Baltic American Clinic performs neurosurgical operations and interventional procedures to treat diseases of the spine and peripheral nervous system and pain. Treatments include surgery for intervertebral disc herniations and peripheral nerve tumours, cryotherapy, therapeutic injections, nerve blocks and laser discotherapy. The treatment method is chosen individually, taking into account your symptoms, neurological condition and the results of diagnostic tests.
We aim to arrange planned operations and procedures as soon as possible, choosing the earliest available date that suits you.
Based on your symptoms, the results of diagnostic tests and your health.
A discreet environment and individual attention at every stage of treatment.
From preparation for the operation or procedure to post-operative monitoring and recovery recommendations.
Which neurosurgical operations and interventional procedures are performed?
Neurosurgical treatment includes surgical operations and less invasive interventional procedures. Not every patient needs an operation – in some cases injections, nerve blocks, cryotherapy or other treatments may be used to reduce pain and irritation of nerve structures.
Neurosurgical operations
Discectomy – surgery for an intervertebral disc herniation
Discectomy is a surgical operation in which the part of an intervertebral disc that is pressing on nerve structures is removed. The aim of the operation is to relieve pressure on the nerve and the symptoms it causes.
An intervertebral disc herniation can cause neck or back pain, pain spreading into the arm or leg, numbness, tingling and muscle weakness.
An operation may be needed when severe pain persists despite appropriate non-surgical treatment, muscle weakness progresses or diagnostic tests confirm significant compression of nerve structures.
During the operation the neurosurgeon reaches the affected segment of the spine and removes the part of the disc that is pressing on the nerve. The surgical approach and the extent of the operation depend on the location and size of the herniation and on anatomical features.
After the operation, pain spreading into the limb may ease fairly quickly, but numbness and muscle weakness may improve gradually. Recovery of nerve function depends on the nature and duration of the damage.
Removal of a peripheral nervous system tumour
Tumours of the peripheral nervous system can form in nerves or in the tissues associated with them. Depending on their location, size and relationship to nerve structures, they may cause pain, numbness, sensory disturbances or muscle weakness.
Not all peripheral nerve tumours are malignant. Their nature is assessed based on clinical and diagnostic test findings.
An operation may be needed when the tumour causes neurological symptoms, grows, impairs nerve function, or its removal is necessary to confirm the diagnosis or for treatment.
During the operation the neurosurgeon removes the tumour, aiming to preserve the integrity and function of the surrounding nerve structures as far as possible. The complexity of the operation depends on the location and size of the tumour and its connection with the nerve.
In some cases complete removal of the tumour may carry a risk of nerve damage, so the extent of surgical treatment is decided individually. If needed, the removed tissue is sent for histological examination.
After the operation there may be local pain, tenderness or changes in sensation. Recovery of nerve function depends on the nature of the tumour, previous nerve damage and the extent of the operation.
Interventional neurosurgical procedures
Interventional procedures can be used to reduce pain and to suppress irritation or inflammation of nerve structures. Some of them are performed under imaging guidance, which helps to reach the treated area more precisely.
Cryotherapy procedures
Cryotherapy is an interventional treatment in which selected nerve structures that transmit pain signals are treated with low temperature. The aim of the procedure is to reduce the transmission of pain signals. The duration of the effect and the result depend on the area treated and individual factors.
Facet joint cryotherapy
Facet joints connect the vertebrae and help keep the spine mobile. Because of degenerative changes or other causes, they can become a source of chronic neck or back pain.
Facet joint cryotherapy is intended to reduce the transmission of pain signals from these joints by acting on the nerve structures that supply them.
The procedure may be considered when the pain is found to be related to the facet joints and other treatments do not give enough relief.
Options performed:
- Facet joint cryotherapy.
- Facet joint cryotherapy under C-arm guidance.
A C-arm is X-ray imaging equipment that makes it possible to monitor the position of the instruments during the procedure.
Peripheral nerve cryotherapy
Peripheral nerve cryotherapy is a procedure in which a selected peripheral nerve is treated with cold to reduce the pain signals it transmits.
This method may be considered for certain localised neuropathic or other types of pain when the doctor identifies a specific source of the pain.
Before the procedure the location of the pain, nerve function and possible treatment risks are assessed. After the procedure there may be temporary changes in sensation or local tenderness.
Cryotherapy of deep peripheral nerves
Cryotherapy of deep peripheral nerves is used for nerve structures located deeper in the tissues.
The aim of the procedure is to reduce the transmission of pain signals when a specific nerve or nerve structure to be treated has been identified.
Because of the location of the nerves and the features of the surrounding anatomical structures, the procedure is planned individually. The doctor assesses the expected benefit, possible changes in sensation and other risks.
Joint cryotherapy
Joint cryotherapy is an interventional pain treatment in which the nerve structures involved in transmitting joint pain are treated with cold.
The procedure may be considered for long-lasting joint pain when a suitable indication for treatment has been established.
Options performed:
- Joint cryotherapy.
- Joint cryotherapy under C-arm guidance.
The treatment options depend on the specific joint, the cause of the pain and your general health.
Intervertebral disc cryotherapy
Intervertebral disc cryotherapy is an interventional procedure used in certain cases to treat pain related to an intervertebral disc.
The doctor assesses whether the intervertebral disc is the source of the pain, what changes in it are seen on the tests and whether the chosen method is suitable in the particular case.
This procedure is not the same as a discectomy: in a discectomy the part of the disc pressing on the nerve is removed surgically, while cryotherapy is a different type of intervention.
Spinal cryotherapy
Spinal cryotherapy is an interventional procedure in which the nerve structures involved in transmitting pain from the spinal area are treated with low temperature.
The need for the procedure is assessed based on the nature of the pain, neurological symptoms and the results of diagnostic tests.
The specific area treated and the technique of the procedure are decided individually. This method is not a universal treatment for all spinal pain.
Trigeminal nerve cryotherapy under C-arm guidance
The trigeminal nerve is responsible for sensation in a large part of the face. Damage to or irritation of this nerve may be associated with severe, recurring attacks of facial pain.
Trigeminal nerve cryotherapy is an interventional procedure that aims to reduce the pain signals transmitted by selected nerve structures.
The procedure is performed under C-arm guidance. Whether it is suitable depends on the diagnosis, the nature of the pain, previous treatment and individual risk.
Changes in facial sensation are possible after the procedure, so the expected benefits and risks are discussed in advance.
Therapeutic injections and nerve blocks
Therapeutic injections and nerve blocks are interventional procedures in which medicines are injected into a selected anatomical area or next to nerve structures. They aim to reduce inflammation, nerve irritation and pain. Some nerve blocks can also help identify the source of the pain.
Epidural steroid injections
An epidural steroid injection is a procedure in which an anti-inflammatory medicine is injected into the epidural space surrounding the nerve structures of the spine.
The procedure may be used when, because of irritation or inflammation of a nerve root, pain spreads from the spine into the arm or leg.
Options performed:
- Lumbar epidural steroid injection under C-arm guidance.
- Cervical epidural steroid injection under C-arm guidance.
Imaging guidance helps to determine the injection site more precisely. The effect of the procedure and its duration vary from person to person. The injection does not remove all structural changes in the spine, so its suitability is assessed as part of the overall treatment plan.
Paravertebral block
A paravertebral block is the injection of medicines next to nerve structures located beside the spine.
It may be used to reduce certain types of pain in the spinal area or pain related to nerve irritation.
During the procedure the doctor chooses the injection site and medicines according to the location of the pain and the intended aim of treatment.
Anaesthetic injections next to peripheral nerves
In this procedure a local anaesthetic is injected next to a selected peripheral nerve to temporarily reduce the transmission of pain signals.
The procedure may be used for certain types of neuropathic or post-operative pain, or pain related to nerve irritation. In some cases the injection helps to assess whether a particular nerve is the source of the pain.
The duration of the effect depends on the medicine used, the location of the nerve and individual factors. After the injection there may be temporary numbness or muscle weakness in the treated area.
Trigger point injection (block)
Trigger points are painful, hypersensitive areas of muscle that can cause local pain or pain spreading to the surrounding tissues.
In a trigger point block, medicine is injected into the identified painful area to reduce muscle pain and tension.
The procedure may be combined with other measures recommended by the doctor to improve muscle function and movement.
Percutaneous block of the trigeminal ganglion
This is an interventional procedure used in certain cases to treat severe facial pain related to the trigeminal nerve system.
A percutaneous approach means that the treated area is reached through the skin, without open surgery.
The suitability of the procedure is assessed based on the nature of the pain, the diagnosis, previous treatment and neurological condition. Before the procedure the expected benefit and the risk of changes in sensation and other complications are discussed.
Other neurosurgical treatment procedures
Laser discotherapy
Laser discotherapy is a minimally invasive interventional procedure in which laser energy is used to act on an intervertebral disc.
It may be considered in certain cases of intervertebral disc changes when the results of diagnostic tests and the symptoms meet the criteria for using this method.
The aim of the procedure is to reduce symptoms related to the damaged disc. However, it is not suitable for all types of disc herniation and is not equivalent to a surgical discectomy in every case.
Before choosing the treatment method, the location and size of the herniation, compression of nerve structures and neurological symptoms are assessed.
Treatment of carpal tunnel and cubital tunnel syndrome
Carpal tunnel syndrome develops when the median nerve is compressed at the wrist. It can cause numbness and tingling in the fingers, pain at night and weakness of the hand.
Cubital tunnel syndrome is related to compression of the ulnar nerve at the elbow. The most common symptoms are numbness in the little and ring fingers, weakness of the hand or problems with fine movements.
Treatment is chosen according to the severity of the symptoms, the degree of nerve dysfunction and the test results. The doctor assesses whether non-surgical measures are enough or surgical treatment is needed.
The specific method used is decided during the consultation.
How to prepare for a neurosurgical operation or interventional procedure
Before treatment the neurosurgeon assesses your symptoms, neurological condition, diagnostic test results, other conditions and the medicines you take.
Preparation depends on the chosen treatment method – different requirements may apply to a surgical operation and to a smaller interventional procedure.
- Diagnostic tests. If needed, blood tests, heart function tests, magnetic resonance imaging, computed tomography or other necessary tests are carried out.
- Medicines. Tell the doctor about all medicines and food supplements you take, especially those that affect blood clotting.
- Chronic illnesses and allergies. Tell us about your illnesses, previous operations, allergies and any reactions to medicines or anaesthesia.
- Infections and changes in your health. Inform the clinic if you have a fever or an infection, or feel significantly different, before the planned procedure.
- Food and fluids. If anaesthesia or sedation is planned, follow the doctor’s instructions on eating and drinking.
- Going home. If sedation or general anaesthesia will be used, or the procedure may temporarily affect movement and sensation, arrange for someone to accompany you.
Important: do not stop or change prescribed medicines on your own. It is especially important to discuss medicines that affect blood clotting in advance.
Anaesthesia during the operation or procedure
The type of anaesthesia depends on the treatment method, the extent, duration and location of the procedure and your health.
Neurosurgical operations are usually performed under general anaesthesia. Other anaesthesia methods may be chosen for some smaller peripheral nerve operations.
Interventional procedures may be performed under local anaesthesia and, in certain cases, with sedation or another type of anaesthesia chosen by the doctor.
Before treatment we explain which anaesthesia is planned, how it will be given and what sensations are possible during and after the procedure.
Inpatient stay and care after the operation or procedure
Post-operative monitoring
After a neurosurgical operation your wellbeing, vital signs, pain intensity and neurological condition are monitored.
Depending on the type of operation, movement and sensation in the limbs and other important neurological signs are assessed. If needed, painkillers are given, dressings are changed and other necessary care procedures are carried out.
Monitoring after interventional procedures
After injections, nerve blocks, cryotherapy or laser discotherapy, the length of monitoring depends on the type of procedure, the anaesthesia used and how you feel.
Some procedures can be performed on an outpatient basis, while others may require longer monitoring.
After nerve blocks there may be temporary numbness or muscle weakness, so the doctor explains what precautions are needed.
Inpatient care
After surgical operations, the length of inpatient care depends on the extent of the operation, the anaesthesia and your individual recovery.
In some cases shorter monitoring may be enough, while more complex operations may require longer care.
Leaving the clinic
Before you leave, you receive individual recommendations on:
- Care of the surgical wound or injection site.
- Taking medicines and pain control.
- Permitted physical activity.
- Restrictions on sitting, bending and lifting, if needed.
- Driving and returning to work.
- Follow-up visits and further treatment.
- The need for rehabilitation, if it is recommended.
Recovery after a neurosurgical operation or interventional procedure
The course of recovery depends on the treatment performed, the condition of the nerve structures, how long the symptoms have lasted and individual characteristics of the body.
After a discectomy, pain caused by nerve compression may ease sooner than numbness or muscle weakness. Recovery of nerve structures may take several months, and in some cases neurological problems remain.
After removal of a peripheral nervous system tumour, the course of recovery depends on the location of the tumour, its relationship to the nerve and the extent of the operation.
After cryotherapy there may be temporary tenderness, aching or changes in sensation at the procedure site. Pain relief may not occur immediately, and the duration of the effect varies from person to person.
After therapeutic injections and nerve blocks, some patients feel relief quickly, but anti-inflammatory medicines may need more time to take effect. When the local anaesthetic wears off, the pain may temporarily return.
After laser discotherapy, recovery recommendations depend on the procedure performed and the condition of the spine. The doctor may recommend temporarily limiting certain movements or physical exertion.
It is important to follow the doctor’s individual recommendations and not to rush back to intensive physical activity.
If after treatment you develop new or increasing weakness in the limbs, loss of bladder or bowel control, numbness in the groin and buttock area (saddle area), fever or other unusual symptoms, you must seek medical help immediately.
Frequently asked questions
Does an intervertebral disc herniation always need an operation?
No. In most cases non-surgical treatment is tried first. An operation may be needed when symptoms persist despite appropriate treatment or significant neurological problems are found.
What is the difference between discectomy and laser discotherapy?
In a discectomy the part of the disc pressing on the nerve is removed surgically. Laser discotherapy is a minimally invasive interventional procedure that uses laser energy. The indications for these methods differ, so the most suitable treatment is chosen by the doctor.
Can cryotherapy replace spinal surgery?
Not in every case. Cryotherapy can be used to treat certain pain syndromes, but it does not remove all structural changes in the spine. If significant compression of nerve structures or a progressive neurological problem is found, a different treatment may be needed.
Are nerve blocks painful?
During the procedure you may feel a needle prick, pressure or brief discomfort. The sensations depend on the site of the block and the method of pain relief used.
How long does a nerve block last?
The duration of the effect depends on the medicines used, the area treated and the cause of the pain. The effect of a local anaesthetic is usually short-lived, while the effect of anti-inflammatory medicines may appear later and last longer. The result varies from person to person.
Does the pain go away immediately after an epidural steroid injection?
Not necessarily. If a local anaesthetic is used, temporary relief may come quickly. The anti-inflammatory effect of the steroid usually develops gradually.
Is the effect of cryotherapy long-lasting?
The duration of the effect of cryotherapy varies depending on the nerve structure treated, the cause of the pain and individual factors. In some cases the pain may return.
Can I drive straight after an interventional procedure?
This depends on the procedure and the anaesthesia used. You must not drive after sedation, and after a nerve block driving may be limited by temporary numbness or muscle weakness. Follow the doctor’s instructions.
Can numbness or muscle weakness remain after a neurosurgical operation?
Yes. Recovery of nerve function depends on the nature, severity and duration of the damage. Pain may ease sooner than problems with sensation or movement.
Is a peripheral nervous system tumour always malignant?
No. Peripheral nerve tumours can be benign or malignant. Their nature is assessed based on diagnostic test results and, when needed, histological examination.
When can I return to work after a neurosurgical operation?
This depends on the type of operation, the course of recovery and the nature of your work. People with desk jobs may be able to return sooner than those doing heavy physical work. Individual recommendations are given by the doctor.
When must I seek urgent help after an operation or interventional procedure?
Seek medical help immediately if you develop new or rapidly increasing weakness in the limbs, loss of bladder or bowel control, numbness in the saddle area, a severe unusual headache or other sudden neurological symptoms. A fever, signs of infection or increasing pain also need to be assessed urgently.
Price of neurosurgical operations and interventional procedures
The prices of neurosurgical operations and interventional procedures are set according to the current Baltic American Clinic price list.
The final price depends on the chosen treatment method, the extent and complexity of the procedure or operation, the medical supplies used and your individual health.
Anaesthesia, inpatient care, post-operative nursing, additional tests and other services, if they are not included in the price of the operation or procedure, are charged separately according to the current price list.
Before treatment we discuss with you the individual treatment plan, the planned extent of the operation or procedure and the costs.