Spine – spinal canal stenosis – herniated disc – sequestrectomy

Symptoms of spinal diseases

  • Do you keep having back problems with pain when sitting, lying, standing and walking?
  • Does the pain perhaps also radiate into the buttocks, into the hips or down into the thighs and lower legs?
  • Are parts of your leg numb or does it feel like ants are running up and down your leg?
  • Do you sometimes buckle in the knee joint due to lack of strength and do you have such a hard time staying on your feet?
  • Are you unable to raise or lower your foot properly?
  • Are you unable to stand up properly because of back pain and can you therefore only walk bent over?
  • Does the back pain not go away since you lifted something heavy?
  • Can you hardly move at all because of the back pain?
  • Or have you already been diagnosed with a herniated disc or spinal canal stenosis by another doctor?

Registration at the doctor’s office

If you suffer from one or more of these conditions, professional assessment from an experienced surgeon is always recommended.

You can easily, quickly and confidentially arrange an appointment in our doctor’s office.

Of course, we treat privately insured patients, but as a surgical doctor’s office with statutory health insurance, we can of course also offer our expertise to people with statutory health insurance.

  • by phone
  • directly online in the appointment calendar on our website or
  • by email

Initial consultation

At the first appointment, it is important that you can describe your symptoms in detail and calmly, how they affect you in everyday life, how long the problems have been occurring, how they could be influenced and how the entire course of time has developed.

It is important that sufficient time is devoted to the complaints at this stage, as even seemingly unimportant details can be crucial clues.

Targeted questions by the experienced surgeon often give a good first indication of the cause of the symptoms.

Back pain is a very common complaint, it occurs more or less frequently in almost everyone. They can occur without any major detectable change in the spine. Occasionally, however, a pathological change occurs as a cause at a young age. An acute herniated disc is a good example of this. Of course, there are many causes for the many possible changes. In old age, degenerative changes are the main cause of back pain.

But the initial consultation is more than just listing complaints by type, severity, time of occurrence and ways to influence them. The initial consultation must always provide space for a professional acquaintance with the person who trustingly goes into treatment.

Different people may objectively have the same complaints, but they are perceived individually, which is unbearable for some, but does not bother the other at all and vice versa, and so the assessment by the surgeon must also take this fact into account and that is only possible if the initial consultation is not reduced exclusively to the objective complaints, but focuses on the person as an individual with their own assessment of their physical problem.

Physical examination

In addition to describing the history of the symptoms, the physical examination is one of the main pillars for finding a diagnosis.

Of course, it is important to you that the physical examination is also in the hands of a surgeon with many years of clinical, technical and operational experience in order to avoid misinterpretations. After all, it should be routine and discreet and quickly lead to a reliable result.

The herniated disc and the spinal canal stenosis reveal themselves clinically through typical findings on the back itself, in standing and walking attempts, muscle reflex examinations and function tests.

The clinically raised suspected diagnosis usually has to be confirmed by an MRI examination if the symptoms persist.

In our doctor’s office we offer you the ideal combination of experienced examiners and modern technical equipment.

Diagnosis and explanation

The diagnosis is based on the history, the physical examination and the technical examination, usually by magnetic resonance imaging.

I would then like to explain to you exactly what it means to have spinal canal stenosis or a herniated disc.

  • What exactly are the anatomical changes in your body?
  • How and why did these develop?
  • How severe is this illness?
  • Which nerve structures are affected?
  • Will the changes continue to change in the future?
  • What effects can be expected on other areas of life?
  • Are further investigations necessary?
  • Are the changes harmless or dangerous?

Ultimately, you should be able to recognize which anatomical change causes your symptoms in which way mechanically and how your change should be evaluated individually in comparison to most other patients in the eyes of an experienced surgeon.

Your referring family doctor automatically receives a detailed report of findings and recommendations from us, so that a professional flow of information is guaranteed.

Treatment options

There are different ways to treat back pain with or without nerve pain.

Emergency surgery

The diagnosis of a herniated disc or spinal canal stenosis rarely necessitates an operation. This is only the case if there are signs that a nerve is being damaged from which it no longer recovers or only partially recovers. A sign of non-reversible (irreversible) damage is the functional failure of the nerves, i.e. a persistent paralysis of a muscle group or the sensory disturbance of a skin region. Bladder and bowel emptying disorders or sexual dysfunctions are also typically among these nerve dysfunctions.

Acute paralysis and sensory disturbances are therefore absolute reasons for surgery, and they are often even declared to be emergency surgeries. In these cases, there is a risk of permanent damage to the pinched nerve or nerves.

The other complaints in themselves do not constitute a reason for an operation in the case of back pain, even if there is a clearly recognized reason for the pain, for example a herniated disc or a narrowing of the spinal canal.

Successful conservative therapy of back pain

The vast majority of back pain patients can be treated successfully without surgical therapy. Consistent treatment measures such as physiotherapy, pain therapy and muscle building training as well as regular exercise often lead to a significant improvement in the symptoms after a short time.

Before an operation, a correctly performed attempt at conservative therapy must always have taken place over a reasonable period of time.

The most common source of error in conservative therapy for back pain is treatment that is too infrequent, interrupted or carried out in an unstructured manner. In our experience, this is too often left to you as a patient, although you probably find it difficult to organize it professionally.

With us you will not be left alone with your back pain, we will organize an optimal treatment strategy for you in our professional network in which the treatment elements support each other. In this way, we can work with you to quickly and sustainably improve your back pain.

Planned surgical therapy for back pain

After exhausted conservative, i. H. non-surgical therapy, a decision must be made as to whether an operation is the right treatment for you. They play a crucial role in this decision. Only they can know how back pain is affecting them in their daily lives.

This decision must include the fact that back pain, which is due to wear and tear on the spine, cannot usually be completely eliminated even by surgery.

However, if it is clear that even a limited improvement in symptoms will lead to a significant increase in quality of life, then an operation makes sense.

The decision for or against an operation on the spine is always a case-by-case decision and depends very much on you, your symptoms, your circumstances and the aim of the operation.

The prerequisite for surgical therapy is, of course, a finding that matches the anatomical and physiological symptoms described and that can be improved by surgery.

Spinal stenosis

Spinal canal stenosis is a narrowing of the spinal cord canal. It is usually caused by enlarged intervertebral joints or thickened ligaments in their vicinity. The so-called dural tube filled with cerebrospinal fluid is compressed in the area of ​​the constriction in an hourglass shape and the nerves that otherwise freely pass through here are also squeezed. This causes the typical pain in the back and can also lead to pain radiating into the legs. Depending on how severely the nerves are squeezed, paralysis or sensory disturbances can even occur.

The treatment of spinal canal stenosis consists in the surgical expansion of the spinal canal at the narrowed point. The spinal canal is expanded under the microscope using microsurgical technology in such a way that the nerves passing through have enough space again and the pressure is relieved.

Disc prolapse

The intervertebral disc consists of a soft core surrounded by solid cartilage fibers. The intervertebral disc can push out in the direction of the spinal canal as a result of incorrect loading, sudden force effects, tissue composition and anatomical conditions. Either it leads to a narrowing of the spinal canal or it presses directly on the spinal nerve, which emerges at this level between the vertebrae. The prolapsed disc causes pain that is direct or radiates into the leg. Depending on how badly the nerves are squeezed, paralysis or sensory disturbances can even occur.

The treatment of a herniated disc consists of the surgical removal of the herniated part of the disc. Access to the spinal canal is created under the microscope using microsurgical technology and the prolapsed disc is removed. This gives the nerves enough space again and the pressure is taken off them. The pain goes away over time.

Planning and preparation of the surgery

Operating with minimal bleeding is part of reducing surgical risks. One of the prerequisites for this is good blood clotting. Many patients take blood-thinning medications, including aspirin (ASA), Marcumar, Xarelto, Plavix, and others. If possible, these drugs must be discontinued in good time before the procedure. Whether this is possible is sometimes only a matter of consultation with the doctor who prescribed the medication, such as your general practitioner, angiologist, cardiologist or neurologist.

In advance, the family doctor should prepare a current laboratory with blood count, liver values, inflammation values ​​and coagulation.

In the case of certain previous illnesses, clarifying examinations such as an X-ray of the lungs or functional tests of the lungs and heart are also important in order to be able to assess the risk of anesthesia.

Please bring all the papers and reports you have about yourself with you, that is

  • medical letters
  • findings reports
  • allergy pass
  • X-ray passport
  • blood group card
  • List of medications, especially insulin regimens for diabetics and anti-Parkinson medication for M.Parkinson.

The preparation for the operation includes an informative briefing on the type and scope of the planned intervention, which also addresses the possible complications and risks. This briefing gives you the opportunity to ask any questions you have about the surgery.

  • Which procedure is used in your case and for what reasons?
  • What exactly do you do with this operation?
  • What type of anesthetic is used for the operation?
  • How long does this operation take?
  • What are the risks of this operation?
  • How long may you need to stay in the hospital?
  • What scars will be left from the surgery?
  • What complaints can be expected in the future?
  • How likely is it that the symptoms will come back?

The interview is based on a standardized information sheet, which also serves as a legally relevant document.

Dealing with uncertainty, anxiety and nervousness

Of course, the informational discussion must also take into account aspects that go beyond the factual facts.

Many people have an uneasy feeling when they think about having an operation, and we know how regularly modern medicine ignores this fact, despite the importance it plays. Especially if you have never had an operation before, you may feel uncertain and nervous before the procedure.

By addressing and discussing these concerns in a targeted manner, in addition to the extensive factual information, a prepared and confident mind is ultimately created, so that you can then give yourself comprehensive confidence in the surgical treatment.

For us, you as a person are the focus of our activities and our actions are geared towards ensuring that you also feel optimally cared for emotionally.


Sobald Sie nach dem Eingriff wieder erwachen, werden Sie im Operationsgebiet schmerzfrei sein. Dies liegt daran, daß Sie dann unabhängig vom durchgeführten Eingriff ein örtliches Betäubungsmittel im operierten Bereich eingespritzt bekommen haben, dessen Wirkung zeitlich über den Eingriff hinaus anhält. Unwillkürliche Reaktionen des Körpers, die sonst bei Schmerzen auftreten, bleiben so aus und tragen zusätzlich zu Ihrem Wohlbefinden bei.

Im weiteren Verlauf der folgenden Tage werden Sie mit leichten bis mittelstarken Schmerzmitteln versorgt, die Sie nach Bedarf einnehmen sollten.

Ein Liegen im Bett ist nicht nötig, Bewegung wird stattdessen sogar zur Vermeidung von Thrombosen empfohlen.

Angeraten ist eine körperliche Schonung für ca. 2 Wochen, für diese Zeit besteht in der Regel auch eine Arbeitsunfähigkeit.

Daher sollten in dieser Zeit beispielsweise keine schweren Gegenstände angehoben und die meisten Sportarten ausgesetzt werden.

Die Fäden werden am 12. Tag nach der Operation gezogen.

Mit einem wasserdichten Pflaster auf der Wunde dürfen Sie nach der Operation jederzeit duschen, mit einem Vollbad und Saunagängen sollten Sie besser bis zur abgeschlossenen Wundheilung ca. 14 Tage nach dem Eingriff warten.

In jedem Fall erhalten Sie einen ausführlichen Merkzettel, auf dem alle Verhaltensempfehlungen und Informationen zur Nachbehandlung jederzeit nachgelesen werden können.

In akuten Notfällen können Sie uns natürlich jederzeit auch persönlich telefonisch erreichen.

Control examination

We then check the wound and the neurological findings after the operation.

All appointments will of course be given to you in writing as a reminder.

After the treatment has been completed, your family doctor will receive a detailed report on the entire process, including the operation performed, the recommended follow-up treatment and medication.