Spine surgery includes operations and various interventions performed on the spine, which protects the spinal cord and nerve roots as well as this delicate nerve tissue. Various diseases of the spine and spinal cord cause clinical disorders by leading to structural, functional and/or mechanical disturbances in these critical structures. The spine, spinal cord and nerve roots are affected by many disease groups, and clinical signs and symptoms emerge mainly in the form of pain, as well as nervous system function losses such as paralysis and sensory loss, restriction of spinal movements and deformities. The most commonly encountered disease groups in clinical practice can be listed as follows:
Disc diseases (Lumbar and cervical herniated discs…)
They arise from mechanical stress on the discs located between the vertebrae or from degenerative effects over the years; depending on the degree, the mode of onset, the location and the clinical picture of the disease, various surgical or non-surgical treatments may be required.
Degenerative disorders arising in the aging spine
Structural disorders developing in the bone, joints and soft tissues of the spine may cause compression of the spinal cord and nerve roots, leading to narrowing of the spinal canal that presents with gait disturbances, pain/numbness in the arms and legs, movement difficulties and loss of function, or to similar clinical pictures.
Tumours of the spine, spinal cord and nerve roots
These tumours may be primary tumours or metastases that have spread here from elsewhere in the body. In some patients, surgical treatment alone may be sufficient and complete recovery may be achieved; in some tumours, radiotherapy, chemotherapy and other treatments may also be applied in addition to surgical treatment.
Vascular diseases
Spinal haemorrhages and vascular diseases of the spinal cord (vascular malformations, fistulas,…) are sudden-onset conditions that generally require urgent diagnosis and treatment.
Trauma (causes such as traffic accidents, falls from height,…)
Spinal fractures/dislocations and avulsions caused by such causes,… spinal cord and nerve injuries resulting from them (severe paralysis, intense pain,…); impairment of spinal stability, load-bearing capacity and movement ability (spinal instability) are emergencies frequently encountered in life. Prompt diagnosis and treatment may sometimes be life-saving or prevent severe disability.
Paediatric spinal diseases
Congenital spinal and spinal cord abnormalities and deformities (open spinal canal, meningeal sac protrusion/exposure of the spinal cord and nerve sheaths,… diseases/cysts within the spinal cord,…) are conditions that again require a multidisciplinary and delicate approach to diagnosis and treatment.
Infections and abscesses
These are generally critical conditions requiring urgency and surgical and/or drug treatment.
Diseases that are widespread in the body or belong to another organ
For example, when rheumatological or metabolic diseases also involve the spine, they may cause deformation and malformation of the spine/spinal instability, impairing the function of the spinal cord and nerve roots, resulting in progressive severe clinical syndromes. Complex diseases requiring multidisciplinary advanced diagnostic and treatment methods are also within the field of interest of our advanced spine centre. These diseases may develop over a very short period (sudden/acute onset, e.g. haemorrhages,…) or may extend over a very long period spanning years or even decades (chronic/long-standing course, e.g. degenerative diseases of the spine…). Accordingly, signs and symptoms may appear across a very wide spectrum, such as pain, gait disturbances, restricted movement, deformities, loss of strength, loss of sensation, muscle wasting, thinning of the arms and legs, and bladder and bowel control disorders. For early diagnosis and effective treatment of this broad group of diseases, a detailed neurological examination and advanced imaging methods (next-generation Magnetic Resonance Imaging = MRI and Computed Tomography = CT…) and electrophysiological studies (EMG, SEP…) are necessary. In these various diseases affecting the spine and spinal cord/nerves, excellent and gratifying results can be achieved by applying surgical treatment when necessary. In this field too, by using the advantages of microneurosurgery and especially by applying the new surgical approaches and technical methods developed over the last few decades, the highest level of treatment of the existing disease is possible with the least impact on the patient and the shortest hospital stay, and decompression of the spinal cord and nerve roots as well as reconstruction and stabilisation of the spine can be effectively achieved.
