Treatment of herniated disc (spinal disc herniation) in Germany
Herniated disc (spinal disc herniation) is a medical condition that is most common in middle-aged people. The disease manifests itself as pain or movement syndromes. This is one of the most common causes of back pain.
Causes of Herniated disc (spinal disc herniation)
The spine is made of small fragments (vertebrae) with intervertebral discs between them. They provide spine mobility. Nucleus pulposus is one of the disc structures. It is surrounded by a fibrous ring. If this ring ruptures, the nucleus pulposus protrudes to the spinal canal. That is exactly how herniated disc develops.
According to etiology, there are traumatic and non-traumatic hernias. Spinal injuries cause protrusions in approximately 10% of cases. The fractures of the cervical spine end up with hernias in 50% of cases.
Non-traumatic herniated disc can develop due to various diseases, including:
- Systemic connective tissue diseases
- Infections (tuberculosis, some viruses)
Risk factors for spinal disc herniation are:
- Strenuous physical exercises
- Sedentary lifestyle
- Genetic predisposition
- Female gender
- Age of 30-50 years
Herniated disc (spinal disc herniation) - Symptoms
The clinical manifestations depend on the herniated disc localization. Most often it is the lumbar spine (over 80% of cases). Thoracic disc herniation is very rare and account for only 1% of clinical cases.
Possible localization of lumbar herniated disc:
- Between the first sacral vertebra and the fifth lumbar vertebra – 48% of cases
- Between the fourth and the fifth lumbar vertebrae – 46% of cases
- Other localizations in the lumbar region – 6% of cases
The main symptom of the herniated disc is pain, which is characterized in the following way:
- It may occur suddenly due to a sharp movement or a strenuous physical activity
- Pain increases with movement and weakens at rest
- In some patients pain increases in a lying position and therefore they have to sleep in a semi-sitting position
- Pressing the point of protrusion increases pain
Located in the lumbosacral spine, the pathological process has the following symptoms:
- Weakness of the lower limbs
- Half-bent position of the leg relieves pain
- Lameness – a patient avoids a big load on the leg on the affected side
- Disappearance of lumbar flexion (a result of muscle spasm)
The vast majority of patients suffer from the muscle spasm in the area of intervertebral hernia formation. Numbness of the skin in the area of innervation of the pinched nerve, paresis, paralysis of the muscles, and pelvic organ disorders can develop. Over time, these disorders worsen due to nerve atrophy.
Symptoms of the cervical herniated disc:
- Pain or numbness in the upper limbs and fingers
- Muscle weakness in the area of innervation of the pinched nerves
- Dizziness, high blood pressure, tinnitus
A thoracic herniated disc can be very similar to heart diseases or diseases of other organs of the thoracic cavity.
Herniated disc (spinal disc herniation) - Diagnosis
MRI (Magnetic Resonance Imaging) is the best diagnostic method for herniated disc. CT (Computed Tomography) and myelography can be used for diagnosis
Treatment of Herniated disc (spinal disc herniation) abroad
With the exception of surgical methods, all treatments are aimed to eliminate symptoms of the disease. These include:
- Medication involves the use of painkillers and muscle relaxants to relieve muscle spasm
- Massage, manual therapy, physiotherapy, traction (stretching) of the spine and other methods of physical action are airmed to decompress (release) a spinal nerve root
- Blockades by means of local anesthetics and glucocorticoids allow relieving pain for some time by stopping pulse advancement over the corresponding nerve
- Therapeutic exercises, corsets, formation of posture, lower body masses are aimed o unload the spine and to decrease the degree of compression of the nerve roots
- Laser hernia removal is the evaporation of protrusion by a laser beam. The technique is effective only on the protrusion stage, when nerve roots are not pinched. Therefore, it is used quite rarely
Most patients reach compensation of the disease by conservative treatments. Other patients need surgery, which is performed in case of:
- Strong pain syndrome
- Inefficiency of conservative treatments within 6 weeks
- Cauda equina syndrome
- Paralysis and disorders of pelvic organ functions
Following types of surgeries can be done:
Microdiscectomy. A fragment of the intervertebral disc is removed together with the herniation. Currentl,y microdiscectomy is considered as a “gold standard” in the field of surgical treatment of the herniated disc.
Endoscopic nucleotomy. If hernia is not big, it is an alternative of microdiscectomy. This is a high-tech endoscopic procedure, which does not even require hospitalization. Its efficiency is almost the same as that of microdiscectomy, but this technique causes more relapses. The advantage is a low risk of complications compared with open surgery.
Discectomy with intervertebral disc prosthesis. The intervertebral disc is removed and replaced with an artificial one. This surgery excludes any risk of recurrence. The hernia can develop only in other area of the spine in the future. After the prosthesis placement the patient’s mobility is preserved.
Herniated disc (spinal disc herniation) - Prognosis
The conservative treatments help to eliminate or significantly relieve symptoms of the herniated disc in 80-85%.
According to various studies, 80-95% of patients have a considerable and steady clinical improvement after microdiscectomy. The risk of relapse is from 2 to 18%. It depends on the size of the fibrous ring defect.
Endoscopic nucleotomy leads to the considerable improvement in 75-85% of cases. The necessity for the repeated surgery is nearly 2 times higher than after microdiscectomy.
Here you can find the cost of treatment for this disease at the German University Hospitals. Leave a request and we will provide a free consultation with a doctor and will start organizing the whole treatment process.
The program includes the following:
- Issuing of an invitation for getting a visa for treatment as quick as possible
- Fixing an appointment at a time convenient for you
- Preliminary organization of a comprehensive examination and discussion of the forthcoming treatment plan
- Arranging transfer from the airport to the hospital and back to the airport
- Provision of interpreting services and services of a personal medical coordinator
- If necessary, assistance in the organization of further surgical treatment
- Provision of a medical insurance against treatment complications covering up to 200,000 euro
- Preparation and translation of medical records and recommendations from the hospital
- Assistance in the subsequent communication with your attending physician, including consultations on repeated X-ray images through the unique medical document management system E-doc