly soft-tissue lumbar stenosis is successfully treated with the installation of an interspinous implant based on the principle of indirect decompression. The percutaneous technique of implant placement achieves the effect of minimally invasive surgery because the patient can walk independently and leave the hospital the very next day. Another part of the patients has predominantly bony stenosis, and the surgical technique of choice is microsurgical interlaminectomy. In the case of preoperatively confirmed microinstability, an interspinous dynamic stabilizer can be implanted. These patients get up on the second day with the help of a physiotherapist and can leave the hospital after 2-3 days.

What is spinal instability?

The inability of the spine not to change its shape under physiological loads. Chronic vertebral dynamic segment dysfunction, spondylolisthesis, and progressive degenerative deformity can lead to instability that needs to be treated with spinal surgery. In these patients, it is necessary to perform dynamic restabilization or fusion of unstable spinal segments. The classic surgical technique of fusion with a long incision significantly damages the paravertebral musculature and prolongs the rehabilitation of patients for 3-4 months. When stabilization of one or two segments of the spine is indicated, we perform the installation of interspinous inserts, minimally invasive fusion using the sophisticated technique of percutaneous transpedicular fixation (MISS - minimally invasive spine surgery), anterior intercorporeal fusion (ALIF) or transforaminal intercorporeal fusion (TLIF). This type of treatment is carried out in specially equipped operating rooms, using implants of the world's leading companies (Synthes, Johnson&Johnson) of high quality and guaranteed safety, and course with specially trained spinal surgeons and medical staff. With such principles, the duration of postoperative pain, the duration of postoperative recovery, and rehabilitation are shortened to 4-8 weeks.

What is an osteoporotic fracture of the spine?

Spinal fracture caused by osteoporosis most often occurs after physical overload in everyday life or a fall on the same level. Two-thirds of patients notice the first signs after 2-3 weeks, and due to minimal changes on a classic roentgenogram, these fractures are sometimes diagnosed with a delay. Most spinal fractures caused by osteoporosis heal naturally, but some patients suffer constant pain with worsening symptoms. The solution to these problems is a modern minimally invasive operation of vertebroplasty with high viscosity cement (Vertecem, Confidenc). Vertebroplasty is the filling of a broken vertebra with cement, which becomes stable with this procedure and the previous pain stops immediately. It is performed under local or short general anesthesia, which is especially important for elderly patients who make up the majority of patients with this problem. If the broken vertebra is significantly reduced in height, it is possible to restore the height of the vertebra with the additional technique of installing a "vertebral body stent" (VBS) and only then filling it with cement. Regardless of which of these procedures is performed, the patients are mobile and able to return home the very next day.

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