Diagnosis
Spondylolisthesis of the lumbar spine. Spinal stenosis. Osteochondrosis. Protrusion of the intervertebral disc. Butterfly-shaped L5 vertebra. Left-sided scoliosis.
Patient:
Female, 70 years old, Kazakhstan
Physician:
Professor Martin Scholz, Chief Physician at the Duisburg Neurosurgery Clinic
Patient's complaints:
Pain in the lower back and pelvic area, radiating pain down the right lower limb, a feeling of tightness and numbness in the right leg. Limited mobility when walking. Pain in the right knee and hip joints. A tingling sensation down the back of the lower leg. What treatment would you recommend in this case?
Response from Professor Martin Scholz, neurosurgeon:
I have carefully examined the MRI scans. The patient presents with pseudospondylolisthesis, accompanied by spinal canal stenosis. She is also likely to be suffering from lumbosciatica, with pain radiating into her right leg.
In order to determine whether there is any instability in this part of the spine, it is necessary to obtain functional images of the lumbar spine. We can carry out this procedure at our clinic.
In this case, the least invasive option would be microsurgical decompression. If there is instability in the lumbar spine, decompression surgery may need to be combined with the implantation of a micro-implant, such as an interbody cage. The final decision on the surgical treatment method should be based on the results of the functional diagnostic tests.
The right knee joint has severe gonarthrosis (Grade III) and signs of meniscal tears. Both hip joints are also affected by coxarthrosis. Before deciding on spinal decompression or knee surgery, it is necessary to determine the cause of the pain. In principle, knee surgery is more complex, as orthopaedic surgeons will likely need to perform a total knee replacement.
The first step the patient should take is to lose excess weight gradually. If the spondylolisthesis is unstable, microsurgical intervention involving a 3 cm skin incision would be the ideal option.
During her stay at the clinic, our orthopaedic surgeons, who do not use overly invasive methods, will also be available for consultation. They will be able to advise whether conservative treatment might be sufficient for her knee problems.
Being overweight can lead to wear and tear in joints such as the hips, knees and ankles, as well as degenerative changes in the spine. These issues may require surgical intervention. Being overweight is the cause of all this, and we recommend that patients take appropriate measures to lose weight. It is very important in this process to set realistic goals for the patient.
If she comes in, we will be able to help her.
Estimated cost of treatment: 12,000 Euros