Herniated discYou are looking for a disc specialist in Germany, Switzerland or Austria? Here you will find experienced specialists and clinics for diagnosis and conservative treatment or surgery for a herniated disc. Or find out about the causes and symptoms of herniated discs and learn when a disc surgery makes sense.
List of doctors for herniated disc
Prof. Dr. med. Ralf A. Kockro
Prof. Dr. med. Makoto Nakamura
Dr. med. Oliver Oetke
Conservative and Surgical Spine Therapy Munich
Prof. Dr. med. Wolf Petersen
Dr. med. Henning Rohl
Prof. Dr. med. Dr. phil. Victor Valderrabano, MD PhD
Information about herniated disc
What is a herniated disc?
The intervertebral disc is an elastic disc between the vertebrae of the spine. It is built in between two adjacent vertebrae at a time. Its function is to intercept and evenly distribute body weight acting on the spine (for example, when walking).
In healthy persons, the intervertebral disc is not supplied with blood and is supplied by diffusion (inflow and outflow) of synovial fluid. With age, it is normal for the intervertebral disc to degenerate, that is, to break down over time. The intervertebral disc is divided into two parts, the outer annulus fibrosus, which consists of strong fibrous structures, and the gelatinous nucleus pulposus, which lies within it. The outer part is made of strong fibers that hold the inner part together. The inner part is rather thick. Comparable to a type of gel.
In a herniated disc, the inner part of the disc exits through a tear in the outer part into the canal of the spine (freely sequestered) or between the spine and a ligament covering the spine (subligamentous). The spinal cord or the nerve roots of the spinal column can be pinched, which is why the symptoms occur.
Which causes lead to a herniated disc?
The causes of degeneration of the intervertebral discs are manifold. These include prolonged prere on the disc tie, incorrect loading of the spine, lack of nutrient supply to the intervertebral segment, lack of exercise and poor tie quality due to heredity.
What symptoms can occur with a herniated disc?
In the case of a herniated disc, radicular (related to nerve roots, radix) pain or discomfort may occur. This is pain caused by the compression of a nerve root. Each spinal segment has a spinal cord on each side (right. Left) two nerve roots each. For example, the posterior nerve root receives information about the pain of an arm. If you burn yourself on the forearm, this burn pain is conducted via nerves in the arm to the posterior root and from there is transmitted via the spinal cord to the brain. Then we consciously feel pain in the forearm.
The anterior nerve root works in the other direction. It conducts information from the brain to the arm, for example, that it should move. Understandably, a herniated disc can cause paralysis, spasticity or various pains and sensations. In addition, myelopathic damage can occur with a herniated disc if the spinal cord is directly impacted. Since all fibers of the nerve roots are conducted via the spinal cord to the brain, movement or sensation may also be affected here.
In the case of myelopathic damage, this may even lead to Paraplegia below the herniated disc, because in the spinal cord run all the fibers that contain all the sensory and movement information of the body sections below the herniated disc. Thus, one can be paralyzed from below the navel if a complicated herniated disc develops at this level.
Herniated disc conservative therapy or surgery?
Conservative therapy is initially scheduled for 4-6 weeks if there are no neurological deficits (z.B. sensory disturbances or paralysis). This includes local heat therapy, medications for pain and inflammation, massage, electrotherapy, and physical therapy. Today, the patient is not treated with complete rest. It has been shown that moderate movement supports the healing process more effectively than lying completely.
If conservative therapy fails, the volume of the intervertebral disc can be reduced by aspirating fluid from it (intradiscal volume reduction). If there are motor deficits and signs of spinal cord compression, it is Intervertebral disc surgery advised. Because of the relatively high rate of complications, it is recommended to operate only in urgent indications (need for surgery).
Herniated disc healing process
Most herniated discs usually heal without surgery using conservative therapies. The duration of the healing process varies from individual to individual. This also applies to the healing process after intervertebral disc surgery. The therapy phase is followed by a rehabilitation phase after surgery, but also in some cases after completion of the conservative therapy. This includes outpatient or inpatient rehab. Pasture integration into the work process. In the case of an uncomplicated herniated disc, it takes about 12 weeks until the patient is fit again. However, the healing process can also be faster or slower. Patients are required to cooperate with the exercise therapy and to have a lot of patience. General prognoses are rather difficult, since every herniated disc. patient are individually different.
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Which doctors and clinics are specialists in a herniated disc in Germany or Switzerland?
Anyone suffering from a herniated disc wants the best medical care for themselves. That's why the patient asks himself, where can I find the best clinic for a disc surgery or a disc specialist?
Basically, different specialists can diagnose a herniated disc. The first doctor for back pain, numbness or paralysis is usually the family doctor. The latter can decide whether a referral to a neurologist or orthopedist is necessary. Patients can also consult an orthopedic surgeon directly or, in the event of acute severe pain and paralysis, go directly to a clinic for orthopedics and spinal surgery as an emergency measure. Family physicians as well as orthopedists and neurologists can very reliably suspect a herniated disc based on symptoms, a physical examination and the history of how the herniation occurred.
To ensure the diagnosis, the specialists mostly use imaging techniques such as the Magnetic resonance imaging or the Computed tomography . In addition, neurological examinations can help with the diagnosis. Sensitivity and reflexes are checked or specialized techniques are used to test the nerves, their excitation and their conduction velocity (evoked potentials, EMG, nerve conduction velocity). If disc surgery is necessary, specialists in spinal surgery are the right people to contact.