Minimally invasive therapy
So-called minimally invasive and imageguided spinal interventions, i.e. those monitored by X-ray, computed tomography (CT) or magnetic resonance imaging (MRI). Here, the sites of action may be located
externally (muscles, skin) or internally (intervertebral disc) and are determined individually for each patient.
The different treatment techniques:
Special injections in pain therapy
Under local anesthesia and CT control, an antispasmotic agent (botulinum toxin) is injected into the sacrospinalis, gluteal or splenius muscles.
This salutary solution interrupts the muscle stimulation by the nerve cells and can thus combat even intractable muscle tension pain that other therapies failed to control.
Elimination of pain fibers at the vertebral joints (denervation)
Here, thin surgical needles only millimeters in diameter are inserted into the appropriate spinal nerve endings, which are then obliterated by a special solution or temporary heating.
The patient feels no pain under local anesthesia.
Nerve root treatment (periradicular therapy)
Under CT or MRI control and local anesthesia, thin needles are inserted up to the exit of the irritated nerve root. The location of the nerve and needle is visualized with contrast medium. When the needle reaches its target, analgesic and detumescent drugs are precisely injected into the site. In the case of scar formation, a fine endoscope can be used to free nerve tissue under visual control.
Pain therapy using the spinal catheter technique
This intervention is performed under local anesthesia but requires 2 to 3 days of hospitalization. Here, a very thin tube is inserted through the natural opening of the spine under continuous X-ray control.
A solution of anesthesics, anti-inflammatory substances, enzymes and saline flows through the catheter for several days to calm the nerve.
Removal of disc prolapses through the skin
(percutaneous nucleotomy)
Removal of a disc prolapse through the skin protects the tissue and reduces the risk of postoperative scar formation . In CT-guided endoscopic prolapse removal, thin special instruments with a highprecision
endoscope and camera are inserted into the disc space under local anesthesia. The protruding tissue is removed with fine special forceps or a laser.
Intradiscal therapy (“In the intervertebral disc”)
The aim of intradiscal therapy is to thicken torn intervertebral disc tissue (remodelling of the annular wall), eliminate pain and reduce the size of prolapsed disc components.
Different approaches are available for treatment:
- Anti-inflammatory:
rinsing the disc with detumescent substances like cortisone preparations and certain enzymes
- Reduction of the pressure in the disc:
rinsing with tissue-reducing substances like chymopapain (chemonucleolysis)
- Fixation of the intervertebral disc ring and thermal shrinkage:
“Intradiscal electrothermal therapy” and laser ablation (Nucleoplasty) are minimally invasive treatment procedures, in which a controlled amount of heat is applied in the posterior segment of
the affected disc. Special needles are placed into the disc under X-ray control. They are later used to insert a microfine catheter for thermal shrinkage.
