Spinal Symptoms & Diseases

    On the following pages you will find information on the various spinal diseases and their treatment options.


    function of the spine

    function of the spine

    As axial organ, the human spine is responsible for an upright posture. It is divided into three sections- the cervical, thoracic and lumbar spine- with the same basic structure. The spine consists of 24 vertebrae that are connected to one another by intervertebral discs, facet joints and the various ligaments and form a flexible structure. The cervical and lumbar spine are exceptionally mobile. The thoracic spine in conjunction with the ribs forms an almost completely rigid “cage” to ensure the function of the lungs, heart and other organs. Besides acting as axial organ, the protection of the spinal cord which runs through the spinal column is another important function of the spine. The sagittal profile shows a typical double S-curve which absorbs axial load applications.
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    biology at the point of degeneration

    The structures of the spine are subject to a natural aging process, which begins at around the age of 20 and is essentially determined by genetic processes which are additionally accelerated by external factors. Continuous hard work under adverse conditions, sports injuries and accidents involving high force transmissions can accelerate the biological aging processes and lead to early degenerative changes that can cause pathological disorders. The boundaries between biological aging and the degenerative wear are blurred and may thus lead to pathological disorders at any age. In general, 80% of all people suffer from back pain attacks in their lives; approximately 10% of those affected develop a chronic back pain disorder that creates the need for long-term therapy.
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    pain and chronic pain

    pain and chronic pain

    The main symptom of pathological changes in the spinal column is pain. A pain stimulus is released from the area around the irritated structure and is registered by specific nerve cells which can be found in the region of the rear fiber ring of the disc, in the capsules of the facet joints and also in the ligaments and muscles of the back. The cells transmit the pain stimulus to the brain where it is further processed. The bulk of incoming signals is registered and filtered in a nerve core area in the brain stem called pain center. Further reactions that lead to the conscious registration of pain, as well as defense mechanisms of the organism, are triggered by a certain intensity of pain. Pain gets problematic whenever the intensity of the signal density leads to a permanent flooding of the pain center thus lowering the threshold and resulting in a constant perception of pain. This may lead to a pain processing disorder, a completely separate ailment. If pain persists for more than 6 weeks, it is labeled as chronic pain. The thorough analysis of possible causes which could explain the condition is extremely important, in order to make appropriate treatment decisions.
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    conservative and surgical treatment- reality and illusion

    Treatment approach is determined by the root cause of pain. On a very basic level we have to distinguish between conservative and surgical treatment approaches. Conservative treatment is usually symptomatic, which means, the self-healing tendency of the organ is supported by therapeutic measures. These basically consist of pain management and physiotherapy. Thus, the symptoms of a herniated disc can be alleviated without removing the actual cause. On the other hand a considerable conditional weakness of the back muscles which often leads to chronic back pain can be eliminated by an appropriate pain management-based training program. If structural damages cause permanent or recurring pain as well as restrictions in functionality and quality of life and cannot be treated satisfactorily with conservative measures, it should be investigated to what extend surgical approaches could improve the condition. To begin with, it is important to critically review the sustainability of different procedures. In our opinion many procedures, especially mini-invasive procedures, are of a symptomatic nature only. The surgical removal of a herniated disc does not fix the structural damage to the disc which led to the herniation. In this context reconstructive procedures play an important role. These have to be divided into function preserving and non-function preserving procedures. In case of a disc degeneration a surgical treatment involving intervertebral prosthesis can be considered, as this method establishes the function of the mobile segment. Alternatively, so-called fusion surgery which may allow for segmental reconstruction but results in a loss of movement in the affected segment could be discussed. Both, the conservative and surgical approach, are closely related therapeutic approaches. Usually, success is not achieved through one approach alone, careful consideration is needed to determine which treatment option has the greatest chance of success during the individual phases of the disease.
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