Many people suffer from back pain which is one of the main areas of occupation of the neurosurgeon. Trapped nerve structures in the area of the spinal cord caused by disc prolapses, compression in the area of the spinal canal, spondylolisthesis or scarring after surgical interventions on the spinal cord can greatly impair the quality of life. As a result of constant pain, the patient often has problems in his professional life and with his partner. All these aspects must be taken into account to ensure the success of the treatment therapy. Before any major operations are carried out, it should be checked to see whether there is not a conservative solution (without an operation).

If this is the appropriate solution, the next step is often to consider a microtherapeutic procedure.

Microtherapy is a comprehensive innovative development within medicine as a whole. With the support of imagery (CT or a swivelling X-ray device) locally effective medicines and microinstruments are applied simply and directly through the skin (percutaneous) to the site of the injury. These procedures are carried out mainly on an outpatient basis. Within neurosurgery microtherapeutic procedures are used above all to treat back pains and disc disorders.

In the spinal cord field, there is a whole range of highly modern therapy procedures available to us, the decision to apply them in any given case is only taken after careful consideration of the overall situation. Interventions are mostly carried out on an outpatient or short-term inpatient basis.

In our practice the entire spectrum of microtherapeutic and surgical therapy of the spinal column is offered under the public health plan.

- Interrupting the vicious circle of pain by targeted pain therapy injections: Various substances are injected directly to the site of the injury.

- Peridural pain therapy (PDA): The main nerve tube is specifically flushed with painkilling substances.

- Eliminating pain in the area of intervertebral joints: A common cause of deep-rooted back and neck pain is the chronic irritation of intervertebral joints. After testing a tip with a local anaesthetic, pain is alleviated by targeted obliteration. The procedure is uncomplicated and is carried out on an outpatient basis.

- Targeted rinsing of nerve roots (periradicular therapy or PRT): If the pain can be traced to a nerve root, a special combination of drugs with the support of X-rays can be used to inject the irritated nerve. An advantage of this procedure is the targeted injection of the drug to the origin of the pain. This procedure is low-risk and is carried out on an outpatient basis.

- Microtherapeutic catheter techniques and intradiscal injections: With the aid of a microcatheter and X-rays, appropriate drugs are injected directly into the painful disc or nerve root. This procedure has been criticized recently, as it has often been applied inappropriately, it remains valid, however, for appropriate cases. The procedures are mostly carried out on an outpatient basis.

- Heat therapy within a disc: Due to wear and tear on the spinal cord, pain receptors make the damaged disc oversensitive (discogenic pain). A probe is inserted into the disc to eliminate these receptors thermally in a targeted way. The procedure is also referred to as radio frequency therapy and is carried out on an outpatient basis.

- Endoscopic disc operations: For appropriate cases, disc problems can be eliminated by means of a key hole technique through the skin (percutaneous). The advantage of this method is that the patient can get back on his feet faster and does not have to stay overnight in the clinic.

- Microsurgical operation of disc prolapses and compression in the area of the entire spinal cord: The micro-surgical operation is the "golden standard" for herniated disks and narrowing in the area of the spinal canal (stenosis). Nerve structures can be decompressed at low risk with optimal lighting from the operating microscope. In most cases, a short stay in the clinic is required. Subsequent treatment can be given on an outpatient basis. Longer rehabilitation measures as an inpatient are not necessary for standard disc operations and are totally unknown e.g. in the USA. The patient should be careful for 14 days and circulate in his normal social environment as quickly as possible.

These operations are our main focus and are performed by us in very large numbers for patients from the entire federal territory and foreign countries.

- Stabilising interventions: For unstable spine segments targeted stiffening may be considered. The procedure should only be used after extensive diagnostic clarification and the failure of all conservative procedures. Procedures are available from behind (dorsal instrumentation) and combined from back and front (dorsal-ventral instrumentation with a disc prosthesis if necessary). The choice of the appropriate procedure must be made on the basis of clinical and radiological findings.

In addition to rare conditions such as brain artery herniation, the neurosurgeon deals with much more widespread complaints such as trapped nerves in cases of disc prolapses and back pains.

At our center in the lovely city of Munich, the most modern methods are used to treat not only patients with pain (e.g. back pain), disc prolapses, spinal cord disorders, trapped nerves in any part of the body but also patients with brain tumours or other surgically treatable conditions of the nervous system.

Microsurgical operations are our main focus and are performed by us in a very large number for patients from the entire federal territory and foreign countries.

More major operations can often be avoided thanks to microtherapeutic mini interventions. If an operation is required, it is done with minimum intrusion using the most modern techniques with a view to enabling our patients to have a normal life again as quickly as possible. In our center, the individual patient is the focus of our holistic medicinal approach, with personal and friendly care from our entire team throughout diagnosis and treatment. That is how we seek to ensure the satisfaction of our patients.