Spine Surgery Stuttgart (Baden-Württemberg): Dr Büchin & Dr Schall

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The Center for Spinal Surgery and Back Therapy at the Karl-Olga-Krankenhaus in Stuttgart, under the direction of Dr Petra Büchin and Dr Harald Schall, specializes in the conservative and surgical treatment of diseases of the cervical, thoracic, and lumbar spine.

Focusing on surgical spinal surgery, the highly specialized team around Dr Büchin and Dr Schall provides routinely treatment and surgery for all diseases of the entire spine and sacrum as minimally invasively as possible, microsurgical in the spinal canal, very precisely and gently with good results. Stabilizing procedures such as screw-rod systems are used openly or minimally invasively if necessary. Supported by a competent nursing and therapy team, high-quality medicine based on modern knowledge is guaranteed.

Muscular problems and imbalances cause most back pain. Therefore, a holistic prevention consultation and a consultation for conservative back therapy are offered in an outpatient setting as a service for self-payer.

Prevention: Therapy Plan to Prevent Back Pain

A treatment plan for conservative therapy to prevent recurring back pain is developed with a physical examination, detailed medical history, BIA measurement, and radiation-free back scan, as well as micronutrient analysis and examination of steroid hormones and, if necessary, sonography.

Eliminating Disk Problems: Targeted Therapy for Herniated Disks

The spine is a functional, elastic system that enables a variety of movements and has to withstand a lot of weight. The intervertebral disks are a buffer to distribute and cushion pressure and weight evenly. They consist of a gelatinous, elastic core inside and a shaping and stabilizing fibrous ring on the outside.

The inner gelatinous core can lose its elasticity and protrude or be pushed out through the fibrous ring due to age-related degeneration and years of overloading, but most frequently due to too little movement during sedentary work or, in rare cases, genetic predisposition. This is known as a herniated disk. Depending on the location of the herniated disks, tingling and numbness, pain, and paralysis can occur, as well as bladder and rectal disorders. The symptoms can be assigned to the corresponding nerve root and the level of the spinal cord. The lumbar spine is most frequently affected, followed by the cervical spine.

At the Spine Center in Stuttgart, imaging with MRI and X-rays is carried out after the clinical examination to allow precise treatment planning based on the results. Conservative and surgical procedures are used depending on the severity of the symptoms. In cooperation with the M360° radiology department in the same building, prompt appointments for an MRI can also be organized on an outpatient basis to confirm the diagnosis as quickly as possible and initiate the appropriate therapy. In many cases, pain medication and infiltrations, and once the acute phase has subsided, physiotherapy can significantly alleviate the symptoms.

Exhausting the conservative options is a high priority for the treating team. However, if relevant paralysis or loss of function occurs, the experienced spinal specialists recommend a surgical procedure. If paralysis occurs that restricts mobility, an emergency appointment should be arranged at a clinic to create space for the affected nerve root as quickly as possible. In the vast majority of cases, surgical treatment is usually necessary. Two surgical procedures are available depending on the findings: endoscopic nucleotomy or microsurgical nucleotomy. Above all, the care of athletes and the modern sports medicine approach to treating intervertebral disc problems are critical to the team at the Stuttgart Klinik. The doctors aim to maintain mobility, enjoy sport, and alleviate pain and discomfort.

Microsurgical Spinal Surgery: Relief for Spinal Cord Stenosis (Spinal Canal Stenosis)

Thickening of the ligament structures, osteoporosis, and arthrosis with deterioration and bone growths and increasingly fat deposits in the spinal canal can lead to narrowing the spinal canal. Clinical symptoms include numbness, reduced walking distance, gait and standing disorders, rapid leg fatigue, heaviness, and cramps.

If the nerve exit holes are involved, pain and paralysis of the affected nerve occur. The symptoms develop slowly and can increase over time. Due to the long-term degenerative process with permanent damage to the bony structures, the disease is not reversible.

Conservative treatment with painkillers and exercise therapy can provide relief in many cases. The procedure depends on the extent of the symptoms and the time of onset. In severe cases, the specialists at the Spine Center use a surgical procedure to relieve and alleviate symptoms. Precise imaging and neurological diagnostics are also carried out to plan the procedure.

Many Years of Experience in the Treatment of Degenerative Spinal Diseases

The specialized team has excellent experience and skill in implementing and empathetic care of affected patients in conservative treatment options and surgical therapy procedures.

Degenerative diseases of the spine affect many people and require a multimodal treatment concept and many years of expertise. The decision on which therapy to use is made with the patient, considering their wishes and concerns. The focus is always on the patient.

From conservative therapy and microsurgical decompression surgery to long-term stabilization surgeries, procedures are possible that are selected individually in consultation with the patient.

Gentle Spine Stabilization: Balloon Kyphoplasty for Fractures and Tumors

Accidents can lead to traumatic fractures of one or more vertebral bodies and require surgical intervention. However, unstable vertebral bodies caused by cancer with metastases or age-related fractures due to osteoporotic changes also require intervention.

Depending on the course of the accident and the cause of the fracture, surgery can be elective, i.e., planned, or as an emergency procedure if instability is imminent. In the case of unstable fractures, ligament structures and the intervertebral disks are usually also affected, or there is a risk of a piece of bone slipping into the spinal canal. Collapsed vertebral bodies are stabilized by balloon kyphoplasty with an injected cement mixture in cases of osteoporosis and, in rare cases, tumors. Ideally, the vertebra is straightened at the same time. Balloon kyphoplasty is considered a procedure with few complications. The doctors attach great importance to the rapid post-operative mobilization of patients.

The experienced team led by Dr Büchin and Dr Schall at the Center for Spinal Surgery in Stuttgart carries out extensive and precise clinical and imaging diagnostics if a spine tumor is suspected. The treatment options are then discussed in detail with the patient. If there is a risk of paralysis or severe instability, an emergency fusion of the affected section is carried out. This relieves the pressure on the sensitive spinal cord. In less urgent cases, the patient's case is first discussed in an interdisciplinary tumor conference. At this meeting, a decision can be made as to whether primary surgery, radiotherapy, or chemotherapy is the more sensible option.

Stabilizing Surgery for Fractures, Tumors, Inflammation, or Instability

If the vertebra is fractured or has been affected by a tumor or inflammation to such an extent that there is instability or obstruction of the spinal canal, a stabilizing surgery is carried out from the posterior, possibly anterior, or combined. In most cases, microsurgical decompression of the spinal canal is also necessary. Such a condition is usually found in older patients with multiple concomitant diseases. In the perioperative setting, the department takes experienced and precise care of secondary and concomitant diseases. If necessary, cardiologists, gastroenterologists, and geriatricians are consulted. This therapy or therapy recommendation is also given for follow-up treatment for patients with osteoporosis.

Dr Schall and Dr Büchin's team decides quickly, confidently, and with great experience which procedure is necessary in each case, even in emergencies.

Cervical Spine Surgeries

Surgeries on the cervical spine require a highly experienced surgeon. Dr Büchin, Dr Schall, and the senior physicians in the department have great expertise and many years of experience. This is particularly important when determining indications.

All therapeutic procedures, microsurgical and stabilizing, are offered from the base of the skull (C0) to the upper thoracic spine.

Muscular imbalance with shortening of the chest and anterior neck muscles and weak upper back muscles must be excluded in the differential diagnosis before cervical spine surgery. If pain radiates into the arm without paralysis, a neurological examination should be carried out if possible.

A particular case in the cervical spine is the narrowing of the spinal canal, which can lead to permanent damage to the spinal cord (myelopathy). If clinical symptoms such as unsteady gait and impaired fine motor skills occur, the spinal canal should be relieved promptly to prevent the paralysis from progressing to the point where the patient cannot walk.

Revision Surgery

It may be that previous surgeries on the spine have not led to sufficient success in pain reduction. Thanks to their many years of expertise, Dr Büchin and Dr Schall can provide competent individual advice to help patients find the best solution for their symptoms. Further surgery may also become necessary. The head physicians and their team are prepared for such individual solutions due to their high level of specialization. Exceptional cases are discussed in team meetings. 

In all cases, Dr Schall and Dr Büchin take care of the post-operative outpatient procedure. Individual rehabilitation measures are initiated during the inpatient stay. Correct and detailed discharge management is standard practice in the department.

Please visit the Center for Spinal Surgery and Back Therapy website for more information.