Spine Surgery

The spine is the backbone, support and movable axis of the trunk in humans and vertebrates. It is connected to various parts of the skeleton (head, pelvis, arms, etc.) and encloses the spinal cord.

The role of human spine is difficult to overestimate. Orthograde position is something that makes humans different from animals and this distinction is provided by unique skeletal structure where vertebrae column plays one of the central parts. But not only that. The spinal cord is a main trunk-line of the peripheral nervous system that transmits information from peripheral nerves to the brain. All our motor activity depends on health of our spinal cord and when it is injured or destroyed by chronicle disease, it is important to have immediate professional help of a spine specialist.

Clinic of Braunschweig Clinic of Braunschweig offers comprehensive service in field of spine surgery carried out by specialists of Trauma and Orthopedics Surgery Clinic and Neurosurgery Department. Neurosurgeon MD Martin Willmann and trauma surgeon Ernst Rzesacz together performed a number of spine operations of different complexity. Top spine surgeons of the clinic have at hand a variety of techniques using them with individual approach to every patient.

The spine is the bony axis skeleton that carries the trunk and allows its movements. She is straight from the front. Viewed from the side, on the other hand, it has a double S-shape:

In the neck and lumbar region, it is curved forward (cervical and lumbar lordosis), in the thoracic and sacral region, it is curved backwards (breast and sacral kyphosis). This spine anatomy is important for standing upright and walking, as well as cushioning burdens.

How many vertebrae does a human have?

The human spine consists of 33 to 34 vertebrae. It is divided into five spinal sections, each consisting of several vertebrae:

  • Cervical spine (cervical spine)
  • It is composed of the seven seven cervical vertebrae (cervical vertebra, C1-C7).
  • Thoracic spine (BWS)
  • More about the longest part of the spine, which is made up of the 12 thoracic vertebrae (thoracic vertebra, Th1 - Th12).
  • Lumbar spine (LWS)
  • The third spine section consists of five vertebrae (lumbar vertebra, L1 - L5).
  • Sacrum (Os sacrum)
  • During development, the five sacral vertebrae (sacral vertebra, S1-S5) grow together into a single bone.

The vortex structure varies

The vortices are basically built according to a uniform basic scheme. However, in the various spinal sections there is a somewhat varying structure in adaptation to the function and load: vertebrae that perform more static functions differ in size and shape from those that have increasingly dynamic tasks.

Therefore, the vertebrae of the cervical spine, which carry only relatively little weight with the head, but must allow for a great mobility, shaped differently and smaller than the lumbar vertebrae. The latter must carry a significantly greater weight and therefore be stronger, but allow only a smaller range of motion.

The vertebral body

The basic form of all vertebrae is a ring or hollow cylinder. The anterior part of each vertebra - with the exception of the first and second cervical vertebrae - is a solid, cylindrically shaped bone with a basal and a cover plate, the vertebral body (corpus vertebrae). The vertebral body is the actual supporting and supporting part of the spine. He has a thin compact outer layer and inside a strong spongiosa, a spongy system of fine trabeculae, which is filled with red bone marrow. The central area of ​​the upper and lower surfaces of the vertebral bodies is porous, and only the marginal ridges are made of solid bone.

Only the first cervical vertebra (atlas) that carries the head has no vertebral body. It is connected to the second vertebral body (Axis) via a joint (Articulatio atlantoaxialis).

The intervertebral discs

Between each two adjacent vertebral bodies are pressure-elastic intervertebral discs of cartilaginous tissue, the intervertebral discs.

The vertebral arch and the appendages

The posterior part of each vertebra is the vertebral arch (arcus vertebrae), which is narrower and weaker than the vertebral body. From the vertebral arch go from several extensions:

These include four articular processes (processus articulares), two of which are directed upwards and two downwards. They form the real joints between the vertebrae. The paired transverse process (plural: Processus transversi) goes off to the right and left of the vertebral arch and serves as a lever arm for attaching muscles. The ribs attach to the vertebral arches of the thoracic spine (Th2 to Th10). A single spinous process (processus spinosus) goes backwards.

Types of Spine Surgery

Spine surgery types can be divided based on problem, method and segment of the spinal cord treated. There are five sections of the spine cord including cervix, thorax, lumbar spine, sacral spine and coccyx. The problems in different regions are nearly the same but often they require different approach.

Spine Surgery for Stenosis and Pinched Nerves

Spinal stenosis is a condition when the spinal canal becomes narrowed that results in spinal cord compression. The main symptoms of stenosis are pain, tingling, numbness and weakness in related area. There are a few surgical procedures to relieve the symptoms and eliminate compression as following:

  • Laminectomy and Laminotomy. The both procedures are removal of the bone (lamina) on the back of vertebra over the nerve root but lanimotomy is minimally invasive spinal surgery. With laminoctomy the entire lamina can be remover whilst with laminotomy lesser portion of the bone is extracted. The purpose of laminectomy is to give the spinal nerve more space.
  • Foraminotomy is removal a part of the bone or tissues to relieve the pressure in the neural foramina, passage between two vertebras where the nerves leave the spinal cord.

Spine Surgery for Herniated disks

Vertebras in the spine are separated by intervertebral discs that function as shock-absorbers. At certain conditions interveterbral discs can bulge and develop hernias that compress spinal nerves and cause pain. The following kind of spine operations are used to eliminate this condition

  • Discectomy is removing of the bulged disk or its parts to get rid compressing and inflammation of the nerve.
  • Disk replacement. It is not very common spine surgery when degenerated disk is replaced with artificial implant.

Other Decompression Procedures

Corpectomy is removal of the vertebra body to lessen compression in the spine.

Costotransversectomy is removal of a part of the rib adjoined to the vertebra. Normally the procedure is done together with surgery of the vertebra body.

Spinal Fusion

During spinal fusion surgery two vertebras are joined together to stabilize spine in order to eliminate pain caused by motion. This procedure reduces flexibility of the spine but allows avoiding severe pain produced during motion.

Surgery for Spine Tumor Removal

One of the important directions of spinal surgery is benign and malignant tumor removal. I case of the later, the specialists from Cancer Center are involved. The purpose of surgery is complete removal of the tumor and stabilizing the spinal cord. Sometimes surgery on removal is followed by spinal fusion or other stabilizing procedures.

Trauma Surgery

Trauma Center of Clinic of Braunschweig offers both emergency surgery service and complex restoration of traumatic damages of spine after sports injuries or accidents. The different techniques may be used from traditional open spine surgery to modern minimally invasive techniques.

Minimally Invasive Spine Surgery

Endoscopic minimally invasive methods appeared relatively recent but they are already widely used in all the surgery areas including spine operations. The distinctive features of this type of surgery are smaller incision and using special optical device endoscope which allows translating images from the site of surgery on monitor where surgeon can see the details. Spring approach has advantages as shorter recovery time and reducing of complications as bleeding, infection and other problems associated with open surgery.

Robotic Spine Surgery

Robotic surgery is the newest version of endoscopic surgery when operation is made with robotized device controlled by surgeon by means of computer. The method allows removing smaller parts of tumors in case of metastases or performs accurate spine neurosurgery.

Laser Spine Surgery

Though using of laser surgery for spine is still contradictory, nowadays laser is often applied for disk decompression.

Ask Advice of Top German Surgeons

Among the variety of surgical techniques patients hardly can decide independently what kind of treatment they need. If you are considering on spine surgery, please contact our specialists. In our Spine Clinic we will suggest you the full range of diagnostics services and a number of treatment options.

Department of Spinal Surgery
Chief Physician

Spine Surgery

Professor MD Thomas Gösling

Chief Physician

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Statistics 2017
  • 1350 patient admission
  • 15 physicians
  • 44 medical staff
  • 1056 excisions of diseased intervertebral disc tissue
  • 172 bone replacements on the spine
  • 162 spinal fusions
  • 391 other operations on the spine
  • 248 osteosynthesis (dynamic stabilization) on the spine
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