A herniated disc is a serious condition caused by the displacement of disc material into the spinal canal or nerve root exit zone. This can result from improper strain or pre-existing damage to the disc and often leads to compression of the spinal nerve. Symptoms can range from mild pain and numbness to severe pain, loss of reflexes, and even signs of paralysis, depending on the extent of nerve compression. The treatment of a herniated disc depends on the severity of the nerve involvement. If no paralysis is present, a multimodal conservative pain therapy—such as X-ray-guided spinal injections—can be effective. However, if paralysis occurs in the area supplied by the affected nerve, immediate surgical intervention is necessary. In such cases, the displaced disc material is removed through a minimally invasive procedure known as microdiscectomy. While a herniated disc is a serious condition, it can be effectively treated with the right approach. Prompt recognition of symptoms and early, appropriate therapy are essential for a successful recovery and long-term outcome.

Spondylodiscitis is an inflammatory condition of the spine caused by a bacterial infection. It involves inflammation of the intervertebral disc and/or the adjacent vertebral bodies, often resulting in back pain along with infection-like symptoms such as fever or night sweats. Diagnosis is confirmed through magnetic resonance imaging (MRI) and biopsy of the affected disc tissue. Successful treatment typically includes targeted antibiotic therapy, along with bed rest and the use of a spinal brace to stabilise the affected area. In rare cases, surgical removal of the infected disc and spinal fusion may be necessary to achieve full recovery. Spondylodiscitis is a serious condition, but with timely diagnosis and the appropriate therapy, it can be effectively treated. Prompt response to symptoms and a tailored treatment plan are key to ensuring a swift recovery and successful outcome.

Facet joint osteoarthritis – also known as zygapophyseal joint osteoarthritis – is a degenerative condition of the spine caused by wear and tear of the small joints (facet joints) located between each vertebra. It often occurs in conjunction with disc degeneration or vertebral slippage (spondylolisthesis), and may be triggered by chronic postural misalignment of the spine. Symptoms typically include localised back pain at the affected spinal level, which can radiate to both sides. In more advanced cases, the degeneration and accompanying inflammation of ligaments, as well as joint enlargement, may lead to narrowing of the spinal canal or nerve root canal. This can cause nerve compression and radiating pain, tingling, or weakness in the arms or legs, depending on the affected segment. Treatment primarily consists of image-guided (X-ray-controlled) facet joint infiltrations, which can be carried out either in an outpatient setting or during a short inpatient stay at an orthopaedic clinic. If pain persists, a radiofrequency denervation procedure may be considered. This technique involves targeting the sensory nerves that supply the affected facet joints to reduce pain and inflammation and is usually performed as an inpatient procedure. Facet joint osteoarthritis is a manageable condition that, with the right therapeutic approach, can be effectively treated. Timely diagnosis and tailored treatment are essential to restore quality of life and ensure long-term relief.

Scoliosis, also known as spinal curvature, is a condition where the spine deviates from its normal straight axis or is twisted. It can present as infantile scoliosis, which is usually present at birth and typically involves a left-sided curvature, or as a condition developing during the pubertal growth phase. Fortunately, scoliosis is very treatable when detected early, which can prevent severe pain and degenerative changes in the spine later in life. Symptoms of scoliosis vary depending on the severity but often include visible spinal deformity, pain, reduced mobility, and sometimes breathing difficulties. Treatment depends on the degree of the spinal misalignment. Possible therapies include Schroth therapy, a specialised form of physiotherapy; the use of a brace, which may only be removed for personal hygiene; or corrective spinal surgery. Severe degenerative changes resulting from untreated scoliosis in childhood or adolescence require multimodal treatment to achieve maximum correction of spinal deformity and pain relief. Early detection and treatment of scoliosis are crucial to prevent worsening symptoms and impairment of quality of life.

Symptoms of spondylolisthesis, also known as vertebral slippage, most commonly occur in the lumbar spine, but can also affect the cervical spine where a vertebral body shifts out of place. This results in overloading of the intervertebral discs and facet joints and can cause repeated irritation of the nerve pathways. Symptoms may include pain radiating on both sides at the level of the affected vertebra and within the area served by the corresponding nerve. Acute episodes of pain are common, although chronic pain is rare. Treatment for spondylolisthesis during acute pain phases includes therapeutic local anaesthesia, intensive physiotherapy to stabilise the muscles, and in severe or chronic cases, a stabilising surgical procedure where the affected vertebra is fused to the neighbouring segments.

Vertebral stenosis is a condition where the nerve structures within the spinal canal become compressed. This can be caused by various factors such as disc bulges, degenerative changes of the facet joints, or new bone growths. Symptoms may include limited walking distance and pain that can be relieved by sitting or bending the spine. Treatment for vertebral stenosis depends on the underlying cause and may include targeted epidural injections. In advanced cases, surgical intervention may be necessary to provide adequate space for the nerve structures.

A vertebral body compression fracture, commonly occurring in the thoracic or lumbar spine, results from a sudden overload on the spine, often due to a fall. This causes severe pain in the affected vertebral area but typically without nerve-related radiating symptoms. In some cases, surgery is not required, and stabilising brace therapy is applied for around eight weeks. A common underlying cause is thinning of the bone density (osteoporosis), which needs to be treated. Surgical treatment involves a minimally invasive procedure called vertebroplasty or kyphoplasty, where bone cement or bone substitute material is injected directly into the vertebral body. This often provides immediate pain relief and allows mobilisation without aids as early as the day after surgery.