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Neurosurgery and Spine Surgery

Functional Neurosurgery: targeted pain therapy

Functional neurosurgery deals with the operative normalisation of disturbed or defective functions of the nervous system, which cannot be treated with medication or cannot be treated sufficiently.

Neurological diseases such as Parkinson's disease, tremor or epilepsy are usually treated with medication. In patients who suffer from particularly severe forms, the effectiveness of the drugs may diminish over the years, while at the same time severe side effects may impair quality of life. With the neurosurgical therapy method of deep brain stimulation, the symptoms can be permanently alleviated.

At our clinic, we offer the entire spectrum of pacemaker therapy of the nervous system from deep brain stimulation to spinal cord stimulation and the various possibilities of peripheral nerve stimulation. The comprehensive range of treatments, state-of-the-art intraoperative techniques and close interdisciplinary cooperation between all disciplines involved enables us to plan and implement the best possible therapy for each individual patient. In the treatment of chronic pain syndromes we work closey together with the pain clinic.

Our range of services includes:

  • Chronic pain syndromes
  • Headache, facial pain, back pain, groin pain and other nerve pain
  • Angina pectoris
  • Peripheral arterial occlusive disease
  • Incontinence
  • Epilepsy
  • Movement disorders
  • Parkinson's disease, tremor or dystonia

We offer the following therapy methods of neurostimulation:

In spinal cord stimulation ("spinal cord stimulation" = SCS), electrodes are applied directly to the spinal cord to block or redirect pain impulses. The associated pulse generator (pacemaker) is implanted under the skin. It is connected to the electrodes via thin cables and sends the corrective pulses.
With the help of a small remote control the strength can be individually controlled. Ideally, instead of the pain, you will only notice a slight tingling sensation. The procedure itself takes about an hour and is performed under general or local anesthesia, depending on the diagnosis.

The procedure is particularly suitable for patients:

  • with back and leg pain almost beyond treatment
  • radiating chest / arm pain with angina pectoris
  • Nerve pain with circulatory disorders of the legs (pAVK)


In spinal ganglion stimulation, the electrodes are inserted directly at the affected nerve roots in the spinal canal, which runs inside the spine. In a second step, a pacemaker is implanted. You can control the pacemaker via remote control and thus determine your individual pain regulation independently.

The procedure is used for:

  • Pain syndromes after injuries or operations, such as hernia operations, thoracotomies or breast removal
  • Decompressions in carpal tunnel, sulcus-ulnaris and tarsal tunnel syndrome
  • Nerve pain after knee or hip operations

In contrast to spinal cord stimulation, which focuses on the pathways of the spinal cord, peripheral nerve stimulation (PNS) can target individual nerve fibers, regardless of their location. Electrodes are inserted into the subcutaneous fatty tissue surrounding the nerve in question.

Peripheral nerve field stimulation is used for local, i.e. limited pain conditions:

  • therapy-resistant, chronic headaches
  • local areas of pain in the extremities, trunk and groin

In deep brain stimulation, thin stimulation electrodes are inserted through small openings in the skull into central areas of the brain. The neurostimulator is then implanted under the skin, usually in the collarbone area. The cables are placed under the skin and connected to the electrodes. The exact setting of the stimulation parameters is done through the skin with the controller - a kind of remote control.
The procedure is used for:

  • Symptoms of Parkinson's disease
  • Dystonia
  • Epilepsy
  • for pain therapy
  • in psychiatric diseases such as Tourette's syndrome, obsessive-compulsive disorders, anxiety disorders and chronic depression

The motor cortex is an area of the cerebral cortex from which movements are controlled. It can be stimulated by plate electrodes placed on or under the cerebral membrane. In contrast to peripheral nerve stimulation or spinal cord stimulation, the patient does not experience a slight tingling sensation.
The operation is followed by an extensive test phase: the optimal stimulation parameters are tested and the pain reduction achieved is precisely recorded. If the test phase is successful and no side effects occur, the neuromodulator can be implanted under general anesthesia below the collarbone.

Motor cortex stimulation (MCS) is used for the following clinical pictures:

  • chronic pain after plexus injuries (tearing of nerve roots)
  • chronic or atypical facial pain
  • Stump pain and phantom pain after loss of limbs (especially arm)
  • for neurorehabilitation of paralysis after strokes and cerebral haemorrhages

Sacral nerve stimulation addresses nerve fibres in the area of the sacrum, which supply the bladder and the sphincter muscle. By stimulating the responsible nerves with light electrical impulses, the coordination between the brain, pelvic floor, bladder and intestine and their sphincters can be improved.

In the test phase, the electrodes are first inserted in the sacral region of the lower back and connected to an external pulse generator. This device is initially worn on the belt. If the test phase of several days is satisfactory, a compact pacemaker is implanted above the buttocks.

This therapy is carried out in patients in whom conservative treatment of urinary and faecal incontinence has not been successful.

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