Department of Adult and Pediatric Spinal Surgery - Vitos Orthopedic Clinic Kassel

About the Department of Adult and Pediatric Spinal Surgery at Vitos Orthopedic Clinic Kassel

The Department of Adult and Pediatric Spinal Surgery at the Vitos Orthopedic Clinic Kassel specializes in the treatment of the full range of cervical, thoracic, and lumbar spine diseases. Doctors pay special attention to providing medical care to patients with herniated discs, spinal instability, vertebral fractures, spinal stenosis, spinal deformities, and spinal tumors. The department has at its disposal all modern types of conservative and surgical treatment for spinal pathologies. Spinal surgery is a last-line treatment and is indicated only when conservative methods have failed. Most surgical interventions for spinal diseases and deformities are performed in the department using minimally invasive techniques. Since 2021, the advanced robotic surgical system Globus Excelsius GPS has also been available in the department's operating room. The American-made robotic device is specially designed for spinal surgery. This system provides high efficiency and safety for surgical manipulations. The doctors at the medical facility also carry out interventional treatment for chronic back pain under imaging guidance when an anesthetic is injected into the pathological focus under X-ray or CT guidance. The department's specialists thus have at their disposal all the necessary resources for effective treatment.

The Head Physician of the department is Dr. med. Rafael Sambale. The doctor has already performed more than 10,000 operations, and all of them had a successful outcome with a minimum percentage of complications. According to the Focus magazine, the doctor ranks among the top doctors in Germany specializing in the treatment of spinal diseases!

Spinal diseases are often associated with severe pain. First of all, the department's doctors use the most effective conservative methods, including medicines, physiotherapy, and occupational therapy. In some cases, aids such as a corset, a belt, or a bandage may be helpful. These are designed and manufactured in the department in accordance with the patient's measurements and functional requirements. Interventional pain relief procedures are also performed in the department. The essence of these procedures is the targeted injection of an anesthetic drug into the affected area under X-ray or CT guidance. Interventional treatment provides good results and is highly safe. If conservative treatment options are exhausted, the department's specialists resort to surgical interventions.

The department's specialists have rich experience in the treatment of chronic back pain. Patients with pain syndrome suffer not only physically but also psychologically. Pain rules their lives. In such cases, physicians provide multimodal pain management while patients are examined and treated using an interdisciplinary approach. Treatment tactics are determined with the participation of pain management specialists, anesthesiologists, psychotherapists, physiotherapists, neurologists, osteopaths, and caregivers. Multimodal pain management can take place in a hospital or on an outpatient basis, depending on the complexity of the clinical case. During the treatment of chronic back pain, the department's doctors use drug therapy, physiotherapy, acupuncture, cognitive behavioral therapy, biofeedback, relaxation techniques, qigong exercises, tai chi, neural therapy, and other methods.

In complex clinical cases, the department's doctors resort to surgery for spinal diseases. The department's surgeons have an excellent command of minimally invasive techniques, which are often used for operations on the intervertebral discs and stabilization surgery. The department also performs extensive surgical interventions aimed at restoring the mobility of the spine, for example, prosthetic intervertebral disc replacement and dynamic stabilization. Rigid spinal stabilization is also within the scope of the tasks of the department's doctors and is recommended for such diseases as vertebral fractures, spondylolisthesis, spinal tumors, and spinal inflammatory diseases.

The department performs safe interventions for posture correction, for example, in patients with kyphosis and scoliosis, as well as destructive processes, for example, inflammation, tumors, or deformities after vertebral fractures. Revision interventions after unsuccessful spinal surgery are another focus of the department's work. Such surgical procedures are complex tasks that require a lot of experience, careful planning, and preparation from the operating surgeon, up to the manufacture of special implants.

The department's special offer in the field of spinal surgery is an operation using a computer-assisted robotic device called Globus Excelsius GPS. This American technology has been used in the department since 2021. Robot-assisted interventions using this surgical device are performed for pathological lesions of the cervical, thoracic, and lumbar spine, which require the implantation of a screw and rod stabilization system. Such systems are most often placed for patients with spinal instability due to vertebral degeneration, fractures, tumors, or displacement. Robot-assisted surgical interventions are also often performed for sacral fractures in older people suffering from osteoporosis. The main advantage of the Globus Excelsius GPS robot is the highest accuracy and safety of the operation. At the stage of preoperative preparation, a CT scan of the spine is done, after which the surgical robotic device analyzes the images and determines the optimal trajectory for implanting screws to stabilize the spine. During robot-assisted spinal surgery, it is enough for a doctor to make small skin and soft tissue incisions, which contributes to the absence of pain in the postoperative period. It should be noted that all surgical manipulations are performed by the surgeon, and the robotic system only provides imaging of the optimal trajectory for inserting screws into the spine and their position.

The department's therapeutic options include the following:

• Conservative treatment
  • Drug therapy with oral medications
  • Physiotherapy
  • Occupational therapy
  • Pain management with X-ray or CT-guided injections
  • Therapy with aids (corsets, belts, and bandages), also in children
  • Multimodal pain management
    • Drug therapy: oral medications and injections of painkillers under X-ray or CT guidance
    • Physiotherapy
    • Acupuncture
    • Cognitive behavioral therapy
    • Biofeedback
    • Relaxation techniques
    • Qigong gymnastics
    • Tai chi
    • Neural therapy
• Surgical treatment
  • Prosthetic intervertebral disc replacement surgery
  • Spinal stabilization surgery, including using the Globus Excelsius GPS robot-assisted system
  • Decompression surgery for spinal stenosis
  • Spinal fusion
  • Surgery to correct spinal deformities, including the correction of scoliosis and kyphosis in children
  • Treatment of vertebral fractures
  • Treatment of spinal tumors
  • Revision spinal surgery in cases of ineffective previous treatment
• Other medical services