Spinal Neurinoma — Surgical treatment in the Best Hospitals of Germany
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Department of Spinal Surgery
The Department of Spinal Surgery annually treats more than 690 patients with spinal neurinoma. The specialists remove the tumor endoscopically with the best possible preservation of healthy nerve tissue. The surgery involves the use of a three-dimensional O-Arm x-ray system that provides additional protection for the spinal cord. The department is headed by Dr. med. A Bitter, who specializes in microsurgical spinal interventions.
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.
Department of Spinal Surgery
The Department of Spinal Surgery offers the full range of effective treatment methods in the area of its specialization. A highly qualified team of doctors is at the service of the department's patients, who have in their arsenal advanced conservative and surgical treatment methods for pathological changes in the spine. Spinal surgical procedures are performed in modern operating rooms, the technical equipment of which allows spinal surgeons to perfectly perform both major open surgery and sparing interventions: minimally invasive, endoscopic, and microsurgical. Surgical treatment is complemented by a carefully planned course of physiotherapy. This includes procedures such as therapeutic exercises, manual therapy, massage, osteopathic treatment, etc. The department's team of doctors consists of 10 highly qualified specialists who, together with experienced nursing staff, admit more than 1,300 inpatients annually. The medical facility is certified by the German Society for Spine Surgery (DWG) as a level II specialized center. The department's medical team makes every effort to provide each patient with optimal treatment in a pleasant and friendly atmosphere.
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.
Department of Neurosurgery and Spinal Surgery
The Department of Neurosurgery and Spinal Surgery offers the full range of modern surgical procedures for patients with diseases of the brain, spinal cord, spine, and peripheral nervous system. The department has state-of-the-art equipment, including navigation systems, monitoring devices, surgical microscopes, intraoperative X-ray diagnostic systems, angiography systems, and laser equipment. In addition, a system for minimally invasive stereotactic interventions has been installed in the department's operating room. The department's neurosurgeons use the latest microsurgical and endoscopic techniques in their work. The medical facility is one of only three in Europe to successfully use the VISUALASE™ device for MRI-guided laser ablation to treat epilepsy. This minimally invasive procedure is highly effective and represents a real breakthrough in epilepsy surgery. The department's neurosurgeons always strive to provide the patient with optimal medical care. They talk in detail about each stage of treatment and are happy to answer the patient's questions. Neurologists and specialists in the field of neuroradiology are often involved in the therapeutic process, which guarantees a comprehensive approach to treatment.
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.
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.
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.
Department of Neurosurgery and Spinal Surgery
The Department of Neurosurgery and Spinal Surgery provides top-class medical care for patients with diseases of the central and peripheral nervous systems. The medical facility performs surgery of any complexity on the brain, spinal cord, spine, and peripheral nerves. The department is the largest healthcare facility of this kind in Germany and has a team of highly professional neurosurgeons with long clinical experience. The department's specialists focus on patients with brain tumors (gliomas, meningiomas, and brain metastases), neurovascular diseases (aneurysms, arteriovenous malformations, and dural arteriovenous fistulas), and traumatic brain injuries. Spinal surgeons operate on patients with herniated discs, spinal canal stenosis, spondylolisthesis, spondylodiscitis, spinal fractures, and spinal tumors. The department extensively uses minimally invasive surgical techniques that allow for good therapeutic results with high safety in surgical manipulations. The medical facility has two hybrid operating rooms with state-of-the-art equipment, including the Zeego® intraoperative robotic angiography system and the intraoperative Brainsuite® MRI.
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.
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.
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.
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.
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.
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.
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.
Spinal neurinomas are rare benign tumors that grow slowly and rarely recur after their total removal. The main method of treatment for these neoplasms is surgical resection. You can seek medical attention from one of the hospitals in Germany to undergo your spinal cord surgery. The country offers modern Neurosurgery Centers equipped with the latest technology for treating spinal cord and brain diseases. You are welcome to use the Booking Health service to find out the cost of treatment in Germany and choose a treatment program at the best price.
Content
- What is a spinal neurinoma?
- Who may need surgical treatment for spinal neurinomas?
- How is surgery for spinal neurinomas performed?
- Results of surgery for spinal neurinomas
- Why to undergo your spinal neurinoma treatment in Germany?
What is a spinal neurinoma?
Spinal tumors are classified into the following two groups according to their location relative to the dura mater: extradural and intradural. Intradural neoplasms are located inside the dural sac. In turn, these types of spinal cord tumors are further classified as intramedullary and extramedullary. The intramedullary ones grow inside the spinal cord, and the extramedullary ones grow outside it.
Neurinomas are among the most common intradural extramedullary tumors. They account for up to 30% of neoplasms in this group. Neurinomas (schwannomas) do not grow from the spinal cord itself but from the spinal nerve sheaths.
Who may need surgical treatment for spinal neurinomas?
Almost all neurinomas found in the spinal cord are benign tumors. They grow slowly and do not spread any metastases. Therefore, patients who do not have any symptoms do not require treatment. Dynamic monitoring is sufficient for such patients.
Surgical treatment may be indicated in the following cases:
- a spinal neuroma causes symptoms by compressing the nerve roots;
- the size of the neoplasms rapidly increases during dynamic monitoring.
Spinal neurinomas are more severe in patients with a hereditary disease, namely type 2 neurofibromatosis. Such tumors can be multiple and grow faster. They are larger, and the symptoms are more severe. Such neoplasms often invade the nerve roots, which complicates treatment and increases the risk of developing a neurological deficit. They recur more often, so it is better to remove such spinal neurinomas completely, even if total resection may worsen the patient's neurological status.
How is surgery for spinal neurinomas performed?
Doctors in Germany use different surgical approaches depending on the location and size of the neurinoma.
Whenever possible, surgeons in Germany try to perform a laminectomy or a hemilaminectomy. Doctors approach the spinal cord by removing one or two vertebral arches. German neurosurgeons tend to use only a hemilaminectomy, since in this case the trauma of the intervention is much lower and the stability of the spine is preserved.
If the tumor grows from the anterior (motor, ventral) spinal nerve root, a partial facetectomy (removal of part of the intervertebral joint) is required to approach it.
After the formation of an approach, doctors must determine the boundaries of the tumor and remove it completely. If only partially removed, a good treatment result can also be achieved, but the risk of neuroma recurrence is higher. Intraoperative diagnostics help doctors determine the boundaries of the neoplasm. The Departments of Neurosurgery abroad use neurophysiological monitoring during surgery to safely remove neurinomas.
In modern neurosurgery, doctors use not only mechanical instruments but also various energies, such as lasers or ultrasound. Hard-to-reach neurinomas can be removed with their partial destruction by ultrasound, followed by aspiration of the resulting fluid.
In 20% of patients, the tumor invades the intervertebral foramen, taking the form of a dumbbell or an hourglass. Such neurinomas are more difficult to remove. There are nine types of such tumors depending on their location, and in each case, a special approach is required to remove the tumor safely, completely, and with the least trauma. Sometimes it may be necessary to remove a facet joint or even the whole vertebra to resect a neurinoma, for example, if it is located in the lower part of the cervical spine.
Results of surgery for spinal neurinomas
If you choose to undergo your treatment in one of the German hospitals, you can expect good results. As a rule, the neurinoma can be removed completely. The risk of recurrence on long-term follow-up is about 5%. However, this risk is higher with dumbbell tumors, reaching about 10%.
Doctors at the Neurosurgery Centers in Germany strive to remove the neurinoma completely, but not at any cost. If the operation becomes too traumatic and risky, threatening to lead to a neurological deficit, doctors in Germany perform a subtotal resection, which means that they will remove most of the tumor. Following this, many patients will not require any additional treatment, as the remaining fragment of the spinal neurinoma does not grow at all or grows very slowly, without causing any symptoms for decades. If it starts to grow, radiation therapy can be used to treat the neoplasm.
Patients usually do not have any postoperative neurological deficits. Doctors try to preserve the spinal roots if possible. However, even if the spinal root is completely removed, this root usually loses its function at the time of the operation, and other nerves take over. Doctors in German hospitals assess the function of the affected spinal root using intraoperative stimulation before removing it to minimize the risk of developing a neurological deficit. If the nerve has lost its function, it will be removed, but if it still functions, surgeons make attempts to preserve it.
Surgical outcomes may be worse in patients with neurofibromatosis type 2 because neurinomas are multiple, large, and, in 30% of cases, malignant. However, even in this group of patients, German doctors manage to perform a total resection in 75% of cases, achieving a cure for the disease with a minimal risk of recurrence or spinal instability.
Why to undergo your spinal neurinoma treatment in Germany?
Germany is a country where the healthcare system is well-funded. If you choose German hospitals for your treatment, you will receive top-class medical care. There are a few reasons for you to undergo your treatment of neurinomas at one of the Neurosurgery Centers in Germany. These are the following:
- high level of training for neurosurgeons;
- the use of new technologies in medicine, such as intraoperative ultrasound and neuromonitoring, powerful operating microscopes, and ultrasound destruction and aspiration of tumors;
- doctors mostly manage to perform a total tumor resection, which reduces the risk of recurrence;
- doctors in Germany use minimally traumatic approaches, and posterior root tumors are removed with a hemilaminectomy (removal of one vertebral arch) if possible;
- preservation of spinal stability after surgery;
- if it is necessary to resect a significant amount of bone tissue, German hospitals perform spine stabilization with a dynamic system to maintain its mobility;
- the spinal nerve root is preserved during the treatment of the disease whenever possible to minimize the risk of developing neurological disorders.
You can find out the cost of treatment in Germany on the Booking Health website. Our website offers the best hospitals in Germany that admit foreign patients. When you make your treatment appointment through Booking Health, the cost of treatment in Germany will be lower than when you contact the hospital directly. The price for your treatment will be reduced due to the lack of taxes for foreign patients.
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!
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