The top experts of our neurosurgical team will resolve your problems and make sure you return to your everyday life pain-free. We nurture a holistic approach to the patient, and top diagnostics and the best method of treatment with regard to the general condition of the patient are a priority at our Clinic. Consequently, it is sometimes necessary to perform certain examinations, tests or procedures, and we always choose an individual approach to the patient in accordance with the difficulties he/she experiences. If in the end it is necessary to have a procedure performed, we will make sure that it goes as painlessly and successfully as possible.
With us, your health is in safe hands.
At the back of each segment of the spine, a pair of small joints connect the bones of the spine through which two-thirds of the spinal load are transmitted. The facet joints of the lumbar spine (lower back) sustain a large amount of stress and weight, which makes them more susceptible to degeneration and injury. Deforming spondyloarthrosis includes degenerative changes and atrophic thickening of these joints. The pain stemming from this part may initially be acute (short-lived) and eventually become chronic. The pain may be localized in the lower back or affect one or both legs.
DEGENERATIVE CHANGES OF INTERVERTEBRAL DISCS
The flexible part of the spine is connected by intervertebral discs which consist of two functionally aligned parts of the fibrous ring and the soft core. These parts provide strain relief as well as elasticity of the spine. The upright posture of humans as well as various loads in the human body expose intervertebral discs to extremely high pressures and stresses. A change in any of these structures leads to a disorder of the biomechanics of the spine and causes further changes in adjacent parts of the spine due to the extreme proximity of anatomical structures. The origin of pain in the spine therefore has three main sources, and they are: the muscles around the spine, other bone and joint structures of the spine and spinal nerves. Degenerative changes of intervertebral discs are caused by numerous effects of numerous physiological and non-physiological loads that are visible in humans from a young age and that develop faster or slower throughout life.
INTERVERTEBRAL DISC HERNIATION
Intervertebral disc herniation occurs when the intervertebral disc moves beyond its anatomical boundaries. Depending on the extent of core migration, disc herniation may result in protrusion, prolapse, extrusion, or sequestration of the core content. With protrusion there is a smaller bulge of the fibrous ring, and with prolapse with further penetration of the bulging part of the ring and pulpal tissue there is pressure and irritation of nerve structures. Extrusion refers to a condition when the pulpal tissue completely penetrates the fibrous ring and the contents come out of the disc, but still hold on to it. Sequestration is an irreversible separation of the bulging tissue of the pulpal core which forms a sequester that is separated from the disc. Disc herniation is a condition that can occur anywhere in the spine, but most commonly occurs in the lower back. If a disc of the cervical spine herniates, it is usually one of the three lowest cervical vertebrae (C5 to C7).
In most of the described conditions, there is irritation of the nerve roots of the spinal cord (radiculopathy) and sometimes of the spinal cord itself (myelopathy). As a result, pain occurs in the entire innervation area of the pinched nerve, which can lead to it falling out, thus the pain spreads to other parts of the body. In certain severe cases, pressure on the spinal cord can lead to inability to move in the form of tetraplegia, hemiparesis or hemiplegia.
THE LUMBOSACRAL SYNDROME
The lumbosacral syndrome is a disease that occurs in the lumbosacral joint in the lower back. The term lumbo refers to the lumbar vertebrae, and the term sacral refers to the sacral area, i.e. the bones in the lower part of the spine. This disease is caused by entrapment of the nerve roots of the sacral nerve plexus (L4, L5, S1-S3) which form the nerve of the hip – nervus ichiadicus. The pain can manifest as long-term chronic pain that is weakly exacerbated in the lumbar spine, as occasional bouts of pain, and as severe pain that is exacerbated by coughing, sneezing, bending, or sitting. The pain can have the characteristics of burning and cramping, and a distinct feature is the intensity of pain when getting up.
Myelopathy is an injury to the spinal cord due to compression which may result from trauma, congenital stenosis, degenerative disease or disc herniation. The spinal cord contains a series of nerves located inside the spine. When any part of the spinal cord is compressed, it causes nerve dysfunction along the spinal cord resulting in pain, loss of balance and coordination, and numbness in the area around the point of compression. Myelopathy can occur in any area along the spinal cord. Types of myelopathies include cervical myelopathy (which occurs in the neck), thoracic myelopathy (which occurs in the middle part of the spine), and lumbar myelopathy (which occurs in the lower spine). If left untreated, myelopathy can lead to permanent spinal cord injury and nerve damage.
LUMBAR SPINAL STENOSIS
Lumbar spinal stenosis is a narrowing of the spinal canal in the lower back. Stenosis, which means narrowing, can cause pressure on your spinal cord or on the nerves that run from the spinal cord to the muscles. Spinal stenosis can occur in any part of the spine, but it is most common in the lower back. The narrowing is often accompanied by lower back pain and a characteristic symptom – the spreading of the pain into the legs when moving, which stops when resting in a sitting or bent position. As the disease progresses, severe pain, cramps and tingling in the legs appear even when resting, and neurological damage is possible. This disease has a slow course over a number of years with periods of exacerbation and periods of improvement. The disease can be diagnosed by a specialist’s examination and by magnetic resonance imaging of the lumbar spine.