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Treatment of Lumbar Spine Disorders

Interview

Spinal problems can cause severe pain and a decrease in quality of life. Many patients, driven by fear of surgery, avoid seeking medical help, even though 90% of cases can be treated with conservative care without surgery.

At Dr. Rose Private Hospital, comprehensive spinal care is provided, including thorough examinations, possible surgery, and rehabilitation. Dr. András Erbszt, orthopedic specialist and spine surgeon, answered our questions regarding comprehensive care.

WHAT SURGERIES ARE PERFORMED AT DR. ROSE PRIVATE HOSPITAL?

Currently, Dr. Rose Private Hospital specializes in minimally invasive lumbar spine surgeries, primarily for lumbar disc herniation, spinal stenosis, and pyriformis syndrome. The minimally invasive surgical technique minimizes tissue damage, ensuring a quicker recovery for patients. We aim to preserve muscles by gently moving them aside, entering the spinal canal carefully, and performing the intervention with minimal damage.

HOW IS THE EXAMINATION OF PATIENTS CONDUCTED?

In the case of spinal disorders, establishing an accurate diagnosis and identifying the source of pain are crucial. This requires a precise physical examination conducted during medical visits and radiological examinations. The examination of spinal diseases is a highly complex task. In my experience in spinal medicine, the intellectual challenge it presents brings me the greatest satisfaction. I have realized during my career that the treatment of spinal patients is often done on an ad-hoc basis, attempting to address the current situation. However, by following a healing process through a protocol, patients recover faster and are more likely to remain symptom-free. I named this procedure the Integrated Spinal Patient Care Model.

THE PROTOCOL HAS FOUR ELEMENTS:

1.     Identification of the source of pain, with a focus on a thorough physical examination followed by radiological examinations (MRI or CT).

2.     Pain relief, utilizing various methods.

3.     Rehabilitation, with a primary focus on physiotherapy. If conservative treatment is unsuccessful, surgery may be considered.

4.     At Dr. Rose Private Hospital, all elements of the Integrated Spinal Patient Care Model are implemented: physical examination during specialized consultations, some radiological examinations at the hospital, CT and MRI scans at the Pozitron Medical Diagnostic Center (a partner institution of Dr. Rose), access to all pain relief procedures, and the ability to treat the majority of patients with minimally invasive surgeries. Excellent physiotherapists assist in conservative therapy and rehabilitation following surgery.

WHAT IS THE TYPICAL PATIENT JOURNEY IN TERMS OF THE NEED FOR SURGICAL SOLUTIONS?

Approximately 10% of disc herniations require surgery. It is essential to emphasize that this is because patients often hesitate to consult a doctor due to fear of surgery. Many live with unnecessary pain or a decreased quality of life. Most patients can recover without surgery through conservative therapy. Surgery is only performed in cases where the patient's pain is unbearable or when paralysis symptoms jeopardize their quality of life. Additionally, surgery is considered in cases of vegetative function disorders that could lead to a long-term decrease in the patient's quality of life.

DISC HERNIATION OR PYRIFORMIS SYNDROME – WHAT’S THE DIFFERENCE?

Our hospital specializes in the complex treatment of pyriformis tunnel syndrome, also known as gluteal or buttock syndromes. The diagnosis of pyriformis syndrome is primarily established through a physical examination. The condition is a classic tunnel syndrome, where the sciatic nerve becomes trapped between the pyriformis muscle (known as the pear-shaped muscle in Hungarian) and the muscle group beneath it, causing symptoms very similar to those of disc herniation. It is crucial to differentiate between the two conditions since the treatment approaches are fundamentally different. We have a diagnostic protocol available for examination, allowing us to determine whether the problem is related to one or the other.

WHEN WOULD ONE SUSPECT PYRIFORMIS SYNDROME?

Among the symptoms of the syndrome, it is important to note that pain often intensifies during sitting. The treatment of pyriformis syndrome is predominantly conservative. While approximately 10% of disc herniation cases undergo surgery, the likelihood of surgery for this condition is even lower, ranging from 3-5%. The most common cause of pain is incorrect loading during increased sports activities, such as running or using a stair climber. However, numerous other factors can trigger pyriformis syndrome. In rare cases, falling on the buttocks or other accidents can also cause similar symptoms, but unfortunately, the prognosis for recovery from these incidents is significantly worse than for pyriformis syndrome caused by overuse.

WHAT IS THE TYPICAL PATIENT JOURNEY FOR SPINAL SURGERY AT DR. ROSE PRIVATE HOSPITAL?

If, with the patient's consent, we decide on surgical intervention, we take the patient's hand from that point onward. The patient does not have to independently organize examinations; instead, the examination is arranged by the surgery coordinator, with the involvement of assistants, the anesthesiologist, and nursing staff. The examination process proceeds quickly and comfortably. Skilled nurses, experienced in caring for spine patients, participate in postoperative care. Rehabilitation, which begins on the day after surgery with the involvement of our physiotherapists, is of paramount importance. Additionally, it is worth noting that our patients recover in five-star hotel-like conditions.

Working at Dr. Rose Private Hospital is rewarding because a highly cohesive and professional community works for the well-being of patients. It is a great experience for me to be surrounded by professionals who share the same goals, and with our mission to heal all patients who come to us.

 

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