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On Thursday, January 18, 2024, Dr. med. univ. David Major, Head of Radiology at Emmental Hospital, about “Degenerative changes in the spine and their minimally invasive treatment options”. The lecture highlights the latest imaging techniques used to diagnose and evaluate these conditions and emphasizes the importance of accurate diagnostics for effective treatment. In addition, modern, minimally invasive therapy options that are carried out under CT control are presented and their advantages for patients with degenerative spinal diseases are discussed.
«D’REGION»: What are the most common degenerative changes in the spine and how do they occur?
David Major: The most common degenerative changes in the spine are spondylosis, herniated discs and spinal canal stenosis. These diseases usually result from the body’s natural aging process. Over time, the intervertebral discs lose moisture and elasticity, which leads to a reduction in their ability to absorb shock and increased stress on the vertebral joints. This can lead to spondylosis, an ossification and stiffening of the spine. Spinal canal stenosis, a narrowing of the spinal canal, is often caused by thickening of the ligaments and bony outgrowths that leave less room for the nerves and can cause pain and numbness.
«D’REGION»: In addition to the physical examination, imaging is an important pillar in diagnostics. What procedures are mainly used?
David Major: Imaging procedures are essential in the diagnosis of spinal diseases. X-rays provide an initial overview of the bone structure of the spine. However, magnetic resonance imaging (MRI) and computed tomography (CT) are often used for a more detailed view. MRI is particularly valuable because it can provide excellent visualization of soft tissue structures such as intervertebral discs, nerves and ligaments. CT scans, on the other hand, are the method of choice when assessing bony structures and for patients who are not suitable for MRI, such as those with certain medical implants (such as pacemakers or neurostimulators).
«D’REGION»: How important is precise diagnosis for subsequent treatment?
David Major: Accurate diagnosis is crucial for planning effective treatment. It not only helps to identify the exact cause of the symptoms, but also makes it possible to choose the most appropriate treatment options and avoid possible complications. Accurate diagnosis is particularly important in spinal diseases, as the symptoms are often non-specific and precise localization and characterization of the pathology is required for targeted treatment.
«D’REGION»: What role does radiology play in treatment?
David Major: Radiology plays a central role in the treatment of spinal diseases, not only in diagnosis but also in the implementation of therapies. Radiological procedures enable precise localization and visualization of the affected areas, which is essential for minimally invasive procedures. In addition, radiology supports the monitoring of the course of treatment and helps to assess the success of the therapy.
«D’REGION»: Minimally invasive therapy options that are carried out under CT control are becoming increasingly important. For which clinical pictures do you use these procedures?
David Major: Minimally invasive treatment options under CT guidance are particularly useful in the treatment of herniated discs, some forms of back pain and sometimes vertebral fractures. These techniques make it possible to inject medication directly into the site of pain without the need for major surgical procedures. These procedures are less stressful for the patient and often require shorter recovery times.
“D’REGION”: How can laypeople imagine the process of such CT-guided therapy?
David Major: With CT-guided therapy, the patient is first placed in the CT scanner, whereby the area to be treated is precisely positioned. The radiologist then uses the CT images to determine the exact location for therapy. During the treatment itself, an instrument, such as a puncture needle, is guided precisely to the target region under CT control. This allows for very precise treatment with minimal risk to surrounding structures. The procedure is usually carried out on an outpatient basis and usually only lasts a short time.
“D’REGION”: What advantages do these therapeutic procedures bring to patients?
David Major: These minimally invasive therapeutic procedures offer several advantages: They are usually less painful, have a lower risk of infection and require shorter recovery times compared to open surgical procedures. They enable targeted treatment, which often results in faster and more effective pain relief. They also reduce the burden on patients, as many of these procedures can be carried out on an outpatient basis and do not require long hospital stays.
«D’REGION»: To what extent do lifestyle factors such as exercise, diet and work influence the health of the spine, and what preventative measures do you recommend?
David Major: Lifestyle factors play a critical role in spinal health. Regular exercise, especially activities that strengthen back muscles and increase flexibility, can reduce the risk of degenerative spine diseases. A balanced diet rich in calcium and vitamin D supports bone health. Occupational factors, particularly jobs that require long periods of sitting or heavy lifting, can increase the risk of spinal problems. Ergonomic workplaces and regular breaks for exercise are therefore important. Prevention also includes promoting good posture and regular medical check-ups to identify potential problems early.
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Lectures: Thursday, January 18, 2024, 7:00 p.m., in the course room (ground floor) in Spital Emmental, Oberburgstrasse 54, Burgdorf; Thursday, January 25, 2024, 7 p.m., in the hospital in Langnau.
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