Assoc. Prof. Dimitar Haritonov: In recent years, we have seen an increase in the number of people with disc disease, and the age limit of patients has fallen dramatically

Assoc. Prof. Haritonov, why did you decide to devote more time to the patients in Burgas?

I am honoured to be able to contribute to improving the quality of healthcare in Burgas. My decision is based on the desire to provide high quality neurosurgical care to the people of the region and to support the development of medical services here. I see great potential and am convinced that I can help many patients.

What innovations do you plan to introduce in the hospital in Burgas?

-I believe that modern medicine requires continuous improvement and adaptation of the latest technologies and methodologies. I plan to introduce minimally invasive surgical techniques and robotic surgery, both in spinal and cranial surgery, which will reduce recovery time and improve treatment outcomes. I will also work on creating multidisciplinary teams to provide comprehensive patient care.

We already have enough experience and expertise and my teams are the first to apply these innovative treatment methods and most importantly, they are now available in our country thanks to the super modern equipment of the Heart and Brain Hospitals.

People suffering from oncological diseases, degenerative diseases of the spine, vascular diseases of the central and spinal cord, as well as those with traumatic injuries or congenital malformations will receive adequate, high-quality and highly specialized neurosurgical health care at the Heart and Brain Hospital Burgas.

We are talking about an extremely minimally invasive method, where the patient does not feel any pain and can return to his normal rhythm of life hours after the procedure. The indications for the application of this method are mainly aimed at patients up to 45 years of age. The method is mainly recommended for the initial stage of disc disease. The intervention is performed in an operating room, but in practice it is an injection. The injection is placed directly into the nucleus of the intervertebral disc itself, where the appropriate amount of discogen is inserted under X-ray control. Half an hour after the procedure, the patient can get up and move around on his own without the need for any aids. The only restriction is the refinement of physical exertion within 3 to 4 weeks after the procedure. Discogel treatment has been successfully applied in the USA and Europe for several years and now also in our country. At this stage ‘Heart and Brain’ is the only one in Bulgaria where the innovative treatment is available.

– What does disc disease represent?

– Disc disease (discopathy) is one of the most common diseases in human pathology, the main symptom of the disease being recurrent neck, back and low back pain. Usually, the pain is provoked by exertion, sudden movement, weight lifting, cold, and intensifies with movement. At some stage in the development of the disease (onset of disc protrusion or herniation) the pain begins to radiate to the arms and legs, sometimes with numbness and weakness. Diagnosis is made after examination by a neurologist and conducting so-called neuroimaging studies – X-ray, CT scan and MRI. It should be borne in mind that a simple X-ray cannot prove the presence of a protrusion or hernia. For this, it is necessary to conduct a computed tomography or, preferably, an MRI, which has the highest diagnostic value.

– Can everyone develop disc disease or are there more vulnerable groups of people?

-Absolutely anyone can at some stage in their life face this health problem. Disc herniation is one of the most common causes of back pain. It can form between any two vertebrae of the spine and at any age no matter the gender. Since this problem is associated with wear and tear of the discs, its occurrence is typical in people with occupations involving a lot of physical exertion, also in people with frequent injuries. Apart from systematic strain and wear of the discs, the problem can occur after sudden movements or strain that cause tearing of the fibrous ring.

In rare cases, disc herniation is due to congenital anatomical features of the spine.

– How does disc disease manifest itself in its early stages and which symptoms indicate that the disease is progressing?

– In its early stages, disc disease presents with pain in the spine that “descends” to the tailbone. It manifests with prolonged standing upright or with prolonged sitting. In older patients, this problem is also due to the so-called aging process or disc degeneration. The strength of the ligaments decreases and a seemingly small effort or rotational movement can cause a disc rupture.

– What more serious complications can result? Which of these cases in your practice can you share?

– Disc disease cannot lead to serious complications as it is a chronic relapsing disease and develops slowly unless there is a traumatic moment. So, if the patient hasn’t been paying attention for a long time and hasn’t been treated – then he comes to us in a pretty severe condition. After proper surgical intervention, this problem naturally gets under control. So again we come to the most natural and correct advice – seek medical help on time, before the onset of complications.

– From your observations in practice, could you tell us: are patients with this health problem increasing and is there a change in the age limit?

– There has definitely been an increase in the number of people with this health problem in recent years, and I can say that the age limit is dropping dramatically. We have had cases of operating on patients at the age of 19-20 with disc herniation, and this was not the case 10 to 15 years ago. I explain this fact by heredity, which is often underestimated as a factor, and the other by improper lifestyle and improper physical activity.

– What is your vision for the development of neurosurgery in Bulgaria?

– My teams in Pleven and Burgas work exactly as they work in the big university clinics in Europe and the USA. I have personally convinced myself during my visits to Switzerland, Germany, Great Britain, USA, etc. Their knowledge and skills are world class. Leading neurosurgeons who have chosen our clinics to present new technologies and innovative approaches regularly come here for inspections. For us, every method we apply must be as atraumatic as possible and the possibility of a rapid recovery for patients is paramount. We believe that only with appropriate investment in training and technology can we maintain a high standard of quality health care. It is important that we encourage young doctors to specialise in this field and provide them with opportunities for professional development.

– What would you like to say to the patients in Burgas who hope for your help?

-It is very important and a matter of honour for me to build trust and be there for them in every step of the treatment. My team and I will work hard to improve the quality of life of our patients.