Treatment: The spine
Spine treatments

The spine – a moving interaction.

Walking upright, bending and stretching are all a matter of course for us, usually without even thinking about it. Thanks to the healthy harmony of 24 free vertebrae, sacrum and coccyx, 23 discs, 133 joints, 143 muscles and 224 ligaments. Various causes can disrupt this interplay and give rise to deformities or degenerative diseases. Prof. Dr. med. Michael Akbar treats both congenital and spinal disorders acquired over time due to wear and tear or stress at EXPERTS FIRST.


Prof. Dr. med. Michael Akbar treats all spinal deformities such as:

Scoliosis –
Sideways curvature of the spine

Kyphosis –
Forward curvature in the sagittal plane of the spine (also known as "hunchback")

Spondylolisthesis –
One or more vertebrae of the spine have slipped forwards or backwards

Degenerative spinal diseases

Disc prolapse (slipped disk)
Little movement and constant sitting, being very overweight or lifting weights that are too heavy can lead to a herniated disc. Older people also often lose elasticity of the discs, which can also be responsible for the core of a disc breaking through its fibrous ring and therefore pressing painfully against the nerves. A slipped disc can be the cause behind the following symptoms:
- Sudden back pain
- Hardened muscles in the affected area of the spine
- Pain radiating to buttocks, legs, or arms
- Tingling, numbness, or feeling of cold in your arm or hand

This degenerative disease can be caused by chronic inappropriate stress such as constant sitting without compensation. Signs of wear appear that make bony changes to the spine. This can affect various areas, causing the corresponding problems:
- Pain in the neck and throat area that is independent of exercise and occurs at night
- Headache
- Restricted mobility of the neck and throat area
- Severe or chronic back pain if the lumbar vertebrae are affected

As the body's own connective tissue shrinks over the years, the protective buffer becomes smaller. The body attempts to ward off this process, and the small vertebral joints between the vertebral arches increase in size. This forms bony spurs - with painful results:
- Back pain in the lumbar region
- Pain radiating to the buttocks and legs
- Neck pain
- Feeling of cold or tingling in the legs
- Numbness
- Movement disorders and paralysis

Osteoarthritis of the small spinal joints is also often a symptom of old age. However, spondylarthritis can also be caused by excessive strain caused by certain sports disciplines or professions, or due to being overweight, leading to the following typical symptoms:
- Back pain when exercising
- Tension in the lower back
- Feeling of cold or tingling in the legs
- Movement restrictions in the lumbar spine area

Spinal stenosis
When the vertebral canal becomes constricted, pressure is exerted on the spinal cord, blood vessels and nerves – possibly resulting in permanent nerve damage. Constriction of the vertebral canal is also a sign of ageing, and particularly manifests itself in:
- Increasing pain in the legs when walking and standing
- Sitting or bending over relieves the pain immediately
- Back pain radiating into the legs
- Muscle cramps in the legs
- Coordination disorders and unsteady gait

Lumbar scoliosis
In the case of degenerative scoliosis of the lumbar spine, several vertebral segments are affected by wear and tear and a lateral curvature of the lumbar spine develops, which is typically accompanied by the following symptoms:
- Pain in the lumbar spine and hip area
- Movement restrictions in the lumbar spine area

Hollow back loss
A straight, stiff-looking gait is a typical indication of "flat back syndrome". Even though this is hardly visible, unlike a hunchback, persons who are afflicted suffer pain that is equally as severe. The lack of a natural spinal curve can develop as the result of poor posture and growth spurts at a young age, muscular dysbalance or also a lack of exercise and manifests itself in the following symptoms:
- Noticeably straight gait
- Stiff neck and head posture
- Severe pain due to unbalanced load distribution

Fractures of the spine

Traffic accidents and serious falls, but also reduced bone quality due to osteoporosis, can be the cause of the fracturing of one or more vertebrae. With osteoporosis, even a coughing fit or a small stumble can result in the fracture of a spinal component. In this case, it is very important to get a rapid diagnosis.

Tumours on the spine

So-called spinal tumours can occur on the bone and on the nerves - as benign or malignant tumours. In the case of benign tumours, the symptoms can range from local pain to restricted mobility and instability of the spine to neurological disorders. Fever, lymph node swelling, night sweats and lethargy can be signs of a malignant tumour.

As an experienced specialist in spinal surgery, I accompany tumour patients from the initial diagnosis and advice on treatment options to surgery, follow-up care and rehabilitation.

Spinal infections

These usually occur due to undetected sepsis, but spinal injuries or operations can also lead to inflammation of the spine, triggered by penetrating bacteria. For example, patients with diabetes or kidney insufficiency, chronic alcohol or drug abuse or long-term treatment with cortisone or cytostatics are particularly at risk. The inflammation processes caused by the infection can lead to localised destruction of the spine, causing the formation of kinks and even paralysis if left untreated for too long. At first, the symptoms are very non-specific:

Deep-seated backache, independent of stress

Generally feeling unwell, with fever or shivering


Poor performance

Modern therapies

At EXPERTS FIRST I provide the full range of modern holistic therapy options. In these therapies, I adapt every treatment to the patient's individual situation.

Conservative therapy
From pain therapy to physiotherapy and physical therapy to rehabilitation - my range of conservative therapies is characterized by individually selected, modern and recognized treatment methods.

Operative therapies
Be it slipped discs, spinal canal stenosis, Spondylolisthesis, tumours of the spine or fractured vertebrae - with many years of experience and expertise, I use modern surgical techniques such as minimally invasive, microsurgical and endoscopically assisted procedures. For me, it is a matter of course to combine the different techniques in a targeted and individual manner.

Minimally invasive procedures
Whenever possible, I use modern and gentle minimally invasive methods for surgical operations, which are based on very small, precise incisions and have various advantages for the patient:
- Smaller wounds
- Less tissue damage
- Less blood loss
- Less pain
- Quicker healing
- Shorter hospital stay
- Quicker return to everyday life

Minimally invasive kyphoplasty
If a fractured vertebra occurs as a result of a fall or severe osteoporosis, it can be stabilised using the minimally invasive kyphoplasty procedure – and your mobility can be restored.

Prof. Michael Akbar

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Are you looking for a real spine surgery expert in Heidelberg? Prof. Dr. med. Michael Akbar has many years of experience and high degree of expertise and is your ideal contact partner for all matters concerning spinal diseases and therapies.

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