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Facet Syndrome — Facetectomy or Laminectomy: treatment in the Best Hospitals of Germany

Hospital Neuwerk Moenchengladbach

10/10
location_onGermany, Moenchengladbach

Department of Spinal Surgery

The Department of Spinal Surgery annually treats more than 740 patients with facet syndrome. To improve the condition of the patients, doctors perform endoscopic resection of the facet joints or laminectomy. The surgery involves the use of a three-dimensional O-Arm x-ray system, which protects the spinal cord. The department is headed by Dr. med. A Bitter, who specializes in microsurgical spinal interventions.

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Vivantes Auguste-Viktoria Hospital Berlin

9.7/10
location_onGermany, Berlin

Department of Spinal Surgery

The Department of Spinal Surgery at the Vivantes Auguste-Victoria Hospital all diseases of the spine - both conservatively and operatively. Patients with herniated intervertebral discs, displacement of vertebrae, stenosis of the spinal canal or back pain are treated here. In addition, specialists of the department have a unique experience in the field of complex reconstructive and revision surgeries, which are conducted to continue or correct the previous surgical treatment.

Catholic Clinic Koblenz-Montabaur

10/10
location_onGermany, Koblenz

Department of Spinal Surgery

The Department of Spinal Surgery offers the full range of special and general spinal surgeries, all stabilizing and reconstructive interventions, including microsurgery and spinal cord surgery. The department's surgeons have a perfect command of all surgical techniques and widely apply in their practice sparing minimally invasive interventions, which are distinguished by minimal pain, low risk of complications and rapid recovery of the patient. The department treats about 1,300 patients every year. To achieve the best results, surgeons cooperate closely with physiotherapists. Thus, the department has all conditions for the most effective restoration of the patient's mobility.

Charite University Hospital Berlin

9/10
location_onGermany, Berlin

Department of Adult and Pediatric Neurosurgery

The Department of Adult and Pediatric Neurosurgery offers the full range of accurate diagnostics and surgical treatment of diseases of the central and peripheral nervous system. The department's surgeons annually perform over 5,000 surgical interventions, which indicates their high professionalism and tremendous experience. The key attention is paid to the treatment of cerebrovascular diseases, diseases of the spine and spinal cord, brain and skull base tumors, peripheral nerve lesions, cerebrospinal fluid circulation disorders, as well as pain therapy (functional neurosurgery). The treatment of neurosurgical diseases in children and adolescents is carried out by a specially trained team of experts.

Beta Klinik Bonn

9.7/10
location_onGermany, Bonn

Department of Neurosurgery and Interventional Neuroradiology

The Department of Neurosurgery and Interventional Neuroradiology is a modern maximum care medical facility, which offers the full range of diagnostic and therapeutic services in the field of neurosurgery. It provides the first-class treatment of diseases of the brain, bone marrow, spine, blood vessels and peripheral nerves. The successful treatment outcome is facilitated by the high professionalism of doctors and the cutting-edge technical equipment.

University Hospital Freiburg

9.7/10
location_onGermany, Freibung

Department of Adult and Pediatric Neurosurgery

The Department of Adult and Pediatric Neurosurgery offers the full range of surgical treatment of diseases of the brain, spine, spinal cord and nerves in adults and children. The department keeps pace with new trends in medicine, as well as contributes significantly to their development. Therefore, the most modern diagnostic and therapeutic methods are available here. An individual approach to each clinical case is crucial to ensure optimal treatment results with the preservation of all neurological functions.

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

Department of Adult and Pediatric Neurosurgery

According to the Focus magazine, the Department of Adult and Pediatric Neurosurgery ranks among the top German medical facilities specializing in the surgical treatment of brain tumors! The department offers the full range of diagnostics and surgical treatment of diseases of the central and peripheral nervous system. A specially trained team of pediatric neurosurgeons provides treatment for various neurosurgical pathologies in children. During the treatment, the doctors use state-of-the-art equipment, in particular, imaging-guided neuronavigation, functional imaging (fMRI), intraoperative mapping, intraoperative videoangiography, etc.

University Hospital Erlangen

9.1/10
location_onGermany, Erlangen

Department of Adult and Pediatric Neurosurgery, Spinal Surgery

The Department of Adult and Pediatric Neurosurgery, Spinal Surgery offers modern diagnostics and effective treatment of the full range of diseases, injuries, inflammatory processes, tumors and malformations of the brain, spinal cord and their meninges, as well as spinal diseases. Spinal surgery is performed in collaboration with doctors from the Department of Adult and Pediatric Traumatology, Orthopedic Surgery. The department admits adults and children with malformations of the nervous system, brain and spinal cord tumors, drug-resistant epilepsy and other diseases. As one of the largest medical facilities of this kind in Germany, the department's doctors annually perform more than 2,500 surgical interventions on the brain and spinal cord, peripheral nerve endings. The department's specialists also perform over 400 spinal surgical procedures annually. To achieve high success rates of the surgical treatment, doctors use the very latest equipment, including neuronavigation systems. Thanks to this, surgeons not only successfully eliminate the pathology, but also guarantee the patient maximum safety. The department has 78 beds, including 14 beds in the Intensive Care Unit. The priority goal of the department's medical team is to provide high-quality treatment focused on the patient's needs.

University Hospital Ulm

8.7/10
location_onGermany, Ulm

Department of Neurosurgery

The Department of Neurosurgery offers the full range of surgical interventions for the treatment of diseases of the central and peripheral nervous system. The department is one of the largest medical institutions of this kind in Germany. The doctors of the department provide patients with the high-quality medical care of university level, and also take an active part in the experimental fundamental studies and clinical trials to develop new treatment methods.

University Hospital Würzburg

9.2/10
location_onGermany, Würzburg

Department of Adult and Pediatric Orthopedics

The Department of Adult and Pediatric Orthopedics is the center of maximum orthopedic care and offers the diagnostics and treatment of all diseases and injuries of the musculoskeletal system. Along with the full range of modern operative and conservative orthopedics, the department specializes in hip and knee replacement surgery using the minimally invasive methods, replacement/revision of prostheses, orthopaedic oncology, foot surgery and patella problems in the patella.

University Hospital Carl Gustav Carus Dresden

9.1/10
location_onGermany, Dresden

Department of Adult and Pediatric Orthopedics, Trauma Surgery, Foot Surgery

The Department of Adult and Pediatric Orthopedics, Trauma Surgery, Foot Surgery offers the full range of diagnostics, conservative and surgical treatment of musculoskeletal diseases and injuries. The department is a certified Endoprosthetics Center – more than 1,000 primary joint replacement surgeries are performed here annually. The surgeons of the Endoprosthetics Center also specialize in particularly complex clinical cases and revision procedures for the replacement of previously implanted artificial joints. In addition, the department has the status of the interregional Trauma Center certified in accordance with the standards of the German Trauma Society. The department has also been awarded a Certificate of Excellence from the German Orthopedic Foot and Ankle Society (DAF) in the field of foot surgery. A separate area of ​​clinical activity is the treatment of diseases, injuries and congenital malformations of the musculoskeletal system in children. Depending on the severity of the clinical case, both conservative and surgical techniques are used in the treatment of orthopedic pathologies in children. The department's medical team prefers sparing low-traumatic surgery, while open operations are performed only if other therapeutic options are ineffective.

University Hospital Hamburg-Eppendorf

9.2/10
location_onGermany, Hamburg

Department of Adult and Pediatric Neurosurgery

The Department of Adult and Pediatric Neurosurgery offers the diagnostics and comprehensive treatment of neurosurgical pathologies, including tumors of the central and peripheral nervous system. The department is the leading Center of Neurosurgery in Northern Germany and is responsible for the implementation of new algorithms for the treatment of patients with brain tumors. To this end, there is an active participation in the international researches and the development of new surgical methods, for example, operations in the waking state. Close interdisciplinary cooperation also contributes to the achievement of optimal treatment results.

University Hospital Muenster

9.8/10
location_onGermany, Muenster

Department of General Orthopedics and Orthopedic Oncology

The Department of General Orthopedics and Orthopedic Oncology offers the full range of conservative and surgical treatment of all musculoskeletal diseases. The department ranks among the largest medical facilities of this kind in Germany, as well as among the specialized authoritative departments for the treatment of bone and soft tissue tumors in the European medical arena. The treatment is carried out both on an outpatient and inpatient basis, including the outpatient operations. In addition to its successful clinical activities, the department is proud of its productive research work, which has given birth to many innovations in orthopedics, for example, the department's specialists have patented the very latest prosthetic systems, particularly in the field of orthopedic oncology.

University Hospital Jena

8.9/10
location_onGermany, Jena

Department of Adult and Pediatric Neurosurgery

The Department of Adult and Pediatric Neurosurgery offers the full range of modern services in this medical field. The high level of technical equipment in the department allows for the performance of all highly specialized surgical interventions to treat pathologies of the central and peripheral nervous system. The clinical practice mainly focuses on the diagnostics and surgical treatment of diseases, injuries of the brain, spine, spinal cord, intervertebral discs, nerve plexuses, functional neurosurgery and the treatment of neurosurgical pathologies in children.

University Hospital Marburg UKGM

8.6/10
location_onGermany, Marburg

Department of Adult and Pediatric Neurosurgery

The Department of Adult and Pediatric Neurosurgery offers all modern surgical interventions for the treatment of pathologies of the nervous system. The clinical focuses include the treatment of oncological diseases of the nervous system (neuro-oncology), skull base surgery, vascular neurosurgery, spinal surgery and functional neurosurgery, including the surgical treatment of epilepsy. As a state-of-the-art medical facility, the department has the advanced systems for deep brain stimulation, multimodal neuronavigation devices, intraoperative neuronavigation using CT, ultrasound systems, fluorescence imaging devices and endoscopy equipment. Thus, the department has all the possibilities to ensure effective treatment according to the international standards.

University Hospital Rechts der Isar Munich

9.8/10
location_onGermany, Munich

Department of Adult and Pediatric Neurosurgery, Spinal Surgery

The Department of Adult and Pediatric Neurosurgery, Spinal Surgery offers the full range of services in these fields and specializes in the surgical treatment of diseases of the brain and spinal cord, peripheral nervous system and spine. The important areas of the department's clinical activity also include neuro-oncology, vascular neurosurgery and pediatric neurosurgery. The treatment is provided in four state-of-the-art operating rooms equipped with all the necessary facilities. The department admits about 2,700 inpatients and 4,100 outpatients annually. The team of the department's neurosurgeons is distinguished by high professionalism, and performs many operations using sparing minimally invasive surgical techniques. Navigation systems, intraoperative monitoring devices, 5-ALA fluorescence are successfully used during the surgical treatment. Each operation is carefully planned using advanced navigation devices (under the guidance of CT and MRI scanning). In general, the department's surgeons annually perform more than 4,000 neurosurgical interventions, and therefore they are justifiably proud of their unique clinical experience and treatment results.

Facet syndrome is one of the most common causes of back pain in people with intense physical activity. The condition occurs as a result of damage to the facet joints, which are responsible for the mobility of the spinal column. In fact, the disease is arthrosis since it is based on the same processes as arthrosis of the large joints of the lower extremities: cartilage wear and degeneration gradually occur with damage to the adjacent bone tissues. The result is constant pain, disability, and a low quality of life. The disease is, however, curable. You can go to one of the countries with a high level of medicine, such as Germany, to receive top-class medical care. On the Booking Health website, you can find out the cost of operations at German hospitals and make your appointment on your preferred dates.

Content

  1. Diagnostics of facet syndrome
  2. Who may need a facetectomy for facet syndrome?
  3. How is a facetectomy performed for facet syndrome?
  4. Benefits of facet syndrome treatment in Germany
  5. The cost of treatment for facet syndrome in Germany

Diagnostics of facet syndrome

 

Patients who suffer from facet syndrome come to the hospital with complaints of back pain, which:

  • can be unilateral or bilateral;
  • is felt in the leg but does not fall below the knee;
  • appears after prolonged episodes of immobility, and gradually decreases after the movement.

Morning spine stiffness is also possible. Unlike many other spinal diseases, facet syndrome is not characterized by neurological disorders (mobility and sensitivity in the areas of innervation of the spinal nerves are not affected), which helps doctors in the differential diagnostics of the disease.

Clinical diagnostics:

  • palpation of the facet joints;
  • the Kemp test is a provocative test that detects painful movements in the spine.

Instrumental diagnostics can reveal degenerative changes in the facet joints.

The simplest method of diagnostics is an X-ray scan. Doctors in Germany mainly use more accurate diagnostic methods, such as CT and MRI scans. They allow the specialists to assess the severity of the disease, which can be the following:

  • grade 1 is characterized by the narrowing of the joint space up to 2 mm, small bony growths, and a mild joint hypertrophy;
  • grade 2 implies a decrease in joint space of 1 mm or more, as well as moderate bony growths or erosion in the subchondral bone tissue;
  • grade 3 occurs when there is practically no joint space, there are large bony growths, and subchondral bone erosions and cysts appear.

Another informative method of diagnostics is the facet joint block with local anesthetics. A positive test result is an 80% reduction in pain and an increase in the range of motion in the spine after block.

Who may need a facetectomy for facet syndrome?

 

Facet syndrome is usually treated with conservative methods. If systemic drugs do not work, they will be injected directly into the joint. If this treatment does not help, doctors can perform a facet joint block, which provides improvement for up to 6 months.

If there is a good effect from the block, doctors can destroy the nerve endings that conduct pain impulses from the facet joints. This treatment option is called denervation. The procedure can be performed using a laser or radiofrequency method, whereas cryoneurolysis (freezing) or chemical denervation are less commonly used. Such procedures are available at German hospitals.

Open surgery of the spine for facet syndrome is not a common treatment option. In medicine, such operations can be performed to treat facet syndrome if:

  • other treatment options (conservative treatment, facet joint block, or denervation) have not relieved the pain;
  • there are concomitant diseases, for example, if spinal stenosis has developed due to facet hypertrophy.

In such cases, surgery comes to the rescue, as doctors can partially or totally remove the damaged joints. Two adjacent vertebrae will then be fixed firmly, or dynamic fixation systems may be implanted. Germany offers advanced systems, which are actually artificial facet joints. They fully replace them and provide physiological movements, preventing damage to the adjacent segments of the spine.

How is a facetectomy performed for facet syndrome?

 

A facetectomy is the surgical removal of the facet joint. This is an open operation performed through an incision a few centimeters long. In modern medicine, microsurgical techniques are used to reduce the trauma of surgery and minimize the amount of resected tissue. But still, the stability of the spine during treatment is inevitably disturbed, and therefore patients additionally require the implantation of stabilizing systems.

The main objective of their implantation is the prevention of degenerative changes at adjacent levels of the spine. Previously, doctors simply fixed the vertebrae motionless (spinal fusion), but this only provided temporary relief. Due to impaired spinal mobility, degenerative processes continued. And what is more, many patients experienced pain again, and some required additional operations.

Doctors in countries with a high level of medicine are abandoning rigid fixation in favor of dynamic fixation. This procedure allows for not only ensuring the stability of the spine but also maintaining its mobility. After a laminectomy and a facetectomy, German doctors implant total facet arthroplasty systems. These may be the following:

The Total Posterior Arthroplasty System (TOPS) has a transpedicular fixation mechanism. It is made of metal and polymeric materials. The device maintains movement in the spine and normal disc height.

The Total Facet Arthroplasty System (TFAS) is a system for the replacement of the damaged facet joints by placing metal implants. The principle is the same as for the replacement of large joints of the lower extremities: the patient's own joint is removed, and an artificial one is implanted. The implantation of this system requires a laminectomy with a total facetectomy. Studies show that this system restores movements in the operated segment, and they become as close to physiological as possible.

Benefits of facet syndrome treatment in Germany

 

If you have been diagnosed with facet syndrome, you can undergo your diagnostics and treatment abroad. You may not need a facetectomy and a laminectomy, and the problem can be solved with less traumatic techniques. For example, treatment can be carried out using radiofrequency facet joint denervation. If open surgery is required to treat the disease, the treatment in a country with top-class medicine will allow you to solve the problem more safely and reliably.

There are a few reasons for you to undergo your treatment in Germany. These are the following:

  • modern and well-equipped hospitals;
  • high-quality preoperative and intraoperative diagnostics;
  • the latest modifications of surgical procedures for facet syndrome treatment;
  • a low risk of complications;
  • total arthroplasty systems (artificial facet joints) are used instead of rigid (fixed) stabilization of the spinal column;
  • the stability of the spine is maintained after surgical treatment;
  • reliable results with a low risk of back pain recurrence;
  • a low risk of degeneration of the adjacent segments of the spine after surgery;
  • several spinal diseases can be treated concurrently, as patients with facet syndrome can also have a herniated disc or spinal stenosis;
  • full-fledged rehabilitation after the operation, which will allow a patient to get back on their feet and return to their normal life in the shortest possible time.

The cost of treatment for facet syndrome in Germany

 

You are welcome to use the Booking Health service if you want to find out the cost of treatment. Our website specifies prices for all procedures and surgical interventions available for facet syndrome treatment. You can just enter your diagnosis into the search bar and you will get a list of available hospitals and the cost for each treatment method.

The website provides patients with the ability to sort hospitals by price. You can choose a more cost-effective option. In any case, when you make your appointment through the Booking Health service, the cost of treatment will be lower for you than when contacting a medical center directly, since there are no taxes for foreign patients.

In addition, you will receive insurance against unforeseen medical expenses. This means that the initial cost of your medical care program will not increase. Even if additional procedures are required, the excess cost of the services will be covered by the insurance company.

If you choose a medical care program through Booking Health, you will not have to worry about organizing your trip to Germany. Our specialists will contact the hospital themselves, agree on everything with its administration, and help you shorten the waiting period for the start of your treatment. They will also book hotel and airline tickets for you and translate your medical records. We will meet you at the airport and take you to the hospital in Germany by car. After the completion of your treatment, we will take care of your return transfer.

 

Authors: 

The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!

 

Sources:

National Spine Health Foundation

SPINE-health

Science Direct




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