More than just back pain - modern spinal medicine at Zollikerberg Hospital

Dr Wälchli, you combine specialist qualifications in orthopaedic surgery and traumatology of the musculoskeletal system with training in chiropractic. How does this combination influence your view of spinal therapy?

As a chiropractor, I know the limits of both conservative and surgical treatments. This helps me to assess whether surgery or conservative therapy is more appropriate. In principle, I always try to treat the symptoms with conservative measures first - if these options have not already been exhausted.

You head up the interdisciplinary centre for spinal surgery at Zollikerberg Hospital. What characterises this approach - and what added value does it bring for your patients?

As an independent department, we are closely networked with other clinics. It is often a question of assessing whether patients with chronic pain or after accidents need to be treated conservatively or surgically. We therefore work closely with the Surgical and Medical Clinic. The collaboration with the Radiology Clinic enables us to carry out investigations and interventions in-house without long waiting times.

In which cases is an operation really necessary, and where do you see the strengths of conservative treatment methods such as chiropractic or physiotherapy?

Our aim is always to avoid surgery. Conservative methods such as physiotherapy, chiropractic or infiltrations are very effective. Surgery is performed if there is a risk of severe paralysis or if the spinal cord is constricted or if the pain-related pressure of suffering is too much for the person affected. In rare emergencies - such as spinal cord compression or when patients are no longer able to empty their bladder - urgent surgery is required.

Many people with chronic back pain are also afraid of surgery. How do you manage to create trust?

The most important thing is to take patients seriously. Even if complaints sound trivial to us, they are real and stressful for those affected. We look for causes together and discuss all the options. In the end, it is always the patient who decides which path they want to take. And even in very elderly people, an operation is often worthwhile if the findings are clear and the general condition is good.

What distinguishes spinal surgery at Zollikerberg Hospital from other services?

We are a small, well-rehearsed team of three specialists. We discuss difficult cases together and I personally accompany practically all patients. This close and personalised care is a big plus and a strong motivation for me.

How important is the collaboration with orthopaedics, pain therapy, physiotherapy and chiropractic?

Very important. Most patients have already undergone conservative therapies. After an operation, we are again dependent on our colleagues, especially physiotherapy, to enable a successful return to everyday life.

Which developments in technology and teamwork do you consider to be particularly relevant?

Technology is developing rapidly. Navigation and robotics will make spinal surgery even safer. In addition, minimally invasive methods such as endoscopy allow us to achieve excellent results with small incisions - a method that we have been using successfully at Zollikerberg Hospital since 2007.