Treatment of lumbar spinal stenosis in combination with instability with decompressive laminectomy and the stabilizing operation (1 segment) in Hospital Harlaching Munich

About the department

The Department of Adult and Pediatric Traumatology, Orthopedics, Foot Surgery, Hand Surgery and Reconstructive Surgery at the Hospital Harlaching Munich offers the full range of diagnostic and therapeutic services in the areas of its specialization. The doctors of the medical facility provide both conservative and surgical treatment. The department is distinguished by its exceptional competence in the treatment of injuries of any severity, including multiple injuries. The department is certified in accordance with the requirements of the German Trauma Society (DGU). The key focus of clinical practice is also on the treatment of such spinal diseases as spinal disc herniation, spondylolisthesis, osteochondrosis, spondyloarthritis, osteoporotic vertebral fractures, spinal stenosis, spinal fractures, etc. In addition, the department's specialists can boast of their rich and successful experience in joint replacement surgery. The medical facility performs operations to replace knee, hip, shoulder, elbow and ankle joints, including revision interventions. The department's therapeutic options are complemented by the correction of congenital and acquired foot deformities, hand surgery. The department annually performs more than 3,000 interventions, while about 600 of them are spinal surgical procedures. The Chief Physician of the department is Prof. Dr. med. Georg Gradl.

The department often admits patients with suspected spinal disc herniation. During the initial consultation, the doctor attentively listens to the patient's complaints, studies his medical history, carries out clinical examination and prescribes a set of diagnostic tests. X-rays and magnetic resonance imaging are usually required to confirm the diagnosis. After receiving diagnostic results, the attending physician develops the optimal treatment regimen. In 90% of clinical cases, the department's orthopedists manage to avoid surgery and achieve a good result with the help of such conservative treatments as pain therapy with pills, injection pain therapy and physiotherapy. Surgical treatment is usually indicated for patients with large hernias, for patients with urinary incontinence and rectal lesions, as well as for patients with movement disorders due to disc herniation. The decision to perform surgery is made cooperatively by orthopedists, traumatologists and neurosurgeons. In most cases, the surgical procedures are performed using sparing minimally invasive techniques, which greatly facilitate the patient's postoperative recovery.

Spondylolisthesis is also a fairly common spinal disease, and the department's doctors can be proud of the successful therapeutic results in this field. To make a diagnosis, the doctor performs a clinical examination, X-ray scanning and magnetic resonance imaging. In some cases, CT and functional MRI scans are also required. The first-line treatment for spondylolisthesis is pain therapy (local X-ray-guided injections of drugs). The next step after the elimination of pain is strengthening of the muscles of the back using a special complex of exercises and physiotherapy. If several months of conservative treatment do not lead to an improvement in the patient's health condition, the specialists make a decision to perform surgery. The main surgical treatment technique for spondylolisthesis is spondylodesis, which involves immobilization of the adjacent vertebrae by their fusion. The department's surgeons have vast experience in this intervention, so patients can count on an effective result.

The treatment of injuries, including sports ones and polytrauma, is of particular interest to the department's specialists as well. The department enjoys the status of the supraregional Trauma Center and has a quality certificate from the German Trauma Society, which requires a professional team of trauma surgeons, high-tech equipment and a high level of quality of medical care. The patients can receive medical care around the clock. The department has an emergency service, two progressive anti-shock rooms and a helipad for the urgent transportation of severely injured patients. The trauma surgeons mostly use conservative treatments, while surgery is the last-line therapy.

The department is also distinguished by its special competence in the field of joint replacement surgery. It performs operations to replace knee, hip, shoulder, elbow and ankle joints. The department's surgeons specialize in primary joint replacement surgery and revision interventions to replace previously implanted prostheses. With the department's state-of-the-art medical equipment, the doctors can perform most joint replacement surgeries using minimally invasive techniques. The patient can recover mobility after surgery as soon as possible. The endoprosthesis is selected for each patient individually, taking into account his anatomical features and the severity of joint damage. It should be noted that the department's doctors use in their clinical practice only high-quality prostheses from the world's leading manufacturers with a long service life.

The department's therapeutic options are complemented by the treatment of foot diseases and deformities. In collaboration with vascular surgeons, the department's doctors provide treatment to the patients with diabetic foot syndrome. At the initial stages of such deformities, it is possible to conduct conservative treatment using special orthopedic devices and physiotherapy, but in case of severe deformities, the patient should undergo surgery. Whenever possible, the surgeons use minimally invasive surgery.

Hand surgery is also within the competence of the department's doctors. The specialists in this field deal with the treatment (usually surgical) of ganglion cysts, tenosynovitis, nerve compression syndromes, Dupuytren's contracture, hand fractures and burns. The department's medical team cooperates closely with vascular and plastic surgeons.

The department's main clinical focuses include:

• Conservative and surgical treatment of injuries, including severe ones and polytrauma, in adults and children
• Conservative and surgical treatment of sports injuries (for example, ligament tears, meniscus injuries, rotator cuff tears, shoulder dislocations)
• Total and partial knee, hip, shoulder, elbow and ankle replacement surgery, including revision interventions to replace previously implanted prostheses
• Conservative and surgical treatment of spinal diseases
  • Herniated discs
  • Osteochondrosis
  • Spondylolisthesis
  • Spondylarthrosis
  • Spinal stenosis
  • Osteoporotic vertebral fractures
• Conservative and surgical treatment of foot diseases and deformities
  • Hallux valgus
  • Hallux rigidus
  • Hammer and claw fingers 
  • Heel spur
  • Haglund's deformity
• Conservative and surgical treatment of hand diseases and injuries
  • Ganglion cysts
  • Tenosynovitis
  • Nerve compression syndromes
  • Dupuytren's contracture
  • Hand fractures and burns
• Other medical services