Priv.-Doz. Dr. Christopher Becker is an experienced specialist in orthopedics and trauma surgery with a particular focus on spinal and pelvic pain. Since August 2024, he has been running his own practice, spectrum MED in the heart of Munich, while also serving as Head of Spinal Surgery at Artemed Klinikum Munich South. Dr. Becker has earned an excellent reputation, particularly for his expertise in minimally invasive pelvic ring and spinal surgery. His comprehensive understanding of the complex anatomy and function of the pelvis enables him to deliver precise and individualized treatment for a wide range of pain syndromes, including postpartum symphysis pain, sacroiliac joint disorders, and coccyx pain.
In addition to his clinical work in a modern, interdisciplinary setting, Dr. Becker places great importance on patient-centered care. His treatment concepts combine innovative minimally invasive techniques with a holistic approach that encompasses surgical, conservative, and rehabilitative measures. Restoring his patients’ quality of life is always his top priority. Through his involvement in numerous professional societies and expert groups, Dr. Becker stays up to date with the latest scientific developments and continuously integrates current insights into his work. This way, he merges medical excellence with empathetic care, creating the best conditions for successfully treating spinal and pelvic pain. In a conversation with the editorial team of the Leading Medicine Guide, Dr. Becker shared insights into modern spinal surgery, especially for patients with back pain.
Back pain is among the most common complaints worldwide and can significantly impact quality of life. Modern spinal surgery now offers a variety of gentle treatment options to specifically relieve pain and restore spinal function. Thanks to minimally invasive techniques and innovative procedures, many patients recover more quickly and return to their daily routines sooner. The focus is always on individualized therapy that addresses both the underlying causes of the symptoms and the patient’s specific needs.
Diagnosing back pain is a complex task because its causes can vary greatly — from muscular tension and disc disorders to degenerative or inflammatory changes in vertebrae, joints, or nerve structures.
“Most patients initially come to us because of back pain — some also experience leg pain. In such cases, a thorough medical history is crucial, as many clues can already be derived from it. For example, whether there have been previous blockages in the sacroiliac joint or the facet joints. In the subsequent clinical examination, it usually becomes clear quite quickly in which direction the complaints are pointing. If the symptoms have been present for a longer time, I generally order an MRI of the lumbar spine — that’s my standard. This allows us to assess the soft tissue structures: facet joints, ligaments, sacroiliac joint — all of these can be visualized well. In most cases, this already provides a clear indication of the cause of the complaints. Based on this, I then discuss with the patients which treatment options are available — especially in the area of interventional procedures, which is one of our specialties. And, of course, also surgical options, especially since there is now a great deal that can be done in the field of minimally invasive spinal surgery“, explains Dr. Becker.
Before considering surgical therapy, conservative treatment is always the first step. This includes physiotherapy exercises to strengthen the core muscles, posture training, movement programs, and manual therapy. Additional physical measures such as heat or cold applications, electrotherapy, shockwave, or ultrasound can be used. Pain medications — from NSAIDs to muscle relaxants to centrally acting substances — are tailored individually, and early interdisciplinary pain therapy often achieves more lasting effects, particularly for chronic pain. Rehabilitation concepts or multimodal programs also incorporate psychotherapeutic elements to holistically support the patient. Only when these conservative approaches fail to provide sufficient improvement after weeks or months, or in cases of acute, severe symptoms such as paralysis, gait disturbances, or bladder and bowel dysfunction, is surgical therapy considered. The goal is always to choose the treatment method that is best suited to the individual — ideally minimally invasive, tissue-sparing, and aimed at a swift restoration of mobility and quality of life.
Patient factors such as age, pre-existing conditions, or lifestyle play a central role in deciding for or against surgical treatment in spinal surgery. The individual’s physical condition and functional reserve significantly influence the risk assessment and the choice of surgical procedure.
A patient’s biological age — not just their calendar age — is often decisive: while a fit 75-year-old with good cardiovascular function and an active lifestyle may well be a candidate for minimally invasive surgery, a significantly younger but severely multimorbid patient with impaired organ function may carry a much higher risk of complications. Typical comorbidities such as diabetes mellitus, cardiovascular disease, osteoporosis, or chronic lung disease not only affect surgical and anesthesia suitability but also healing and infection susceptibility after the procedure. Lifestyle also has a considerable impact: severe obesity can complicate the technical performance of the surgery and delay postoperative recovery, while a high level of physical activity and good muscular condition support rehabilitation.
“Especially in certain back pain patients, minimally invasive procedures should be deliberately considered — meaning interventions that are particularly gentle, require only short operating times, and involve a brief hospital stay. One important factor influencing healing is lifestyle. Particularly prolonged sitting — such as in office work — negatively affects prognosis, especially after surgeries like a herniated disc operation. If patients return to long hours of sitting daily immediately afterward, it can significantly impair the healing process. Smoking also plays a role — especially in larger procedures like fusion surgeries. We now know that smoking can disrupt bone healing by negatively affecting blood flow and microcirculation. In procedures where, for example, an implant in the disc space is meant to fuse, smoking can greatly reduce the chances of successful healing. That’s why many doctors — depending on the procedure — advise their patients to quit smoking. In some countries, like the U.S., this is even a prerequisite for certain surgeries“, emphasizes Dr. Becker.
In addition to medical factors, personal expectations, professional and social demands, and the motivation to actively participate in aftercare also play a role. A patient who wants to return to physically demanding work as soon as possible or is very active in sports has different requirements for the stability and resilience of their spine compared to someone with a predominantly sedentary lifestyle. Therefore, the decision for surgery is never based solely on imaging findings or standardized algorithms but always on a careful, individually tailored risk-benefit assessment. An interdisciplinary approach that also considers internal medicine, rehabilitation, and psychosocial aspects is essential to finding the optimal therapy for each patient.
Dr. Becker notes, “Before it even comes to spinal surgery, the question arises as to when a procedure is not possible at all. From a surgical perspective, there are only a few exclusion criteria. Significant limitations usually result more from the patient’s general condition — such as severe cardiovascular disease or severely impaired lung function. In such cases, anesthesiologists often decide that surgery would be too risky. Purely surgically, most procedures — including minimally invasive ones — are often still conceivable. Only in cases of pronounced deformities might surgery also be ruled out from a surgical perspective“.
Modern spinal surgery increasingly relies on minimally invasive techniques that differ significantly from conventional open surgical procedures in several key aspects. The goal of these techniques is to make the intervention as gentle as possible for the patient — with equal or even improved therapeutic effectiveness.
Instead of large skin incisions and extensive muscle detachment, minimally invasive procedures are performed through tiny skin incisions using special instruments and imaging. Often, a so-called tubular retractor (a small tube) is used, through which microsurgical instruments and a camera are inserted.
“Today, many spinal procedures can be performed minimally invasively — this also applies to more complex surgeries like fusions. Still, not every patient is automatically suitable for this method. Overall, the proportion of minimally invasive procedures is increasing significantly, mainly due to the advancement of corresponding instruments. In about 70 to 80 percent of cases, this gentle technique is already being used. The advantage for patients: hospital stays are often short — usually two nights, and about four for fusions. The overall strain is much lower than it used to be. Many patients today are more relaxed about spinal surgeries. Nevertheless, it remains important to speak openly about potential risks — even though serious complications like paralysis now occur very rarely. Thanks to modern, standardized techniques and continuous advancements, spinal surgery is now considered a very safe field“, states Dr. Becker.
Interdisciplinary collaboration between surgeons, pain specialists, and physiotherapists plays a central role in the success of spinal treatments. Back pain and spinal disorders are complex conditions that can rarely be fully addressed by a single therapeutic measure alone.
“We have a very well-established interdisciplinary collaboration. In our practice, we work closely with pain specialists and maintain regular communication with physical medicine specialists — a network that also stems from our time at the university hospital. We also have close ties to visceral and vascular surgery, especially when it comes to differential diagnostic evaluations — for example, determining whether complaints originate from the groin, are caused by circulatory disorders in the legs, or stem from a disc problem. Such interdisciplinary assessments are routine for us“, emphasizes Dr. Becker.
The surgeon assesses the structural cause of the problem and selects the surgical method, pain specialists ensure individually tailored pain management before and after the procedure, and physiotherapists guide early mobilization and long-term functional rehabilitation. Together, this creates a holistic, patient-centered therapy concept. This coordinated teamwork not only improves clinical outcomes but also enhances patient satisfaction. Ultimately, it is this interdisciplinary approach that defines modern spinal medicine — with the goal of not just operating but sustainably restoring quality of life.
Postoperative care after spinal surgery is a crucial component of treatment success and begins immediately after the procedure. The aim is to promote healing, avoid complications, and best support the return to daily life.
Dr. Becker explains, “Our postoperative care is structured and well organized. It’s important to us that patients return after the procedure because we want to closely monitor the healing process and personally assess the surgical outcome. We have standardized processes for this: two weeks after surgery, we reach out — in-person for local patients, often by phone for those who traveled farther. Our follow-up care plan also includes fixed appointments: after two weeks, six weeks, and three months. Further therapy, especially when to start physiotherapy and which exercises are appropriate, is individually tailored based on the current findings and the patient’s condition. For larger procedures like a fusion, it typically takes about two to three months before patients are fully load-bearing again and can manage their everyday lives — including normal work demands — well“.
Many back issues cannot be attributed solely to diseases — in some cases, genetic factors also play a role. There are congenital malformations or predispositions, such as connective tissue weakness, that can increase the risk of disc herniations.
“One example is Bertolotti’s syndrome, a frequently overlooked transitional anomaly in the lower spine that is congenital and can cause back pain. Overall, however, such congenital causes are relatively rare and are usually not the focus of spinal surgery — more severe malformations, such as in young patients with cerebral palsy, belong in specialized centers. Much more often, back pain is the result of lifestyle factors. Lack of exercise, years of sitting — for example, in office jobs — and poor back muscle conditioning are widespread causes. People with predominantly sedentary activities almost inevitably develop complaints over the years. Simple measures like regular standing breaks, stretching exercises, ergonomic workstations, or targeted muscle strengthening could help prevent or at least slow down wear and tear. Particularly the targeted strengthening of the back and abdominal muscles is often neglected — yet a strong muscular support corset plays a crucial role in spinal health“, advises Dr. Becker.
At spectrum MED Munich, everything is under one roof!
“We offer pain therapy, work closely with physiotherapists, and cover the full spectrum: from simply prescribing physiotherapy to infiltrations and interventional procedures. One example is laser treatment on the disc — a method that lies between an injection and an operation. We try to implement as much as possible directly in our practice rooms before even considering surgery. If it does come to that, we work with specialized partner clinics. When it comes to surgery, ideally, you should turn to experienced specialists — to doctors who perform such procedures regularly. That makes a big difference. We repeatedly see cases where patients underwent procedures where the necessary routine was apparently lacking. That’s why the growing formation of specialized centers is absolutely sensible — and precisely where patients should seek treatment,“ recommends Dr. Becker, and with that, we conclude our conversation.
Thank you very much, Dr. Becker, for these valuable insights!
