How Successful Is Back Surgery for Sciatica?

Sciatica is a condition that causes pain, numbness, tingling, or weakness in the lower back, buttocks, and legs. It occurs when the sciatic nerve, which runs from the lower spine to the feet, is compressed or irritated by a herniated disc, spinal stenosis, or other spinal problems. Sciatica can affect quality of life, mobility, and function, and it may not respond to conservative treatments, such as medication, physical therapy, or injections. In some cases, such as when patients are in the last stages of sciatica, surgery may be recommended to relieve the pressure on the sciatic nerve and alleviate the symptoms. This article will discuss how successful back surgery for sciatica is and the factors that affect the outcome.

Types of Back Surgery for Sciatica

There are different types of back surgery that can be performed to treat sciatica, depending on the cause and location of the nerve compression. Some of the most common ones are:

• Microdiscectomy – A minimally invasive procedure that involves removing a small portion of the herniated disc that is pressing on the nerve root. This surgery is usually done for sciatica caused by a single-level disc herniation in the lower lumbar spine.
• Laminectomy – A procedure that involves removing part of the lamina, the bony arch that covers the spinal canal, to create more space for the nerve. This surgery is usually done for sciatica caused by spinal stenosis, a narrowing of the spinal canal due to degenerative changes, bone spurs, or ligament thickening.
• Foraminotomy – A procedure that involves enlarging the foramen, the opening where the nerve exits the spine, to relieve the nerve compression. This surgery is usually done for sciatica caused by foraminal stenosis, a narrowing of the foramen due to bone spurs, disc bulges, or arthritis.
• Fusion – A procedure that involves joining two or more vertebrae together with metal rods, screws, or cages to stabilize the spine and prevent further movement. This surgery is usually done for sciatica caused by spondylolisthesis, a condition where one vertebra slips forward over another, or for recurrent disc herniation or instability after a previous surgery.

Success Rate of Back Surgery for Sciatica

The success rate of back surgery for sciatica can vary depending on the type of surgery, the patient’s condition, and the definition of success. However, some general statistics are:

• According to a systematic review of 26 studies, the overall success rate of microdiscectomy for sciatica ranged from 78% to 95%, with an average of 88%.
• According to a randomized controlled trial of 501 patients, the success rate of laminectomy for sciatica was 64% at one year and 66% at four years, compared to 36% and 33% for nonsurgical treatment, respectively.
• According to a retrospective study of 60 patients, the success rate of foraminotomy for sciatica was 83% at one year and 80% at two years.
• According to a prospective study of 125 patients, the success rate of fusion for sciatica was 68% at one year and 65% at two years.

Factors Affecting the Outcome of Back Surgery for Sciatica

The outcome of back surgery for sciatica can be influenced by many factors, such as:

• The cause and severity of the nerve compression – Some causes, such as disc herniation or foraminal stenosis, may have a better prognosis than others, such as spinal stenosis or spondylolisthesis. The degree of nerve compression may also affect recovery and the risk of nerve damage or scar tissue formation.
• The patient’s age, health, and lifestyle – People who are older, obese, or smokers may have a lower success rate and a higher complication rate than those who are younger, leaner, or nonsmokers. Patients with other medical conditions, such as diabetes, heart disease, or osteoporosis, may also have poorer outcomes. Patients who are physically active, follow a healthy diet, and avoid smoking and alcohol may have better outcomes.
• The patient’s expectations and satisfaction – Patients who have realistic expectations and are satisfied with their surgery may have a higher success rate and a lower pain level than those who have unrealistic expectations or are dissatisfied with their surgery. Patients who are motivated and compliant with their post-operative care and rehabilitation may also have better outcomes.
• The surgeon’s skill and experience – Surgeons who are skilled and experienced in performing back surgery for sciatica may have higher success rates and lower complication rates than surgeons who are less skilled or experienced. Surgeons who use minimally invasive techniques, such as microdiscectomy or endoscopic foraminotomy, may also have better outcomes than surgeons who use open techniques, such as laminectomy or fusion.

Back surgery for sciatica can be a successful treatment option for patients who have severe, persistent, or disabling symptoms that do not improve with conservative treatments. However, the success rate of back surgery for sciatica can vary depending on the type of surgery, the patient’s condition, and other factors affecting the outcome. Therefore, patients should consult with their doctors and weigh the benefits and risks of surgery before making their decisions. Patients should also follow their doctor’s instructions and participate in their post-operative care and rehabilitation to optimize their recovery and prevent recurrence.

If you have had a discectomy or microdiscectomy to relieve sciatica caused by a herniated disc, you may experience recurrent sciatica if the disc becomes reherniated, which often occurs if there is a large hole in the outer ring of the disc after surgery. Fortunately, there is a new treatment available to help avoid this. Barricaid is a device shown to reduce the risk of reherniation by closing the hole in the disc after a discectomy, and 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in a 2-year study timeframe. This treatment is done immediately following the discectomy—during the same operation—and does not require any additional incisions or time in the hospital. 

To learn more about the Barricaid treatment, ask your doctor or contact us.

For full benefit/risk information, please visit: https://www.barricaid.com/instructions.