Dr Dilyan Ferdinandov on how structured approach, professionalism and latest technology provide top results in treatment of spinal conditions
Back pain is increasingly a part of life for thousands of people. The reasons for it are many, from sedentary living to bad exercise and genetics to trauma and, rarely, oncological diseases. Whatever the reason, the solution is at Vertebra Medical Centre. Vertebra is a unique place in Bulgaria for complex medical treatment of spinal and other musculoskeletal conditions and diseases.
Dr Dilyan Ferdinandov is the head of Vertebra's medical team. He graduated medicine cum laude from the Medical University-Sofia in 2006. He specialised in neurosurgery and in 2013 he had his PhD in spinal surgery. Dr Ferdinandov has attended trainings and qualification courses in the US, Germany, the Netherlands, Spain, France and Italy; he has also practiced in the Netherlands and Germany. His professional interests are in spinal surgery and neuro-oncology. Dr Ferdinandov is one of the top spinal surgeons at St Ivan Rilski University Hospital, a leader in the field in Bulgaria. Now at Vertebra he also treats patients conservatively, combining his high level of surgical expertise with the latest technology in physiotherapy.
What percentage of your patients need surgery and what just need rehabilitation and physiotherapy?
Spinal surgery has evolved rapidly in recent years, triggered by factors such as technological development and the ageing of the general population. Consequently, today not every patient needs surgical treatment for their problem. In my practice about 1-2 in 10 patients need an operation. The rest can improve if they are in the hands of experienced neurologists, physio- and kinesitherapeuts.
However, the current system in Bulgaria does not allow such patients to get quick and adequate treatment. Our country still lacks a well-structured approach for complex treatment, resulting in a vacuum that forces the patient to visit several different specialists, who have their own approaches and ideas, but who often do not communicate with one another. As a result, the patient ends at the neurologist's office only after all other treatment attempts have failed. The need of a safe, well thought plan for post-operative rehabilitation is also in demand across a high percentage of cases.
What is the solution?
For the past several years we have focused on creating a structured, fact- and science-based approach that will shorten the patient's search for adequate treatment of their spinal conditions and diseases. It emphasises on prompt diagnosis, medical treatment, rehabilitation, and physiotherapy. When a patient comes at Vertebra with, say, a common problem such as lower back pain, they will find structured help in one place. We begin with proper examination to establish whether the problem is in the spine or in another organ, whether it is degenerative (such as typical disc herniation) or is caused by a tumour or an infection. Then, if needed, we can suggest a detailed diagnostic plan that includes blood tests, image diagnostics, electromyography for examining the nerves' conductivity etc. The next stage is to decide what results can be achieved with medicines, physiotherapy, kinesiotherapy and another manual or minimally invasive therapy. Surgery, which takes place at St. Ivan Rilski University Hospital, is the last resort and when we use it, we also apply the latest, minimally invasive treatment methods. Clearing the indications then results in much better and faster postoperative rehabilitation and the patient's recovery is more effective.
This is the aim of Vertebra Medical Centre. We wanted a place where neurosurgeons, neurologists, rheumatologists, orthopaedists and other professionals together can conservatively treat spinal and musculoskeletal diseases with the most advanced technologies and ideas currently available.
What technologies do you use for diagnosis and rehabilitation?
Many of our devices are new to Bulgaria and available only in our medical center. Here at Vertebra we treat acute pain and inflammation with the latest generation of focused shockwave. Our robotised high intensity scanning laser helps in physiotherapy and post-traumatic rehabilitation to calm pain and reach the affected tissues in depth. The super inductive magnet is proven to relieve pain and help fractures healing and body stimulation in a safe, non-invasive way.
And there is the David System. This fascinating medical technology allows detailed analysis of each segment of the spine – the cervical, the thoracic, the lumbosacral. The patient's results are compared to that of a control group based on sex, age, height and weight. Using this information, we prepare an individual treatment protocol that will improve and rebalance the muscles, thus healing most of the spinal problems known to medicine. In the hands of experienced kinesitherapeuts and physicians David effectively treats pain in 90% of patients. This medical technology has been in use for decades in the United States and Europe, and has only improved with time.
Thus, the David System allows us to be proactive and to strengthen the spine before serious problems appear. The approach is safe and personally tailored to each patient's needs. Thanks to it we can not only treat acute conditions, but are able to identify and minimise problems before they manifest themselves.
What diseases do you treat at Vertebra?
Our patients suffer musculoskeletal diseases and conditions such as degenerative bone changes, disc herniation and spinal stenosis known as abnormal narrowing of the spinal canal. We also offer outpatient treatment of neurological and rheumatological diseases and also chronic pain.
Pain in particular is the most common reason why people seek help at Vertebra. It is an amazingly common problem and we also try to help with minimal use of medicines such as corticosteroids. Those are effective, but have grave side effects and are best avoided.
Post-operative rehabilitation is a strong focus for us and we achieve great results, significantly shortening the recovery period. Thus we can help the patients get back to living their lives normally again.
Many people exercise to avoid such problems. Is it safe to do this?
If I am allowed to exaggerate a bit, I will say that the patients that come to Vertebra fall in two opposite groups. One is people who do not exercise enough as they work on a desk or drive for hours. The other is people who exercise, but do not do this properly. They are not aware that bad exercise can damage their spine. On the surface it is often hard to notice, as these people have beautifully sculpted bodies. But their spines are seriously imbalanced and can cause more serious trauma.
How can we be sure that we do not end in the second category?
Train under professional guidance as certified trainers are able to identify such problems at an early stage. Do not postpone seeking medical help, because such problems, when unrecognised and treated on time, will become chronic and can result in permanent damage that is beyond help.
To give an example, one such problem is the so-called facet joint syndrome, which is back and neck pain caused by overloaded spinal segments. When exercise extends joint capsules it can cause pain, which, for its part, can result in muscle spasm. Rest is often not enough for the muscles to recover, and with the new training comes a new overload, and more pain. If left untreated, the problem becomes chronic and significantly affects the quality of life.
Sofia, 22 San Stefano St, San Stefano Plaza
phones: 02/441 66 55; 0883 566 555