Services
Treatment of the entire spectrum of neurological disorders with a special focus on minimally invasive therapy, spinal surgery, pain management procedures and many other neurosurgical procedures.
Minimally invasive therapy procedures
The following section presents minimally invasive and image-guided spinal interventions – i.e. under X-ray, computed tomography (CT) or magnetic resonance imaging (MRI) control – for the relief of back pain.
The points of intervention can range from the very outside (muscles) to the very inside (intervertebral disc) and are combined individually for each patient. All minimally invasive interventions are part of a therapy concept with complex outpatient prevention and rehabilitation measures.
Breaking the cycle: pain and tension relief through special pain therapy injections
Under electrical (EMG) or CT monitoring, a tension-relieving nerve toxin (botulinum toxin) can be injected into the back extensor, gluteal or neck muscles.
This healing solution interrupts the excitation of the muscle by the nerve cells and can thus combat even stubborn tension pain in the muscles where all other therapies have failed.
Acupuncture based on traditional Chinese medicine
The stimulation of acupuncture points, primarily with needles and heat, is probably the oldest and most widespread healing method in the world. The best known is classical Chinese acupuncture. By stimulating precisely defined points (meridians) on the skin, disorders throughout the entire organism, including those inside the body, can be alleviated and often even eliminated.
Elimination of pain fibres in the vertebral joints (denervation)
Millimetre-thin surgical needles are inserted into the pain-conducting nerve endings in the spine.
These are then destroyed using a special solution or a brief heat stimulus. Laser energy or high-frequency electrical currents are used. The patient feels nothing during the procedure thanks to local anaesthesia.
An even gentler alternative is pulsed radiofrequency stimulation of the nerve tissue. The positive biological and physical effects on pain have been confirmed by numerous studies.
All of these interventions are performed on an outpatient basis and can be repeated two to three times to achieve lasting pain relief.
Nerve root treatment (periradicular therapy)
Periradicular therapy has been developed for patients with nerve root pain and abnormal sensations caused by disc protrusion or disc herniation.
Under computer or MRI guidance and local anaesthesia, thin needles are inserted into the exit hole of the irritated nerve root. A contrast agent makes it possible to see where the nerve and needle are located.
Once the needle has reached its target, the neurosurgeon injects pain-relieving and decongestant medication precisely at the site of the problem.
In cases of scar tissue (previously operated patients), a fine endoscope can also be used to release the nerve tissue under visual control.
Thanks to the use of modern X-ray technology, these procedures, which are performed on an outpatient basis under local anaesthetic, are particularly safe and efficient.
If there is an improvement in symptoms after the first session, the procedure is repeated several times at intervals of one to two weeks to help achieve long-term pain relief.
Breaking the cycle: pain and tension relief through special pain therapy injections
Under electrical (EMG) or CT monitoring, a tension-relieving nerve toxin (botulinum toxin) can be injected into the back extensor, gluteal or neck muscles.
This healing solution interrupts the excitation of the muscle by the nerve cells and can thus combat even stubborn tension pain in the muscles where all other therapies have failed.
Acupuncture based on traditional Chinese medicine
The stimulation of acupuncture points, primarily with needles and heat, is probably the oldest and most widespread healing method in the world. The best known is classical Chinese acupuncture. By stimulating precisely defined points (meridians) on the skin, disorders throughout the entire organism, including those inside the body, can be alleviated and often even eliminated.
Elimination of pain fibres in the vertebral joints (denervation)
Millimetre-thin surgical needles are inserted into the pain-conducting nerve endings in the spine.
These are then destroyed using a special solution or a brief heat stimulus. Laser energy or high-frequency electrical currents are used. The patient feels nothing during the procedure thanks to local anaesthesia.
An even gentler alternative is pulsed radiofrequency stimulation of the nerve tissue. The positive biological and physical effects on pain have been confirmed by numerous studies.
All of these interventions are performed on an outpatient basis and can be repeated two to three times to achieve lasting pain relief.
Nerve root treatment (periradicular therapy)
Periradicular therapy has been developed for patients with nerve root pain and abnormal sensations caused by disc protrusion or disc herniation.
Under computer or MRI guidance and local anaesthesia, thin needles are inserted into the exit hole of the irritated nerve root. A contrast agent makes it possible to see where the nerve and needle are located.
Once the needle has reached its target, the neurosurgeon injects pain-relieving and decongestant medication precisely at the site of the problem.
In cases of scar tissue (previously operated patients), a fine endoscope can also be used to release the nerve tissue under visual control.
Thanks to the use of modern X-ray technology, these procedures, which are performed on an outpatient basis under local anaesthetic, are particularly safe and efficient.
If there is an improvement in symptoms after the first session, the procedure is repeated several times at intervals of one to two weeks to help achieve long-term pain relief.
Pain therapy using spinal catheter technology
In this procedure, which is performed under local anaesthetic on an outpatient basis or during a two- to three-day inpatient stay, a very thin, flexible tube is inserted through natural openings in the spine under continuous X-ray guidance and temporarily placed on the spinal cord membrane.
In difficult anatomical conditions, the neurosurgeon uses a fine endoscope to place the catheter precisely, i.e. scar tissue can be loosened under visual control and the nerve fibres that are compressed by the disc tissue can be released. An effective solution of anaesthetics, anti-inflammatory substances and tissue-shrinking enzymes is then flushed in. This method is particularly suitable for patients with protrusions at several levels or scar tissue adhesions following spinal surgery.
As a non-chemical method, radiofrequency stimulation of the nerve pathways can also interrupt pain transmission and strengthen the immune system through pulsating stimuli.
Facet infiltration on the spine and joints
In cases of painful joint diseases (not of rheumatic origin), the targeted injection of anti-inflammatory drugs and/or water-binding artificial joint fluids (e.g. hyaluronic acid) can help to significantly relieve pain and improve mobility.
Since all anatomical structures are displayed during the injection in CT, accidental misinjection is ruled out.
The procedure is performed on an outpatient basis and must be combined with professional physiotherapy.
Removal of herniated discs through the skin
Removing a herniated disc through the skin (percutaneously) protects the tissue and shortens the post-operative treatment phase.
During CT-guided endoscopic removal of the herniated disc (discectomy), the neurosurgeon inserts thin special instruments with high-precision endoscopes and cameras into the disc space under local anaesthesia (with an anaesthetist present if necessary). The excess disc tissue is removed using fine special instruments or a laser beam. At the same time, the pain fibres of the disc ring are destroyed using heat.
If no tissue is removed during this procedure, but only the spinal cord sac and nerve roots are loosened, this is referred to as neurolysis.
This procedure is usually performed on an outpatient basis or in a day clinic. After the procedure, the patient is provided with a transitional corset.
Intradiscal therapy (intervertebral disc = disc)
With increasing age or following excessive strain, cracks and tears can develop in the fibrous ring of an intervertebral disc. The ingrowth of blood vessels and nerve endings can then cause these changes to lead to chronic back pain. If disc protrusions exert pressure on the ‘inflamed’ nerve tissue, this can also lead to acute sciatic irritation.
Intradiscal therapy, i.e. treatment of the disc itself, aims to eliminate this painful tissue and the pain receptors and reduce the size of the prolapsed disc nucleus.
There are various treatment methods for this:
- Anti-inflammatory treatment
Flushing of the disc with anti-inflammatory substances, such as cortisone preparations or pulsating stimulation with high-frequency energy - Reduction of the internal disc pressure
Tissue reduction by injection of chymopapain (chemonucleolysis). - Solidification of the intervertebral disc ring and heat shrinkage
Nucleoplasty, ‘intradiscal electrothermal therapy’ and laser vaporisation are minimally invasive treatment procedures in which controlled heat energy is applied to a section of the diseased intervertebral disc. Special needles are placed in the disc under X-ray guidance, after which a special catheter is inserted via this instrument to generate heat.
As with stabilisation, the heat thickens the fibrous tissue, inactivates the pain receptors and retracts the bulging disc tissue.
These interventions are usually performed under local anaesthesia with the assistance of an anaesthetist – communication between the patient and the surgeon during the procedure is important.
In the weeks following the procedure, as with open surgery, it is necessary to follow a gentle physiotherapy treatment plan.
It is not uncommon for such interventions to help avoid more complicated spinal surgery.
Pain therapy using spinal catheter technology
In this procedure, which is performed under local anaesthetic on an outpatient basis or during a two- to three-day inpatient stay, a very thin, flexible tube is inserted through natural openings in the spine under continuous X-ray guidance and temporarily placed on the spinal cord membrane.
In difficult anatomical conditions, the neurosurgeon uses a fine endoscope to place the catheter precisely, i.e. scar tissue can be loosened under visual control and the nerve fibres that are compressed by the disc tissue can be released. An effective solution of anaesthetics, anti-inflammatory substances and tissue-shrinking enzymes is then flushed in. This method is particularly suitable for patients with protrusions at several levels or scar tissue adhesions following spinal surgery.
As a non-chemical method, radiofrequency stimulation of the nerve pathways can also interrupt pain transmission and strengthen the immune system through pulsating stimuli.
Facet infiltration on the spine and joints
In cases of painful joint diseases (not of rheumatic origin), the targeted injection of anti-inflammatory drugs and/or water-binding artificial joint fluids (e.g. hyaluronic acid) can help to significantly relieve pain and improve mobility.
Since all anatomical structures are displayed during the injection in CT, accidental misinjection is ruled out.
The procedure is performed on an outpatient basis and must be combined with professional physiotherapy.
Removal of herniated discs through the skin
Removing a herniated disc through the skin (percutaneously) protects the tissue and shortens the post-operative treatment phase.
During CT-guided endoscopic removal of the herniated disc (discectomy), the neurosurgeon inserts thin special instruments with high-precision endoscopes and cameras into the disc space under local anaesthesia (with an anaesthetist present if necessary). The excess disc tissue is removed using fine special instruments or a laser beam. At the same time, the pain fibres of the disc ring are destroyed using heat.
If no tissue is removed during this procedure, but only the spinal cord sac and nerve roots are loosened, this is referred to as neurolysis.
This procedure is usually performed on an outpatient basis or in a day clinic. After the procedure, the patient is provided with a transitional corset.
Intradiscal therapy (intervertebral disc = disc)
With increasing age or following excessive strain, cracks and tears can develop in the fibrous ring of an intervertebral disc. The ingrowth of blood vessels and nerve endings can then cause these changes to lead to chronic back pain. If disc protrusions exert pressure on the ‘inflamed’ nerve tissue, this can also lead to acute sciatic irritation.
Intradiscal therapy, i.e. treatment of the disc itself, aims to eliminate this painful tissue and the pain receptors and reduce the size of the prolapsed disc nucleus.
There are various treatment methods for this:
- Anti-inflammatory treatment
Flushing of the disc with anti-inflammatory substances, such as cortisone preparations or pulsating stimulation with high-frequency energy - Reduction of the internal disc pressure
Tissue reduction by injection of chymopapain (chemonucleolysis). - Solidification of the intervertebral disc ring and heat shrinkage
Nucleoplasty, ‘intradiscal electrothermal therapy’ and laser vaporisation are minimally invasive treatment procedures in which controlled heat energy is applied to a section of the diseased intervertebral disc. Special needles are placed in the disc under X-ray guidance, after which a special catheter is inserted via this instrument to generate heat.
As with stabilisation, the heat thickens the fibrous tissue, inactivates the pain receptors and retracts the bulging disc tissue.
These interventions are usually performed under local anaesthesia with the assistance of an anaesthetist – communication between the patient and the surgeon during the procedure is important.
In the weeks following the procedure, as with open surgery, it is necessary to follow a gentle physiotherapy treatment plan.
It is not uncommon for such interventions to help avoid more complicated spinal surgery.