Neurosurgery

In the event of persistent or very painful symptoms that are affecting your day-to-day life, such as back or neck pain, pain or weakness in the arms and legs, or neurological issues (problems with speech, writing or walking), a consultation with a specialist is recommended. If these symptoms emerge suddenly, are particularly pronounced or are causing you significant worry, you should contact a specialist or a hospital immediately.

For certain patients who have already undergone surgery for a spinal condition, a second opinion or follow-up consultation with a neurosurgery specialist may be required in order to plan a ‘salvage operation’. This is an operation to realign the spinal column and to correct any general imbalance that often results from previous surgery.

The two fields overlap. For a long time, neurosurgery focused more on relieving pressure on the nerves, while spine surgery, a key area of orthopaedics, focused on procedures known as ‘spinal instrumentation’, for example in the case of fractures. In the past, operations would often involve two surgeons, each contributing their own personal expertise. The decompression surgery to relieve pressure on the nerves in the case of spinal stenosis was performed by a neurosurgeon, for example. The spinal surgeon would then perform a fusion operation in the segment being operated on, to address any instability or curvature.

Nowadays, the question no longer arises as to which specialist is the most suitable. In both disciplines, doctors specialise in the entire treatment spectrum for spinal diseases. Treatment options range from outpatient infiltrations and sclerosis of nerves, to minimally invasive inpatient procedures, disc prostheses and fusion surgery.

This depends on the type of surgery you have and your state of health. Certain procedures can be performed on an outpatient basis (in the day clinic). There is also the option of staying overnight in hospital. For more intensive surgery, you may have to stay in hospital for three to seven days.

This depends entirely on the type of surgery performed. During your stay in the clinic, your surgeon will recommend either an inpatient or outpatient rehabilitation programme. The entire nursing team will offer you rehabilitation measures that are tailored to your needs.

Rehabilitation after a neurosurgical procedure begins on the day of the operation (for patients whose surgery was minimally invasive) or on the following day. A special physiotherapy team will look after you throughout your hospital stay and, in consultation with the surgeon, will offer you a rehabilitation plan tailored to your needs.

Depending on the type of surgery you have had, you may be able to resume your normal routine three to six weeks after the operation. However, the restrictions specified by the surgeon must be observed during the first six weeks. For example, you must avoid twisting and bending your back too forcefully, and you must not lift, push or pull items weighing more than 2.5 kg.

You must inform your employer that you will be unfit for work for around six to twelve weeks. However, patients are frequently able to resume work before the end of this period. It is advisable to exercise caution and common sense. For example, do not force anything if you are in pain.

You can drive again once you feel ready to stop taking any opioid painkillers (based on morphine) and your surgeon has given permission. In general, this is two to three weeks after lumbar decompression and discectomy, and four to six weeks after lumbar fusion surgery.

Start with short distances and get out of the car every 30 to 45 minutes to take a short walk and change your position.

Caution: Certain painkillers slow your reflexes.