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All seven Medical Spheres ›A slipped disc usually improves without surgery. If the pain in the leg persists despite treatment or the leg grows weaker, microsurgical removal can relieve pressure on the nerve – through an incision two to three centimetres long.
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Guide values from the clinics and the clinical guideline; in the case of paralysis, the decision is made sooner. You will discuss your personal plan at the first consultation.
The slipped disc
The intervertebral discs lie between the vertebral bodies: a firm fibrous ring with a soft, gel-like core. They absorb shocks and keep the spine flexible. Over the years they lose water and elasticity. If the fibrous ring tears, material from the core can escape and press on a nerve root – this is a slipped disc. It most often affects the lumbar spine, less often the neck.
Typical is pain that runs from the back into the leg, often below the knee, and that can be stronger than the back pain itself. There may also be tingling, numbness or weakness, for example when lifting the foot. If the herniation is in the cervical spine, the symptoms radiate into the shoulder and arm.
In most people, the symptoms subside within a few weeks: the body often partly breaks down the escaped tissue, and the irritation of the nerve eases. That is why treatment starts conservatively, with movement, pain relief and physiotherapy. Without paralysis or sensory disturbances, an MRI is usually not needed in the first two weeks.
Surgery is considered if the leg pain does not ease sufficiently over six to twelve weeks despite consistent treatment, or if paralysis is present or getting worse. How large the herniation looks on the image is not the only deciding factor. What matters is whether the findings and the symptoms match.
The operation
The displaced tissue pressing on the nerve root is removed. The main aim is to ease the pain radiating into the leg.
Under the operating microscope, only what is pressing on the nerve is removed. The healthy part of the disc stays in place.
With marked paralysis, relieving the pressure is urgent: it is intended to prevent lasting damage to the nerve.
The path
Surgery is rarely the first step. What matters is how things develop over several weeks, the strength in the legs and how much the pain dominates everyday life.
Strength, sensation and reflexes show which nerve root is affected. An MRI confirms the findings if the symptoms persist or there are neurological deficits.
Movement instead of bed rest, painkillers and physiotherapy, and if needed a targeted injection at the nerve root. Most symptoms improve during this time.
If the leg pain is still too severe after six to twelve weeks despite consistent treatment, surgery is discussed. With increasing paralysis or a bladder disorder, it is urgent.
A consent discussion about benefits and risks, the anaesthetic consultation and, if necessary, an examination by an internal medicine specialist.
Under general anaesthetic and lying on your front, the tissue pressing on the nerve is removed under the microscope. The procedure usually takes 45 to 90 minutes.
Most people get up the very next day, followed by physiotherapy and an exercise programme for home, with rehabilitation if needed.
Statutory or private insurance
Statutory health insurance
If the operation is medically indicated, German statutory health insurance covers the procedure, the anaesthetic and the hospital stay. The operation is then carried out at the Bürgerspital Wertheim, the hospital in the state hospital plan at this location.
For the first consultation, please bring your health insurance card, a referral if you have one, your list of medications and any existing results, above all the MRI images.
Private insurance or self-pay
For patients with private health insurance, medically necessary surgery is a benefit of their insurance. They and self-pay patients can also be treated at the Main-Tauber-Klinik, the private clinic in the same building.
At the Bürgerspital, rooms with upgraded amenities are available as an optional extra on request, subject to availability.
Specialists
Operations are performed by specialists in neurosurgery and in orthopaedics and trauma surgery who specialise in the spine. All of them work in Wertheim.
Locations
Each clinic shows on its own website how the treatment works there.
Germany
The Bürgerspital is a hospital in the state hospital plan and also operates on patients with statutory health insurance; the Main-Tauber-Klinik in the same building on Rotkreuzstraße is the private clinic.
Frequently asked questions
Usually not. In around 80 to 90 out of 100 people affected, the symptoms improve over time and with conservative treatment. Surgery is performed if that is not enough or if strength declines significantly.
When you suddenly lose control of your bladder or bowel, sensation fades in the buttocks and genital area, or paralysis worsens rapidly. This is rare, but requires an emergency department immediately – if in doubt, via the emergency services on 112.
Its main aim is the pain radiating into the leg, which comes from the compressed nerve. Lower back pain that originates from the worn disc or the facet joints may remain. This is where movement, physiotherapy and muscle strengthening come in.
Yes. Studies report a new herniation at the same level after surgery in around 3 to 18 out of 100 patients. Strong core muscles and an exercise programme at home can take strain off the spine.
Possible risks include bleeding, infection and wound-healing problems, an injury to the membrane around the nerves, which may cause spinal fluid to leak, and, rarely, damage to the nerve root. Such complications can often be treated well; the consent discussion goes through them one by one.
People with desk jobs can often return after one to two weeks. Heavy physical work, lifting and sport come later – step by step, after medical clearance, and this varies from person to person.
Yes. Before planned spinal procedures, including the removal of disc tissue, patients with German statutory health insurance have been entitled to an independent second medical opinion since 2021. Specialists approved for this can be found through the doctor search at 116117.de.
Yes, if it is medically indicated; patients with statutory health insurance are operated on at the Bürgerspital Wertheim. For patients with private insurance, their policy applies. Whether surgery is indicated depends on the course of the condition, the examination and the imaging.
Consultation
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Reviews
CGCE GroupVerified
5,888 reviews on ProvenExpert
This was the best decision I have ever taken for myself. The whole experience has changed my life for the better. From the first consultation I felt welcomed and treated very well. I did not feel alone during the journey because the team were just a WhatsApp away and they made regular check-ups on me. Thank you for everyone at the hospital from the staff to the doctors, you are all amazing.
Weight Doctors South AfricaWow, was für ein erster Eindruck! Dr. Frank Gruner, dessen Professionalität von jahrelanger Erfahrung zeugt, war äußerst verständlich und menschlich (was mir sehr wichtig war). Er verstand meine Bedürfnisse, und seine Erklärungen und Anweisungen entsprachen genau meinen Vorstellungen. Die Patientenberaterin Jennifer war mit ihrem Charme ebenfalls eine große Hilfe und erklärte mir alles Notwendige und den weiteren Ablauf. Auch die Mitarbeiter am Empfang waren sehr höflich und freundlich. Ich melde mich nach der Operation mit meinen Eindrücken zurück. Vielen Dank an alle!
Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in GermanIch habe eine Unterlidstraffung machen lassen und bin mit dem Ergebnis sehr zufrieden. Mein Dank geht vor allem an Frau Dr. Simidjiiska für ihre Fürsorge, Kompetenz und Empathie. Aber auch das gesamte Team der Klinik macht einen hervorragenden Job!
Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in GermanIch bin rundum begeistert von meiner Erfahrung in dieser Haartransplantationsklinik. Von der ersten Kontaktaufnahme bis zur Nachsorge war alles hervorragend organisiert und professionell. Das gesamte Team war unglaublich freundlich, hilfsbereit und zuvorkommend. Man hat sich jederzeit gut aufgehoben und ernst genommen gefühlt. Besonders positiv fand ich, dass sich alle Mitarbeiter ausreichend Zeit genommen haben, um meine Fragen zu beantworten und jeden Schritt verständlich zu erklären. Auch der Service war erstklassig. Die Organisation, die Betreuung vor und nach dem Eingriff sowie die Kommunikation waren wirklich hervorragend. Das gesamte Team hat einen sehr kompetenten und gleichzeitig menschlichen Eindruck gemacht. Die Klinik selbst ist modern, sauber und sehr gut ausgestattet. Während der Behandlung wurde äußerst sorgfältig und professionell gearbeitet, und ich hatte zu jedem Zeitpunkt das Gefühl, in guten Händen zu sein. Ein großes Dankeschön an das gesamte Team für die tolle Betreuung und den freundlichen Umgang! Ich kann die Klinik absolut weiterempfehlen und bin mit meiner bisherigen Erfahrung sehr zufrieden. Wer Wert auf Professionalität, Qualität und einen hervorragenden Service legt, ist hier meiner Meinung nach bestens aufgehoben.
Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in GermanBisher war es nur ein Beratungsgespräch aber es war sehr gut.
Weight Doctors Group · Original in GermanIch fand, dass der Arzt gut und verständlich erklärt hat. Ich habe diese Woche noch einen Termin in einer anderen Klinik, da ich mich gründlich informieren möchte; auch der Preis wird dabei eine Rolle spielen – darüber bin ich ganz offen.
QUOLE Medisch Centrum · Original in GermanHervorragende Behandlung. Von der ersten Beratung bis zur Nachsorge hat mir Dr. Koch stets ein sehr gutes Gefühl vermittelt. Ich litt jahrelang unter einer echten Gynäkomastie, nach der OP kann sich das Ergebnis sehen lassen, mein Selbstbewusstsein ist endlich zurückgekehrt. Ich kann die Alster Klinik jedem empfehlen, der schon lange mit dem Gedanken spielt sich operieren zu lassen.
Alster-Klinik Hamburg · Original in GermanDr. Schubert gab mir das Gefühl, in genau der richtigen Praxis zu sein für mein Anliegen. Ich habe mich beim Beratungsgespräch sehr wohl gefühlt und verstanden gefühlt.
Alster-Klinik Hamburg · Original in GermanÜber die ehrliche Einschätzung
Alster-Klinik Hamburg · Original in GermanIch habe mich sehr wohl geführt, das Gespräch war sehr gut, die Ärztin hat mir sehr ausführlich alles erklärt und bin mit einem sehr guten Gefühl nach Hause gegangen.
Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in GermanIch bin eine sehr ängstliche Person. Bei Herrn Dr. Neis habe ich mich sofort wohlgefühlt. Behandlungsgespräche, Umgang, Freundlichkeit – es passt alles. Ich kann ihn ohne Bedenken und Einschränkung nur weiter empfehlen. Dankeschön Herr Dr. Neis für die tolle Arbeit.
CGCE Group · Original in GermanDr. Klarner ist sehr nett, hat mich sehr gut beraten und aufgeklärt. Ich hab mich gut aufgehoben gefühlt, vielen Dank!
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