Treatment of Spinal Disorders and Intervertebral Disk

The human spine consists of seven cervical, twelve thoracic, and five lumbar vertebrae, as well as the underlying sacrum and tailbone. In detail, each vertebra consists of the body, a vertebral arch that protects the spinal cord structures, the transverse processes, a spinous process, and the facet joints, where the vertebra articulates with the vertebra above, respectively below it. The connectors between the vertebral bodies are the intervertebral disks, which may be considered to be shock absorbers; together with the facet joints, they are responsible for the mobility of the spine.

Intervertebral disks consist of a fibrous ring (annulus) of connective tissue, which surrounds a soft gelatinous nucleus and contributes to distributing the pressure between the vertebral bodies.

Intervertebral Disk Protrusion and Herniated Disks

The degeneration of the disk’s fibrous ring can lead to a shifting of the gelatinous nucleus (disk protrusion) or result in the extrusion of the gelatinous nucleus from the disk structure (disk prolapse/herniated disk).
The shifting of the gelatinous nucleus can cause local back pain; pressure or compression of nerves in the area of the spine cause typical pain in the extremities, loss of sensation, or even paralysis. In the area of the thoracic spine, herniated disks are extremely rare.

Facet Joint Syndrome

Incorrect weight bearing or degeneration of the small vertebral joints (facet joints) may result in local or radiating back pain.

Spinal Stenosis

This is a narrowing of the spinal canal in different sections of the spine, which is caused by degenerative processes and is rarely congenital; typically, leg pain is observed as well as a reduction of the distance someone can walk.

Spinal Instability

This refers to congenital or acquired loosening of sections of the spine, which, if conservative stabilizing treatment fails, can also be stiffened (fused) surgically.

In the event of acute pain, significant pain relief can be achieved through a special kind of positioning. Orally administered medication and anti-inflammatory drugs are complemented by more powerful medication administered to the patient via infusion bottles.

By means of physiotherapy exercises as well as balneo-physical measures, the symptoms can be reduced even further once the acute pain phase is over; these measures can also be used as preventive therapy.

Acute spinal blockages can be treated and relieved via chiropractic therapy; in addition, the possibility exists to administer pain relief medication to so-called trigger points by means of targeted infiltration. Treatment using an epidural catheter, blockage of the sacrum, and the technique of paravertebral spinal nerve blockage are possible treatments in the area of the lumbar spine for treating sacrum pain caused by intervertebral disk problems and for inducing permanent freedom from pain.

Surgical treatment may become necessary after all forms of conservatively possible treatment have been exhausted, if paralysis or loss of sensation persists or if there is acute paralysis of important muscles, as well as in the case of paralysis of the sphincter of the bladder and the rectum (Kauda syndrome).

Possibilities include open decompression of spinal nerves as well as microsurgical treatment of herniated disks using a special surgical microscope. In the case of spinal instabilities for which conservative treatment is not possible, spinal fusion operations can be offered using various procedures.