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Pieter-Paul Vergroesen’s ground-breaking findings

‘Why do some intervertebral discs degenerate?’

Looking at newspaper headlines today, one doesn’t generally get the feeling that the world is heading in the right direction. Every page of the newspaper presents fresh tragedies. Fortunately, I was recently given a pleasant surprise which somewhat increased my faith in the future and in mankind. Pieter-Paul Vergroesen, the son of old friends of mine from Brabant, was awarded his doctorate by Amsterdam VU University at the end of October. Vergroesen is a highly talented and enthusiastic young doctor who was studying a subject that is at the heart of my profession: intervertebral discs. Such discs are positioned between our vertebrae. They serve as shock absorbers to our spine and allow the spine to move. Pieter-Paul Vergroesen was trying to find new answers to the question as to why intervertebral discs degenerate and so give rise to hernias and backache. I’ll spare you the hard-to-understand jargon he used in his dissertation, but his conclusions were groundbreaking. I’ll paraphrase them for you below.

Overloaded muscles, tendons and joints

The condition of an intervertebral disc is determined by the balance struck between cells, tissue and mechanical loading. This balance will remain in order as long as sufficient water can be bound to the intervertebral disc. Once an intervertebral disc starts degenerating, this balance is disrupted and the intervertebral disc loses the capacity to bind water, thus causing it to collapse. This puts the adjacent muscles, tendons and joints at risk of being overloaded, which may cause backache.

Establishing that an intervertebral disc is degenerating at an early stage

To a fifty-something doctor like myself, it is inspiring to see a new generation of doctors keen to lift my beautiful profession to an even higher level. Thanks to discoveries such as those made by Pieter-Paul, degeneration of an intervertebral disc can in the near future identified at an early stage. This may help scientists develop a preventive therapy to treat such intervertebral discs, so that the onset of backache can be delayed or even prevented in many people.

This is excellent news, because the patients I meet in my surgery every day tell me that backache can totally disrupt your life. Another thing that strikes me when talking to young doctors is how close they are to their patients and how well they can communicate with them. PhD theses tend to be dull as dishwater. Pieter-Paul’s dissertation contains nuggets of self-deprecating humour, which are funny without going at the expense of the scientific contents of his thesis. This occasional wink was music to my Brabant ears. Brilliant, well-trained scientists who still manage to be nice doctors and who like to be innovative... If that’s the future of health care, maybe there is hope for the planet, after all.

Pieter-Paul Vergroesen’s PhD thesis

Vergroesen’s findings can be accessed on line! Click the button below to view his dissertation:

View the dissertation

Surgery manual

Dr. Schröder is happy to inform you about the surgical treatment of your neck or back condition. He also discusses the possible complications of the procedure with you.

After you've carefully weighed up the pros and cons of the surgery, you can decide for yourself whether you consider your condition serious enough to operate.

View the surgery manual

  • Instructions for after you have left the clinic

    Once you leave the clinic:

    • Make sure that someone comes and picks you up in a car, and refrain from driving yourself
    • Make sure that you recline your car seat
    • Make sure that you are not home alone for the first few days following the operation
    • Allow the wound to heal for the first 2 to 3 weeks
    • You are allowed to shower, as the nurses will give you a waterproof plaster to cover your wound before you leave the clinic
    • You must not drive for 3 weeks, but you will be allowed to sit in the passenger seat while someone else drives you around
    • You are allowed to do whatever you feel up to, as long as you keep listening to your body and stop doing whatever it is you are doing whenever your body tells you to stop

    Your doctor, nurse and/or physiotherapist will provide you with more information on how to look after yourself following the operation.

  • How long will I have to stay at the clinic?

    Depends on the nature of the operation

    The duration of your stay with us will depend on your situation and on the type of surgery you are undergoing. If everything goes according to plan, and if you are undergoing a minor back or neck operation, you will only have to stay with us for one night. If you are undergoing major surgery, such as a spinal instability operation, you will generally have to spend a few nights at our clinics.

  • Swelling after surgery

    Swelling reduced after 2 to 3 months

    After the operation, your wound will swell, which may be painless but may also be a little uncomfortable due to your skin being pulled so taut. Generally speaking, the swelling will subside of its own accord within 2 to 3 months of the operation, and the skin will grow less thick.

  • Medication after surgery

    Following the operation, you will be given painkillers for as long as you need them. You will receive these painkillers in accordance with a set schedule. It is vital that you take your medication at the scheduled times, even when you are not experiencing any pain. In this way, your body will build up a steady level of analgesia.

    Most people will be able to stop taking painkillers a few days after undergoing back or neck surgery. If your painkillers somehow fail to provide you with a sufficient level of relief, we recommend that you notify a nurse as soon as possible. If you were on morphine-like medication prior to your operation, we advise that you gradually cut down on your medication after the operation, if your level of pain allows you to do so, in consultation with your GP. Acute withdrawal may result in adverse events.

  • Post-operative pain

    If you are experiencing an excessive amount of pain, you will receive additional painkillers

    The level of post-operative pain differs from person to person, and from operation to operation. Generally speaking, major lengthy operations will prove more painful than brief minor operations. At our clinics, all patients receive proper painkillers following surgery, as a result of which very few of our patients ever experience a great deal of pain. In consultation with yourself, we will determine your pain score, both at the ward and once you are home (we will call you to discuss this with you). If your pain score is too high, you will be given additional painkillers.

100% insurance covery

Nearly all treatments performed by Dr Schröder are covered by health insurance. This is true for the following conditions: neck hernia, spinal hernia, lumbar spinal stenosis and cervical spinal stenosis.

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Dr Schröder's blog

Dr Schröder regularly publishes new articles on his blog. Read all about spinal hernia, neck hernia, spinal stenosis, neurosurgery and other related subjects.

View all blog posts

  • 13. On coincidence, bad luck and science

  • 12. Dozing off

  • 11. The Big Spinal Quiz for the articulate patient

  • 10. Sherlock Holmes and Dr Watson

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