Spinal surgery: everything you need to know

What motivated you to join our hospital and what added value would you like to bring to our team?

There were two main factors that motivated me to move to this hospital: the proximity to my family and the opportunity to work with Dr Wälchli. Working with him is particularly valuable for me, as he is an extremely experienced and pragmatic surgeon who has been performing exactly those procedures that I am particularly interested in for years - including anterior and lateral approaches to the spine, endoscopic procedures and interventions for spinal deformities.

Another reason was the size of the hospital. I prefer manageable structures with short distances, efficient decision-making processes and a strong human touch. In large university centres, despite all the excellence, there is sometimes a danger of a certain depersonalisation. Here, on the other hand, I find an environment that very much corresponds to my idea of medicine. Above all, I want to bring calm, respect, resilience and a structured way of working to the team - qualities that I believe are particularly important in the demanding field of spinal surgery.

What characterises your approach to treating patients with spinal disorders?

The difference between the pure treatment of a disease and the holistic care of a person is particularly important to me. Patients bring much more to the table than just their pathology: expectations, fears, life experiences and individual social and economic circumstances have a significant influence on the clinical course. Therefore, the same illness can require completely different therapeutic approaches in two people.

A central aspect of my work is to provide patients with reliable support even when complications arise. Complications are part of surgery; the decisive factor is how you deal with them and guide those affected through this difficult phase. This is exactly where trust is built.

In your opinion, what are the most important current trends in spinal surgery?

We are seeing a clear development towards minimally invasive techniques, particularly endoscopic spinal surgery, which currently has the greatest growth potential. This enables a very targeted and tissue-sparing procedure and often a faster recovery.

At the same time, holistic patient care is becoming increasingly important. Comorbidities, frailty and the balance between the burden of surgery and individual resilience are becoming increasingly important - not least due to the ageing but at the same time extremely active population. The challenge is to balance innovation, safety and sustainability.

What role do minimally invasive techniques play, and what advantages and disadvantages do you see?

Minimally invasive procedures offer numerous advantages - fewer infections, less pain and faster rehabilitation. Nevertheless, minimally invasive surgery should not be an end in itself. The primary goal is always to maximise safety and effectiveness. In certain situations, a more classic approach can achieve a more stable and sustainable result. It is also important to correct a common misconception: "minimally invasive" does not refer solely to the size of the skin incision, but to the overall physiological stress of a procedure.

In which areas have you developed particular experience or interest - and why?

I am particularly fascinated by deformity surgery in adults. To deepen my knowledge of this complex field, I completed a fellowship in Milan with Dr Berjano and Dr Lamartina. I also specialise in the treatment of cervical spinal canal stenosis and spinal metastases. Surgical treatment of cervical myelopathy can have a decisive impact on a person's life. Spinal metastases are gaining in importance due to the long survival time of many oncological patients and increasingly require multidisciplinary approaches.

How do you support patients in the decision-making process - especially for complex procedures?

It is very important to me that patients really understand their illness and all the options available to them. The decision-making process today is participatory; the patient makes the decision themselves - after receiving comprehensive information. This requires time, clear communication and an understandable presentation of even technically demanding content. In the case of complex interventions, I deliberately see those affected several times to enable a viable decision to be made.

How do you proceed if it is unclear whether surgery or conservative treatment should be used?

This situation is common in spinal surgery. The decision is always made together with the patient, after a transparent presentation of the advantages and disadvantages. False expectations are a warning sign and must be addressed openly. Individual risk factors also play a role. Our task is not to operate at any price, but to find the best possible way.

What is the importance of interdisciplinary collaboration?

Interdisciplinary collaboration is crucial for optimal care. Many specialists are in much more frequent contact with patients than we surgeons are, so their feedback is crucial. The general practitioner plays a key role and must be actively involved in the process. Our task does not end with the examination of an indication for surgery: we have to take a holistic approach to the problem and structure the further course of events.

Are you involved in research or innovation projects?

I am a member of Prof Dr Cordula Netzer's research group at the University of Basel. Together with the Basel Functional Biomechanics Laboratory, we are working on the functional analysis of patients with spinal disorders.

I am leading a project on cervical spinal stenosis, which includes both surgically treated and conservatively observed patients.

What future developments are you particularly excited about?

In my opinion, endoscopic spinal surgery offers the greatest potential for innovation. Technological advances have helped it to become widely established in recent years. At the same time, a balanced approach is needed: Many procedures can also be performed equally well using traditional techniques. In certain situations, however, endoscopy is a real "game changer".