The Spine: General Structure

A typical vertebra consists of two essential parts: an anterior (front) segment, which is the vertebral body; and a posterior part, the vertebral or neural arch, which encloses the vertebral foramen. The vertebral arch is formed by a pair of pedicles and a pair of laminae, and supports seven processes, four articular, two transverse, and one posterior.

Spine Dictionary

Prices in Germany are normally 75% below the cost for a spine surgery in the US and are individually quoted. Our prices for both the cervical artificial disc and the lumbar artificial disc are typically 5,000 - 10,000 EUR below other high profile clinics in Germany. Although we offer a range of surgeons to choose from, we have a our preferred doctor, who is the chief neurosurgeon with over 25 years experience. Prices or costsinclude all medical expenses, the hospital stay, surgeon's fees, operation room fees, anesthesia, anesthesiologist's fees, medicine, nursing, semi-private room, meals, pre-op diagnosis, local phone and English TV.

The terms below in what we call our spine dictionaryare provided for the reader, because they may not be specifically defined in other pages. Contributions to the dictionary or proposed corrections are appreciated and may be submitted by e-mail.

Ankylosing Spondylitis

Ankylosing Spondylitis treatment prices in Germany are normally 75% below the cost for Ankylosing Spondylitis in the US and are individually quoted. They include all medical expenses, the hospital stay, surgeon's fees, operation room fees, anesthesia, anesthesiologist's fees, medicine, nursing, semi-private room, meals, pre-op diagnosis, local phone and English TV.

Ankylosing Spondylitis: What is it?

Ankylosing Spondylitis also known as Bechterew's disease; Bechterew syndrome; Marie Strümpell disease / Marie Struempell disease) is a chronic, painful, progressive inflammatory arthritis primarily affecting spine and sacroiliac joints, causing eventual fusion of the spine; it is a member of the group of the autoimmune spondyloarthropathies with a probable genetic predisposition. Complete fusion results in a complete rigidity of the spine, a condition known as bamboo spine.

Arachnoiditis Definition:

Arachnoiditis is a pain disorder caused by the inflammation of the arachnoid, one of the membranes that surround and protect the nerves of the spinal cord. It is characterized by severe stinging, "burning pain," and neurological problems.

Arachnoiditis Symptoms:

Arachnoiditis has no consistent pattern of symptoms, but in many people it affects the nerves connecting to the lower back and legs. The most common symptom is pain; but, arachnoiditis can also cause:

Tingling, numbness, or weakness in the legs
Sensations that may feel like insects crawling on the skin or water trickling down the leg
Severe shooting pain that can be similar to an electric shock sensation
Muscle cramps, spasms and uncontrollable twitching
Bladder, bowel and/or sexual dysfunction
Direct injury to the spine

Possible Causes:

Chemicals: Dye used in myelograms (diagnostic tests in which a dye called radiographic contrast media is injected into the area surrounding the spinal cord and nerves) have been blamed for some cases of arachnoiditis. The radiographic contrast media responsible for this is no longer used, however. Also, there is concern that the preservatives found in epidural steroid injections may cause arachnoiditis.

Infection from bacteria or viruses: Infections such as viral and fungal meningitis or tuberculosis can affect the spine.

Chronic compression of spinal nerves: Causes for this compression include chronic degenerative disc disease or advanced spinal stenosis (narrowing of spinal column).

Complications from spinal surgery or other invasive spinal procedures: Similar causes include multiple lumbar (lower back) punctures.

Prognosis:

Inflammation of the arachnoid can lead to the formation of scar tissue and can cause the spinal nerves to stick together and malfunction. The arachnoid can become inflamed because of an irritation from one of the following sources:

As the disease progresses, symptoms may become more severe or even permanent. Many people with arachnoiditis are unable to work and suffer significant disability because they are in constant pain. Causes of Arachnoiditis

Treatment option available in Germany.

Endoscopic operations were performed on patients suffering from varying symptoms with an enlarged lumbar subarachnoidal space. Having confirmed the diagnosis of lumbar arachnoiditis, a number of endoscopic operations ranging from adhesiolysis to subarachno-epidurostomy are carried out.

Results:

Radicular symptoms in lumbar arachnoiditis were successfully relieved by various endoscopic dissection techniques, such as restoration of the improved CSF flow by subarachno-epidurostomy along the rootlet. This has been identified as one of the causal factors of the clinical symptoms. In cases where lumbar pain persists in spite of a previous thecaloscopy, further treatment with a lumboperitoneal shunt device has proved most successful.

Artificial Disc Replacement

Artificial disc replacement prices in Germany are normally 75% below the cost for the surgery in the US and are individually quoted. These cost savings are especially realized in multi level artificial disc replacement. All surgeries are performed by the best doctors, chosen for your specific need. Costs / prices include all medical expenses, the hospital stay, surgeon's fees, operation room fees, anesthesia, anesthesiologist's fees, medicine, nursing, private room, meals, pre-op diagnosis, local phone and English TV. For artificial disc replacement surgery we are exclusively recommending Dr. Rudolf Bertagnoli.

EMT is a client advocate and charges no fees to our clients.

Artificial Disc Replacement: Video

See a Typical Second Day Post-Op Exam with One of our cervical clients

See an interview with one of our lumbar clients

See an interview with a second lumbar client

Artificial Disc Replacement - Overview

Prices in Germany are normally 75% below the cost of disc replacement surgery in the US and are individually quoted. They include all medical expenses, the artificial disc (FDA approved Prodisc) or the Charite) the stay in hospital, semi-private room, meals, pre-op diagnosis, therapy, phone and English TV. We have negotiated prices with several institutions and doctors in Germany to perform this surgery. Prices can range from 14,000 EUR to 29,000 EUR per disc depending on whether or not the disc is a cervical disc or lumbar disc and how high a profile the hospital and doctor has.

• Artificial Disc Replacement: Descriptions
• Artificial Disc Replacement: Success Rate
• Artificial Disc Replacement: Life Span
• Artificial Disc Replacement: The Surgery

Artificial Disc Replacement - Life Span

Prices in Germany are normally 75% below the cost for a artificial disc replacement surgery in the US and are individually quoted. Our prices for both the cervical artificial disc and the lumbar artificial disc are typically 5,000 - 10,000 EUR below other high profile clinics in Germany. All surgeries are performed by our preferred doctor, who is the chief neurosurgeon with over 25 years experience. They include all medical expenses, the hospital stay, surgeon's fees, operation room fees, anesthesia, anesthesiologist's fees, medicine, nursing, semi-private room, meals, pre-op diagnosis, local phone and English TV.

How long will an artificial disc last in any individual patient cannot not be precisely determined by anyone, however statistics on previous patients and the knowledge of manufacturing testing can give us a fairly good estimate for the patient population in general. Because the artificial disc procedure for the lumbar spine has only been performed since the early 1990's with the artificial disc for the cervical spine soon following and because several modifications and variations to the original artificial disc design have been made, duration statistics of 20 to 40 years are not available. However, examination of the few artificial disc patients, who have died (all from reasons unrelated to the artificial disc), have shown the discs to be completely in tact. Additionally, at the time of this writing no known artificial disc failures have occurred in a living patient. Manufacturers of the artificial disc try to simulate the wear and tear of 40 to 50 years of life, by implanting the discs in cadavers and mechanically stressing the cadaver's back. The simulation plays a role in FDA approval. Now we even have some manufacturers guaranteeing their artificial disc replacements for 40 years.

Artificial Disc Replacement - Success Rate

The success rate for artificial disc replacement surgery is not as straight forward as listing a series of spine surgery statistics. Success is judged on many subjective and objective measures. The artificial disc operation is usually judged successful if the patient's pain is dramatically reduced, mobility is restored and there is no lingering complication. Please note here that we did not say that the pain was completely eliminated, only that was dramatically reduced. If a patient has experienced back pain for many years from degenerative disc disease, changes due to compression of the ligaments of the spine, the spinal processes and nerves may still cause pain after the artificial disc is inserted. Nerve changes may cause phantom pain, which is pain that is no longer caused by the initial mechanical force on the nerve. So while the doctor from an objective point of view considers the artificial disc operation a success, the patient may not, because pain is still present. This is why we hear success rates varing between 70% and 96%.

Bone Graft

Lumbar fusions, cervical fusions and many types of orthopedic procedures require bone grafts to stimulate the bones to heal and to provide support the skeleton by filling in gaps between the two vertebrae.