Oftentimes, surgery isn't the first option with sciatica—referring to compression or irritation of the sciatic nerve, which starts in the lower back area. However, if other treatments aren't effective or symptoms are severe and potentially life-threatening, surgery may be recommended. This article discusses the options and considerations related to surgery for sciatica.
Factors to Consider
There is no one "best" surgery for sciatica, since there are many patient-specific factors to consider. The benefits you gain from surgery depend on the circumstances that apply to your situation. Typically, surgery options recommended for sciatica-related issues are based on:
• The causes of pinching or irritation of your sciatic nerve
• The nature and severity of your symptoms
• Your overall health and goals with surgery
The most common type of surgery performed for patients with sciatica is a discectomy. The reason this procedure is recommended so often is because roughly 90 percent of the time, sciatic nerve irritation is related to a herniated disc in the lower back area. According to Spine Universe, a discectomy or a less invasive microdiscectomy results in significant symptom relief for anywhere from 80 to 95 percent of patients with sciatica. Today, it is typical for a discectomy to involve only removing enough of the protruding disc material to relieve pressure on the nerve. This is done to preserve range of motion in the affected area and avoid the need for fusion surgery.
While a herniated disc is often the source of sciatica, some patients have sciatica related to a lamina. The lamina is the back part of a spinal bone that plays a role in protecting the spinal canal. In some instances, this structure is abnormally narrow or affected in some other way that contributes to sciatic nerve irritation. Surgery to address anything involving the lamina is referred to as a laminectomy. With this procedure, all or part of this vertebral bone is removed. It is more common for older patients to need this type of surgery.
When to Consider Surgery
Sciatica patients are usually advised to try a variety of nonsurgical remedies first before surgery is discussed. That being said, surgery for sciatica is more likely to be suggested under the following circumstances:
• Conservative treatments haven't worked for several months
• Motor or sensory function is lost due to compression of a group of nerves known as the cauda equina
• Sciatic nerve irritation is related to a spinal tumor
• There is extreme difficulty with mobility and lower body sensations, which is more likely to be the case with bilateral sciatica affecting both legs
When Surgery Isn't Recommended
There has to be a structural source of your sciatica for surgery to be recommended, which is the case with any type of spine surgery. If your sciatica is caused by muscle irritation, surgery would not be recommended. This is why it is important to get an accurate diagnosis as soon as symptoms that could be related to sciatica are noticed.
Patients who have had discectomies for herniated discs may experience sciatica if their discs become reherniated, which often occurs if there’s a large hole in the outer ring of the disc after surgery. Fortunately, there’s a new treatment shown to reduce the risk of reherniation by closing the hole in the disc after a discectomy. This treatment is done immediately following the discectomy—during the same operation—and doesn’t require any additional incisions or time in the hospital. Barricaid was proven 95 percent effective in a study of over 500 patients, meaning 95 percent of patients didn’t experience a reoperation due to reherniation in the 2-year study timeframe.
If you have any questions about the Barricaid treatment, ask your doctor or contact us at 844-288-7474.
For full benefit/risk information, please visit: https://www.barricaid.com/instructions.