"The spine is one of the most complex and important parts of the human body, and spinal complaints and diseases can have a drastic impact on a person's overall health and quality of life."
Spinal surgery requires close collaboration between different disciplines, especially orthopaedic and brain surgeons. Congenital progressive spinal deformities, traumas and other severe disorders are treated by skilled physicians, surgeons, and physical therapists.
Liv Hospital's Spine Treatment Clinic offers the highest level of medical care and preventative health measures within Liv Hospital’s multidisciplinary philosophy.
At Liv, we believe that every international patient at our Spine Treatment Clinic should receive the all benefits of our comprehensive range of medical expertise across the spectrum of medical specialties.
Liv Hospital’s Spine Treatment Clinic brings together highly experienced and well-trained specialists in neurosurgery, orthopaedic surgery, neurology, physical therapy, and other specialties to create the most effective treatment for your condition. The team includes specialists in cancer, pain management, physical therapy, radiation oncology and rheumatology. In addition, stem cell treatments are performed in collaboration with Liv Hospital’s Centre of Regenerative Medicine and the Centre for Stem Cell Research and Application.
Experts in neurosurgery, orthopaedic surgery, spine and pain management partner to diagnose and treat a variety of spinal conditions, some of which are described below:
Main diseases treated in the Spine Treatment Clinic of Liv Hospital
- Scoliosis: When viewed from the side, the anatomy of a normal person shows a certain degree of curvature. For example, our back has an outward curve while our neck and lower back curve inward. But, when viewed from the front or back, the spine is straight and does not curve. Scoliosis is a condition in which our spine has an S-shaped or C-shaped curve to the side; this abnormal curve can cause scoliosis patients to have shoulder asymmetry, rib hump, torso curvature, and asymmetry in the curve of the lower back. Scoliosis is not a diagnosis but a descriptive term. The cause is unclear in 80% of cases and this type is called "idiopathic scoliosis". It occurs most often during the period of rapid growth just before puberty. Other types include congenital scoliosis (caused by vertebral abnormalities present at birth), neuromuscular scoliosis (the result of neuromuscular diseases such as spina bifida, cerebral palsy, spinal muscular atrophy, or physical trauma) or syndromic scoliosis (associated with various medically defined syndromes).
- Kyphosis: When viewed from the side in normal human anatomy, a certain degree of curvature is visible. For example, our back has an outward curve while our neck and low back curve inward. Increased physiological rounding in the upper back or abnormal rounding of the neck or waist area is usually pathological. The most common type, mainly found in male adolescence is Scheuermann kyphosis. Other types include congenital kyphosis related to spinal injury at birth, post-traumatic kyphosis related to inadequate treatment of physical trauma, and post-laminectomy kyphosis, which is related to the surgical procedures performed to treat cervical.
- Spinal curvature (Developmental Spondylolisthesis): spondylolisthesis is the term that means the slippage of one vertebra over the one below it. The integrity of the bone can be compromised when growth during childhood includes a crack in a part of the vertebra called the pars interarticularis. Roughly translated this means the part between two joints. A defect in the pars represents a crack in that part of the bone. This crack causes the upper, anterior part of the vertebra to separate from its lower, posterior part. Such a disorder could be a precursor to developmental spondylolisthesis. It usually occurs as a result of repetitive trauma after the age of 8. Both diseases cause serious back pain and spasms. In some cases, it can even lead to scoliosis.
- Diagnosis: spinal or vertebral fractures in healthy, non-osteoporotic cases can result from a high-force trauma, such as a car accident or fall. Partial and complete paralysis can result from spinal cord compression.
- Treatment: If deformity is unlikely to occur as a result of trauma and there is no neurological evidence of nerve compression, treatment may be performed with a corset. Rigid polyethylene corsets or corsets with a metal frame are used for this purpose. In cases of more severe damage to the spine, it may be necessary to fix it using small splints and screws to prevent future deformity. In the case of a neurological finding of pressure on the bone, this pressure could be removed during the same surgical session.
Aging vertebrae and osteoporosis
- Osteoporotic vertebral fractures: as a person ages, and/or with changes associated with menopause, osteoporosis can cause a reduction in bone mass. This disease can lead to bone fractures caused by minor trauma or impact. The most commonly fractured bones are the vertebrae and hip joints. In very severe cases of osteoporosis, even a sneeze can cause a bone fracture. The most common symptoms are back and low back pain. In some cases, the patient may not experience severe pain from the fracture and should consult his doctor because of the deformity that results from the fracture.
- Kyphosis in the elderly: as a person ages, he or she may develop kyphosis from both osteoporotic fractures and vertebral degeneration. In these cases, breathing difficulties may occur and daily activities may be interfered with.
- Scoliosis in the elderly: as a person ages, scoliosis can be caused by degenerative diseases of the spine as well as by worsening of existing scoliosis. The former case is often associated with increasing pain in the legs due to pinched nerves.
Degenerative spinal diseases
- Disc herniation: intervertebral disc is the name given to the joint between all the vertebrae. A disc herniation refers to a problem with the elastic cushions (discs) between the individual bones (vertebrae) that make up your spine. A spinal disc has a softer core encased in a harder outer part. Sometimes called a slipped disc or ruptured disc, a disc herniation occurs when part of the softer "jelly" comes out through a crack in the hard surface. A herniated disc can irritate nearby nerves, causing pain, numbness, or loss of strength in an arm or leg. On the other hand, many people have no symptoms of a herniated disc. Most people with a disc herniation do not require surgery to correct the problem, but it is required if the pain persists or in the case of neurological loss.
- Spinal stenosis (narrowing of the spinal canal): Spinal stenosis is a narrowing of the open spaces inside your spine that can put pressure on your spinal cord and on the nerves that run through your spine. Spinal stenosis most commonly occurs in the neck and lower back. It can cause pain, numbness, muscle weakness and problems with the urinary bladder and bowel function. It is most often caused by changes from wear and tear on the spine associated with aging. In severe cases of spinal stenosis, doctors may recommend surgery to create additional space for the spinal cord and nerves.
Spinal tumours
- Diagnosis: Spinal tumours can be benign or malignant. Benign tumours (usually found in adolescence) can cause pain; they mostly originate from the bone and are called osteoid osteoma or osteoblastoma. Tumours on body tissues or organs most commonly extend to the spine. Therefore, if a malignant tumour is found in the spine, it is very likely that it originated from another part of the body.
- Treatment: The diagnosis of the tissue is very important in terms of the approach to be taken. Therefore, if the origin of the tumour is unclear or the tumour originates from the spine, a biopsy should be taken first. Once established, chemotherapy, radiotherapy, surgery, or a combination of these treatments follows depending on the type of tumour.
Spine infections
- Tuberculosis (TB): This is the most common effect of spinal infections in underdeveloped and developing countries. Kyphosis of the spine may be predisposed by spinal degeneration. Tuberculosis responds well to medication when diagnosed early. In cases where an abscess develops, there is persistent pain, deformity, or other neurological findings - surgery may be necessary.
- Nonspecific infections: secondary infection in the spine is possible, especially in cases of urinary tract infection when bacteria spread through the blood stream to the spinal area. The treatment strategy is similar.
Operation for scoliosis:
The goals of the operation for scoliosis are three:
- The best and safest possible healing of the spine
- Balancing the torso and pelvic areas
- Long-term maintenance of the correction
The process to achieve these goals consists of two parts:
- Fusion (joining) of the vertebrae along the length of the curvature
- Maintaining these fused bones using instruments (steel rods, hooks, and other devices) that are attached to the spine
Our team of specialists is fully equipped with the latest technology and medical techniques to perform scoliosis surgery with a high success rate. While there are many options for the use of various instruments, procedures, and surgical approaches to scoliosis treatment, they all require meticulously precise skills. In most cases, success depends less on the type of surgery and more on the skill and experience of the surgeon.
The cause of the scoliosis is often the deciding factor for the type of procedure. Other factors include the site of the curvature (thoracic, thoracolumbar, or lumbar); whether the curvature is single, double, or triple, as well as any available rotation; and also, how large the curvature is.
At Liv Hospital, we are aware that treatment away from home can be a difficult experience. Parents of patients or elderly patients should not hesitate to ask our physicians and our International Office about their experience and for advice regarding specific procedures they are considering.
Minimally invasive treatment in the Spine Treatment Clinic of Liv Hospital
The principle behind the spinal and orthopaedic endoscopic procedures offered at Liv Hospital is that they are "minimally invasive", involving only a small surgical incision. Since the incisions are small, patients tend to have a faster recovery and less discomfort compared to traditional surgery - while having the same benefits. Patients typically experience less pain, have less scarring and can recover faster than with traditional surgery.
During the minimally invasive procedure, surgeons make several small incisions in the skin - in some cases, only a few millimetres in size. A long, thin tube with a tiny camera attached to its end (called an endoscope) is passed through one of the incisions. The images from the endoscope are displayed on monitors in the operating room, giving surgeons a clear view of the surgical area. Special instruments are passed through the other holes. These allow the surgeon to perform surgery by revealing, removing, and restoring what is wrong inside the body.
Liv Hospital’s Spine Treatment Clinic is particularly experienced in endoscopic hernia repair, the most technologically advanced method in the treatment of general and painful conditions. Liv Hospital also has extensive experience in arthroscopy, a minimally invasive surgery for cartilage and repair of torn ligaments. Arthroscopy helps patients recover in a matter of days, instead of the weeks or months required with traditional "open" surgery.
Total disc replacement
While the idea of an artificial disc is not new, artificial disc replacement technology has only developed enough in the last decade to be used clinically in long-term trials in Europe. Although revolutionary in its nature and design, the technique of inserting an artificial disc (whether in the neck or lower back) is routine and safe.
As soon as the disc is removed, two metal plates are pressed against the vertebral end plate at the top and bottom, leaving a blank space vacated by the disc. Metal spikes hold these plates onto the bone. Eventually the bone will grow on and around the metal plates. A plastic spacer is placed between them. The patient's own weight compresses the spacer once the surgery is complete. The device allows six degrees of freedom of movement.
In many cases, recovery is faster than traditional connecting surgery. Less pain is caused and fewer complications overall. The materials used for artificial disc replacement are similar to the materials used in routine hip or knee replacement surgery. The materials are designed in a way that allows them to cause no sensitivity once they are inserted into the body.
Other orthopaedic operations and procedures
In addition to the healthcare services and surgical procedures offered at the Liv Hospital Spine Treatment Clinic, it also works closely with our Orthopaedics and Traumatology Centre to offer comprehensive care using a wide range of orthopaedic treatments including:
- Spinal stenosis
- Sports injuries
- Knee, hip, hand, foot, shoulder, elbow and spine procedures and other treatments.
- Arthroscopies and minimally invasive surgeries
- 24-hour emergency orthopaedic service