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Frequently Asked Questions on Surgery

  • Concerning open microsurgical methods, is the access also small and minimum-invasive ?

    Open disk surgery, which is standard today, uses ever smaller access apertures. But contrary to endoscopic surgery, bone structures and muscle tissues have to be cut in order to reach the herniated disk. This leads to bleeding which causes scars. Anyway, these techniques are not minium-invasive. The patients have to stay at the clinic for 3 to 5 days und the healing process is longer due to the substantially larger access apertures. Furthermore, a larger wound holds certain risks in terms of healing, which is not the case with TES (Transforaminal Endoscopic Surgery).

  • Endoscopic techniques for removing herniated disks have been used for a long time, but also given up repeatedly. Is that true ?

    The endoscopic system for the removal of laterally herniated disks is a common procedure for 15 years now. But only 4-8 % of all cases are located laterally and can be removed by means of this technique. 92 % of all cases are located medially or mediolaterally.

    The endoscopic method to be chosen for these cases uses the natural nerve hole (foramen) as an access path. For this reason, the method is called transforaminal (leading through the nerve hole). This kind of endoscopy is carried through by means of the Tessys® tool kit since 2002, but until now, only very few clinical centres worldwide are using this technique.

    Thanks to its great advantages compared to open surgery, this surgical method will be the prevailing procedure in the near future, as it has been the case with knee arthroscopy.

  • If this procedure is that excellent, why do only very few centres offer this technique and why don’t university institutions use this system?

    This technique has been developed at the Alpha Clinic Munich, a private clinic for spine surgery. During my time as senior physician I learned this technique directly from the founder MD Hoogland. Generally speaking, you should assist at 50 to 100 surgeries before starting to use this method yourself. The learning phase for this kind of surgery is a long one and highly demanding, thus not implying that it is dangerous. When carried through by an experienced surgeon, there is less risk than with open surgery. Being an expert in this field, I am offering Workshops for learning TES especially in the United States.

  • In general, surgery is chosen too fast. Is that true ?

    That is true. For this reason, we try to avoid surgery by using the Medical Training Therapy. On average, out of 100 patients coming to see us for possible surgical treatment, only 8 are operated on in the end.

    Indications for surgery should be very restrictive and seen as a last option. In case surgery cannot be avoided, the endoscopic method TES should be used.

  • In case of further questions not listed here: Please refer to frequently asked questions on conservative therapies for possible answers. Or simply contact us.