Methods of Treatment

Herniated discs which have not resulted in palsy or a so called kaudasyndrom, can be treated without surgery. The symptoms often degenerate with conservative methods of treatment such as physiotherapy, heat therapy, relief therapy and/or medicamentous pain therapy. 

In order to treat continuous symptoms or an increasing palsy, surgical treatment may be necessary. In this case the following methods are particularly relevant:


Endoscopic Surgery – keyhole technique

Modern operation methods are increasingly replacing classic open surgical treatments. The most developed method is the so-called minimally invasive surgery, which is also used for operations concerning the intervertebral disc. Here, surgeons use sophisticated instruments and devices to enter through a “keyhole”, and no longer need a scalpel. This endoscopic technique enables exceptionally gentle intervertebral disc surgeries. The surgeon undertakes the surgery through a small, fingernail-like cut. In addition, the patient only requires local anesthesia. TESSYS® is a very gentle and effective endoscopic surgery method.

The access to the spinal canal can either be performed laterally with the TESSYS® method or dorsally with the iLESSYS® method. Both endoscopic surgery methods are gentle on the patients and post operative pain or muscle pain are limited. The decision of which technique to choose is the experienced surgeon's responsibility.


Worldwide there are many hospitals offering the TESSYS® or iLESSYS® treatment.

Microsurgery

With the patient under general anesthesia, the surgeon makes a 2–4 cm cut, frees the constricted nerve root and removes the leaked gelatinous substance and worn parts of the intervertebral disc. He has to loosen the muscles and ligaments. So muscle and wound pain are some consequences. But a higher accuracy level than with the classic surgery is possible.

The classic open method

Today, this conventional method is generally only used in surgeries in which the access to the operating field has to be as wide as possible. In this case the patient is under general anesthesia. The surgeon makes a 3–10 cm cut, loosens the musculature, moves the connective tissue and removes bone substances before being able to remove the perturbing troublesome tissue. The disadvantages include possible negative after-effects such as limited mobility or nerve and vascular injuries.