Spinal Neurosurgery

Spinal neurosurgery deals with conditions of the spine, the spinal cord, spinal nerves and their surrounding structures. The most common spinal pathologies are herniated disc disease, spinal canal stenosis, instability and spinal (cord) tumors.

Diagnosis

The spine is permanently exposed to a high mechanical load and is therefore a common site of pain. Numerous factors such as lack of movement, stress, postural dysfunction, overweight, heavy lifting and trauma can trigger or amplify symptoms. Back pain might also be caused by stress and psychological issues or, in rare cases, infections or tumors.

The diagnostic workup includes detailed history-taking and a number of imaging studies:

• X-ray: This tool allows us to identify fractures, degenerative changes and instabilities, to undertake measurements for complex surgery and to assess the placement of screws and other implants. 
• Magnetic resonance imaging (MRI): This is the golden standard for the evaluation of nerval structures, intervertebral discs, the spinal cord and soft tissue.

• Computed tomography (CT): Best tool for the assessment of bony structures in addition to MRI.

• Myelography: This imaging study with contrast medium is performed in patients which are unable to undergo an MRI scan and if other imaging modalities were not conclusive.
• Electrophysiological tests: These tests allow us to identify and localise nerval lesions.

 

Treatment

The treatment of choice consists of a sufficient pain medication regimen combined with physical therapy, referred to as “conservative management”. This includes pain killers, physical therapy, massages, local application of heat, weight loss, exercising and strengthening of body core muscles.  In most cases, these measures help to relief the symptoms. It is important to maintain a certain level of physical activity and muscle strenght even after the pain has improved or has resolved completely.

If conservative management does not suffice, an image-guided injection of cortison and local anesthetics near the affected nerve root (“periradicular treatment” = PRT), into the affected facet joints or sacroiliac joints can be helpful.

If all above measures fail to restore the symptoms, surgery should be considered.

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The Department of Neurosurgery at the Innsbruck University Hospitals is the leading centre for spinal neurosurgery in Austria. We offer every kind of spinal surgery with open, half-open and minimally invasive approaches. We use the latest high-technology equipment including high-end operating microscopes, an intraoperative CT scanner and all modern tools of intraoperative neuromonitoring and neuronavigation.