Frequently Asked Questions
Patient Questions & Doctor Answers
Q: Elena M.: My L4-L5 herniated disc was removed in December 2014. Recently, I've started experiencing acute pain due to stress at work. What recommendations can you give?
A: Hello, Elena M. Please specify the type of pain (e.g., pulling, burning, electric shock-like) both before and after the surgery, as well as its exact localization (local or radiating down the leg or groin) before and after the operation so we can accurately diagnose the source of the recurrence.
Q: Anna K.: I have infectious sacroiliitis caused by Ureaplasma parvum. I completed courses of Josamycin, Azithromycin, and Sulfasalazine. After seven weeks, the main pain is gone, but when I began stretching my lumbar, ilium, and quadriceps muscles, the pain returned. Now, I feel a pulling heaviness under the skin in my lower back and thigh. Can you advise me?
A: Hello, Anna K. Infectious sacroiliitis is treated primarily with a targeted course of antibiotics based on sensitivity tests. While the infectious process is active (monitored via blood tests and pelvic CT scans), it is crucial to restrict motor activity. Physical exertion and stretching exercises are highly undesirable during this phase.
Q: Stefan W.: My diagnosis is arthrosis of the spinal joints, polydiscopathy, spondylolisthesis of the L3 vertebra, herniated discs at L1, L2, and L3, with secondary spinal canal stenosis at L2-L3 and L4-L5. What treatment options are possible?
A: Hello, Stefan W. Depending on your detailed medical history and the severity of your clinical symptoms, we can offer either targeted conservative treatment (injections, blocks, physiotherapy) or surgical intervention to decompress the spinal canal.
Q: Maria S.: My 20-year-old son was recently diagnosed with a sequestered intervertebral hernia. He lifted weights without a coach about a year ago. A neurosurgeon recently told us he needs surgery. We are in shock and do not want surgery, as he has no obvious symptoms like leg numbness or urinary issues. Can we start conservative treatment instead?
A: Hello, Maria S. At this stage, especially given the absence of severe neurological symptoms (like radiating pain or numbness), you can start with conservative measures. Spinal decompression can be achieved gently by relaxed hanging on a horizontal bar. He should avoid axial spinal loading, heavy lifting, and deep forward bending. Symptomatic pain relief can be managed with NSAIDs, provided there are no contraindications. Surgery is usually reserved for cases where conservative treatment fails or severe neurological deficits appear.
Q: Nino G.: My 15-year-old son has been diagnosed with congenital CNS damage and symptomatic epilepsy. He does not speak and has difficulty walking. He has been prescribed medication and rehabilitation, but we see no results. What treatment methods are effective in this case?
A: Hello, Nino G. With congenital brain damage, the normal functioning of the nervous tissue is intrinsically disrupted, which weakens motor control and often triggers epilepsy. Unfortunately, only symptomatic and supportive treatment is possible. This includes ongoing work with a pediatric neurologist, psychiatrist, speech therapist, proper adjustment of anticonvulsants, and regular physical therapy.
Q: Luka D.: The fingers of my left hand have been numb ever since I suffered a traumatic brain injury (TBI). How should this be treated?
A: Hello, Luka D. The root cause of the numbness must first be established. It could be of central origin (damage to specific areas of the brain or spinal cord due to the TBI) or of peripheral origin (damage at the cervical spine level or the brachial plexus). A targeted treatment plan can only be developed after a comprehensive neurological examination.
Q: Sophie L.: Our problem is related to tailbone pain, which we associate with a childhood trauma. CT and MRI scans show no inflammation or abnormalities, but the pain still bothers me constantly. How is coccygodynia treated?
A: Hello, Sophie L. In the initial stages or if a subluxation is present, manual reduction of the coccyx can be performed. Alternative conservative treatments include local therapeutic nerve blocks, physiotherapy, and reflexology. If all conservative measures fail and the pain is intractable, surgical treatment (removal of the coccyx) may be considered.
Q: Alexei R.: My father has a herniated intervertebral disc and lumbar spine instability with a 5 mm displacement of the L5 vertebra. What treatment methods do you offer, and would a B-Twin implant be suitable?
A: Hello, Alexei R. To confirm the instability of the L5-S1 spondylolisthesis, your father needs functional (dynamic) X-rays of the lumbosacral spine (taken while standing straight, bending forward, and bending backward). This will determine if a stabilization system like a B-Twin implant is necessary. Based purely on the MRI, an endoscopic discectomy with spinal canal decompression at the L5-S1 level might be sufficient.
Q: Irina V.: My 54-year-old father was diagnosed with cervicothoracic syringomyelobulbia, bulbar syndrome, mixed tetraparesis, and cerebellar syndrome, alongside cervical disc protrusions. Is surgery possible to stop his neurological disease from progressing?
A: Hello, Irina V. For syringomyelia, surgical decompression is typically performed at the level of the foramen magnum or the specific spinal canal segments where the syringomyelic cavity causes the most severe spinal cord compression. The cyst contents may also be evacuated. However, the indications for surgery must be carefully evaluated by a multidisciplinary team involving a neurosurgeon and anesthesiologist.
Q: Thomas H.: I have a 2nd-degree compression fracture of the thoracic spine (Th7, Th8, Th9 vertebrae) with the anterior height decreased to 13.8 mm. It has been five years since the injury. Is it still possible to perform vertebroplasty or kyphoplasty?
A: Hello, Thomas H. Kyphoplasty is typically performed only in the acute phase (the first few weeks) of a compression fracture. Vertebroplasty is justified if the vertebral compression continues to progress dynamically (confirmed by comparing old and new X-rays) or if there is severe, localized pain at the fracture level.
Q: David M.: My wife suffered an attack involving severe dizziness, vomiting, panic attacks, and severe burning in the back of her neck. After hospitalization, she was discharged, but the symptoms recurred—spiking blood pressure, panic, and nausea. An MRI showed early signs of cervical issues. What could this be?
A: Hello, David M. These symptoms are highly characteristic of cervico-cranial syndrome. It requires active treatment of the cervico-occipital joints, which are likely the primary source of these symptoms. Treatment should include targeted manual therapy supplemented with physiotherapy to normalize muscle tone, followed by specific spinal stabilization exercises.
Q: Giorgi K.: Five years ago, I suffered a severe pinching injury to my right anterior abdominal muscle. Since then, I experience severe pain during physical exertion, especially when the abdominal wall is stretched. CT and ultrasound scans show no hernias. What nerve could be pinched, and how is this treated?
A: Hello, Giorgi K. Your description is highly consistent with Anterior Cutaneous Nerve Entrapment Syndrome (ACNES). The standard treatment is a precise therapeutic injection (nerve block) of the identified trigger point with a local anesthetic, which relieves the pain and relaxes the affected muscle.
Q: Julia P.: My 78-year-old mother has open hernias at L3-L4 and L4-L5. She also suffered a microstroke in 2014, though she has no motor or speech impairments. Is nucleotomy or discectomy safe at her age? What does the recovery process look like?
A: Hello, Julia P. Minimally invasive spinal surgery is absolutely possible at her age, provided there are no severe cardiac or pulmonary contraindications. Because we use modern endoscopic and microscopic techniques, the recovery duration for elderly patients is quite similar to that of younger patients. Most patients can be discharged home on the second day after surgery, with an average overall rehabilitation period of about one month.
Q: Katerina S.: Our child suffered an open penetrating comminuted fracture of the frontal bone with a moderate brain contusion. Does a child need cranioplasty for a bone defect measuring 18x17 mm?
A: Hello, Katerina S. Yes, cranioplasty is generally recommended to close skull defects. It is necessary to provide optimal physical protection for the brain and blood vessels, prevent post-traumatic headaches, eliminate cosmetic defects, and stabilize intracranial pressure dynamics.
Q: Vladimir I.: I received a course of treatment involving Zoladex, Diphereline, and Eligard. Their effect should have ended by August, but I am still suffering from severe sweating and blood pressure fluctuations. I am 70 years old. Is there a way to relieve this?
A: Hello, Vladimir I. Your symptoms could be residual side effects from the prolonged hormonal therapy, or they could be independent manifestations of vascular or endocrine issues. A comprehensive evaluation by an endocrinologist and a cardiologist is necessary to determine the exact cause and prescribe corrective therapy.
Q: Oksana F.: I have a patient with multiple sclerosis who is unable to walk, suffering from concomitant trigeminal neuralgia. Is it possible to perform a trigeminal nerve block at home?
A: Hello, Oksana F. Blockade of the Gasserian ganglion for trigeminal neuralgia is a highly precise procedure that must be performed under sterile operating room conditions using fluoroscopic (X-ray) guidance. Therefore, it requires brief hospitalization and cannot be done at home.
Q: Levan T.: How do you radically treat visually pronounced Scheuermann-Mau disease?
A: Hello, Levan T. Scheuermann-Mau disease is initially managed conservatively (physiotherapy, targeted exercise, and swimming). Surgical intervention is considered only for severe deformity or intractable pain. The surgery involves stabilizing the spinal column using transpedicular screws and metal rods to eliminate excessive mobility, relieve pressure on the defective vertebrae, and correct the kyphotic deformity.
Q: Ruslan B.: I have suffered multiple head injuries. My main goal is to restore the cognitive functions of the prefrontal cortex and frontal lobe. What diagnostics are required?
A: Hello, Ruslan B. For cognitive impairments following TBI, the primary diagnostic step is a high-resolution MRI with in-depth neuroimaging and tractography of the brain. Based on these results, our neurosurgeons and neurologists can develop a customized neurorehabilitation and restorative therapy plan.
Q: Nino T.: I have a cyst in the 4th ventricle of my brain measuring up to 8.5 mm. How dangerous is this?
A: Hello, Nino T. An intraventricular brain cyst can act as a mechanical obstacle to the normal circulation of cerebrospinal fluid (CSF). If it blocks the flow, it can cause acute hydrocephalus and dangerously high intracranial pressure. You must consult a neurosurgeon with your MRI scans to determine if surgical removal or shunting is required.
Q: Chloe D.: My 35-year-old sister was diagnosed with polymyositis and developed cardiopulmonary failure. She has been on a ventilator for 8 days, and the doctors are advising a tracheostomy. Is this safe given her disease?
A: Hello, Chloe D. Tracheostomy is the standard, safest medical protocol for any patient requiring prolonged mechanical ventilation. It drastically improves the drainage of the lungs, reduces the risk of vocal cord damage, and prevents ventilator-associated pneumonia. Even with polymyositis, it is highly recommended.
Q: Ana V.: Is it possible to safely give birth to a child if I have been diagnosed with an eosinophilic granuloma of the left temporal bone?
A: Hello, Ana V. Yes, it is generally possible to carry a pregnancy safely, provided the granuloma is not causing acute neurological symptoms or aggressive bone destruction that would require immediate radiation or surgical treatment incompatible with pregnancy. Continuous clinical monitoring is required.
Q: Dmitry K.: I am 21 years old and suffered tibial nerve neuropathy as an infant. I have muscle atrophy in my left thigh and lower leg, and the knee reflex is absent. EMG shows signs of a secondary myodystrophic process. Is it possible to cure this and restore the nerve?
A: Hello, Dmitry K. Unfortunately, because the nerve damage occurred over 15 years ago, the muscle atrophy is irreversible, and surgical restoration of the lost tibial nerve function is no longer possible. At this stage, only supportive, symptomatic, and adaptive physiotherapy can be offered.
Q: Olga N.: Do you perform MRI angiography of the renal vessels on a 3 Tesla machine? Is 3D image recording possible?
A: Hello, Olga N. Yes, we perform high-resolution magnetic resonance angiography (MRA) of the renal arteries on a 3-Tesla scanner. 3D reconstructions are included and recorded onto a digital disc. Furthermore, contrast injection is usually not required for this specific type of high-field angiography.
Q: Elena S.: I have an aneurysm or malformation in the hilum of the kidney with arteriovenous fistulas. A CT scan with contrast wasn't clear enough for the surgeon to plan the operation. Would MR-Angiography on a 3-Tesla scanner be more informative? Do I need contrast for it?
A: Hello, Elena S. Yes, a 3-Tesla MR-Angiography provides exceptionally detailed visualization of the vascular architecture, which is critical for planning minimally invasive or endovascular kidney surgery. Depending on the specific flow dynamics of the AV fistulas, the radiologist will determine if a specific MRI contrast agent is necessary during the scan.
Q: Markus T.: I am currently taking Levetiracetam for seizures and want to switch to a different medication. What are the modern analogs?
A: Hello, Markus T. Changing anticonvulsant medication is a complex process that carries a risk of breakthrough seizures. Our neurologists evaluate your specific EEG patterns, seizure history, and side effect tolerance before carefully tapering your current dose and introducing a modern analog.
Q: Tamar M.: My mother has an intervertebral spine hernia with severe sciatica radiating down her leg. She is taking muscle relaxants and pain killers, but the pain is still unbearable. Can you perform a therapeutic paravertebral block?
A: Hello, Tamar M. Yes, for acute and severe radicular pain that does not respond to oral medications, we perform targeted paravertebral or epidural corticosteroid blocks. This rapidly reduces the nerve root inflammation and provides significant pain relief.
Q: Viktor P.: My MRI shows an intradural extramedullary space-occupying lesion at the Th8-Th12 level and an aggressive Th8 hemangioma with wedge-shaped vertebral deformity. Do you perform surgeries for this?
A: Hello, Viktor P. Yes, we specialize in the surgical treatment of complex vascular malformations, hemangiomas, and spinal cord tumors. Preoperative planning will require detailed spinal angiography with contrast to map the blood supply to the tumor. Following this, our neurosurgical board will determine the safest surgical approach.
You can also send your questions and medical inquiries to us at minclinic@gmail.com.