Diagnosis
Large right mediolateral intervertebral disc herniation at the L4/L5 level with spinal canal stenosis and severe lumboischialgia (sciatica).
Patient:
Male, 58 years old, Kazakhstan
Physician:
Prof. Dr. med. Martin Scholz, Head of Neurosurgery, Sana Hospital Duisburg
Patient’s Inquiries:
- All the specialists I consulted previously recommended endoscopic disc surgery. Can this procedure be performed at your clinic?
- What is the estimated cost of the surgery?
Expert Opinion by Prof. Martin Scholz:
The MRI scans reveal a large right mediolateral L4/L5 disc herniation accompanied by significant narrowing of the spinal canal (lumbar spinal stenosis).
To achieve thorough and effective decompression of the spinal canal in this specific case, a microsurgical approach (utilizing a minor skin incision of approximately 2 cm) is necessary. An endoscopic procedure carries a higher risk of incomplete nerve root decompression, which could lead to symptom recurrence and revision surgery within a couple of years. While we routinely favor endoscopic surgery for isolated lateral disc herniations without stenosis, a microsurgical approach remains the safest, most effective gold standard here.
When performed by an experienced neurosurgeon, the procedure takes about 60 minutes, though the presence of spinal stenosis adds a layer of complexity. Over my 31 years of neurosurgical practice, I have performed approximately 5,500 microsurgical lumbar spine procedures.
Preliminary Cost Estimate: €13,790
Treatment Performed
The patient underwent a right-sided partial hemilaminectomy at the L5 level, followed by cross-over microsurgical decompression from right to left. The surgery proceeded without complications, and the patient was safely transferred directly to the neurosurgery ward.
Under guidance of our physiotherapy team, early mobilization began on the first postoperative day. The surgical drain was removed on day two. The recovery phase progressed smoothly without any adverse events, allowing the patient to be discharged five days after surgery.
Postoperative Recommendations
- Maintain a gentle physical routine for 4–6 weeks.
- Avoid driving a motor vehicle during this initial recovery period.
Final Treatment Cost: €9,400
Patient Review
"I contacted GHP Pulse to seek treatment for severe lumbar spinal stenosis and an L4-L5 disc herniation on the right side. I could barely walk and had spent over a year trying conservative treatments, physical therapy, and epidural steroid injections with no relief. I found Sana Hospital Duisburg through the GHP Pulse platform and read positive patient reviews.
Within just one week of my initial inquiry, I received an expert remote medical review and personal consultation from Professor Scholz, along with an official treatment invitation and transparent cost breakdown. Thanks to the rapid coordination by GHP Pulse, I arrived in Duisburg, completed pre-op diagnostics in a single day, and underwent successful spine surgery. Exactly seven days later, I was fully discharged.
My sincere gratitude goes to Konstantin Albrecht from GHP Pulse, Professor Martin Scholz, and Vice Chairman Dr. Blaeser for giving me back my mobility."