Sciatica Surgery Overview: What You Need to Know in 2024
Thursday, August 22, 2024
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Sciatica Surgery: Everything You Need to Know [2024 Guide]
Sciatica is caused by irritation of the nerve roots in the lower and lumbosacral spine. The nerve roots may be pinched by the narrowing of their pathway, also known as foraminal stenosis, which irritates the nerves and causes pain and other sciatica symptoms, such as weakness, numbness, and shooting pain.Deuk Spine Institute performs a minimally invasive sciatica surgery with a 99.6% success rate, no hospital stay, and does not damage the spine. This advanced treatment, Deuk Laser Disc Repair, is so successful patients travel from across the US and the world to have their sciatic nerve surgery here.
Sciatica may only affect one side of the body, usually in the legs and buttocks. The pain will radiate down the thigh and into the legs and feet or toes depending on the specific location of the irritation that is causing the sciatica. Numbness in the feet or toes is common in more severe sciatica cases and is commonly described as a tingling sensation in the feet or toes such as when your foot “falls asleep.”
Pain from sciatica can be sporadic and range from mildly discomforting to agonizing. For some, the pain is described as debilitating, even affecting bowel and bladder function in severe cases.
To learn more about sciatica symptoms, watch the video below:
Can Surgery Relieve Sciatic Pain?
Yes, surgery can indeed relieve sciatic pain, particularly for those patients whose pain has not improved with non-surgical treatments or those experiencing severe symptoms like weakness, loss of bowel or bladder control, or severe pain.
Surgery usually involves removing the part of the herniated disk or bone spur that’s pressing on the sciatic nerve. This option is generally considered only after non-surgical treatments have failed to provide relief. Non-surgical options to check out before considering surgery include medications, physical therapy, and steroid injections aimed at reducing inflammation and pain.
What exactly is sciatica?
Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body. It occurs when the sciatic nerve is irritated or compressed by a variety of possible causes, including a herniated disk, bone spurs on the spine, or narrowing of the spine (spinal stenosis), leading to inflammation, pain, and often some numbness in the affected leg.
The pain associated with sciatica can vary widely, from a mild ache to a sharp, burning sensation or excruciating discomfort. Sometimes it can feel like a jolt or electric shock.
Sciatic pain often starts gradually and intensifies over time. It might be worsened by sudden movements, such as coughing or sneezing, and prolonged sitting can aggravate symptoms.
Sciatica symptoms
- Pain in the buttocks or the leg that may get worse when sitting
- Weakness, numbness, or difficulty moving the leg or foot
- Burning or tingling down the leg
- Constant pain on one side of the rear
- Shooting pain down the leg
Common causes of sciatica
- Lumbar spinal stenosis (pinched nerve from foraminal narrowing in the lower back)
- Degenerative disc disease (breakdown of discs or the shock absorbers in your back)
Types of Surgery for Sciatica
The following are the types of surgery for sciatica:
Minimally invasive surgery for sciatica
Traditionally, the only way to get sciatica pain relief was with invasive spine surgery. Today, patients have a better treatment for severe sciatic nerve pain. Deuk Spine Institute’s advanced sciatica surgery, Deuk Laser Disc Repair, is a minimally invasive proprietary method that uses an endoscope to see and repair the problem. It has a 99.6% success rate, doesn’t damage the bone, and leaves a small quarter-inch scar.
Unlike other methods that call for cutting bone and weakening the spine, or large surgical incisions that can lead to painful scarring, the Deuk endoscopic method can repair your sciatica and minimize recovery time, in some cases reducing recovery time to less than a week!
No hospital stay is required, vastly reducing the risk of infection, and the surgery is done on-site to keep hassle to a minimum for our valued patients. Patients leave our facility the same day to recover in the comfort of their own homes.
Deuk Laser Disc Repair has been used to treat over 2,000 patients with a 99.6% success rate.
Get a free MRI review from our team to see if you are a good candidate for Deuk Laser Disc Repair.
Laminectomy
Frequently performed alongside a Foraminotomy and/or traditional spinal fusion, a Laminectomy involves removing parts of the lamina in the spine that may be pressing on the spinal cord or spinal nerves.
Often requiring a large incision and the retraction of muscle, skin, and ligaments, Laminectomy surgery allows surgeons to alleviate pressure on the spinal cord or nerves by excising the lamina bone or bone spurs. The downside of this approach is the collateral impact on soft tissues in the vicinity to access the affected area.
Laminectomy is undertaken as a remedy for Spinal Stenosis, which typically arises as the body ages, causing the spinal canal to narrow and exert pressure on crucial spinal nerves. Spinal stenosis is termed cervical stenosis when it is found in the neck region, thoracic stenosis in the mid to upper back, and lumbar stenosis in the lower back.
Foraminotomy
In traditional spine surgery scenarios, a Foraminotomy is considered a significant open-back surgery aimed at addressing foraminal narrowing. This procedure requires an incision along the length of the targeted area to reach every vertebral level that’s experiencing nerve compression.
Nerves traveling through the foramen can become pinched when a disc protrudes into the foraminal space or when bone spurs constrict the passageway, leading to neurological symptoms such as numbness, tingling, weakness, and pain. To alleviate these symptoms, surgeons frequently carry out a Foraminotomy to eliminate the pressure on the nerve within a narrowed foramen.
Discectomy
There are two main types of discectomy surgery available to patients: an open discectomy or a microdiscectomy. Compared to endoscopic laser spine surgery, a discectomy is generally more invasive, leading to increased complications, more postoperative discomfort, a longer period of recovery, and greater formation of scar tissue.
The key difference lies in that an open discectomy entails a more significant incision, and removal of a larger amount of normal spinal bone and ligaments, resulting in more scar tissue and discomfort than a microdiscectomy.
This method also presents a heightened risk of causing nerve damage to the vertebrae’s adjacent nerves. Additionally, the spinal column may become unstable from the removal of bones, ligaments, and facet joints, necessitating a spinal fusion post-discectomy to restore stability to the spinal column, thus slightly extending the patient’s recovery period.
A discectomy is conducted using an “open” technique, characterized by the surgeon making a larger incision compared to the smaller one utilized in less invasive techniques, such as a Microdiscectomy.
Microdiscectomy
A microdiscectomy and a discectomy surgery both aim to remove all or part of a problematic intervertebral disc. While a discectomy employs an open surgical approach, a microdiscectomy involves a smaller skin incision and utilizes a microscope for precision.
Microdiscectomy, also known as micro decompression, targets patients experiencing sciatica due to herniated lumbar discs. The herniation of a lumbar disc can lead to a broad spectrum of painful symptoms by exerting pressure on the spinal nerves.
In a microdiscectomy procedure, it’s the disc’s inner nucleus that herniates between the vertebrae. Herniation occurs through an annular fissure, where the disc’s tough outer layer (annulus) fractures, creating room for the soft central part (nucleus) to protrude and press on adjacent spinal nerves.
During the microdiscectomy, the surgeon creates a minor incision over the impacted spinal area. The muscle is then detached from the spine, and an endoscope (a microscope with a camera) is utilized to excise bone and ligaments to reach and remove the herniated disc material. This alleviation of the herniated tissue from the surrounding nerves is meant to eliminate the patient’s pain or numbness in the legs.
This surgery involves the partial removal of the spinal facet joint, potentially causing significant spinal instability. Such instability might leave patients with residual back pain, potentially necessitating further interventions.
Spinal Fusion
The spine’s anatomy features disc spaces at the front and paired facet joints supporting it from behind. These components enable daily movement but can sometimes cause pain, necessitating spinal fusion surgery.
This surgery aims to merge two vertebral segments to halt the movement of vertebrae responsible for discomfort. Mimicking the body’s natural bone healing, spinal fusion was developed to emulate this repair process. Often, surgeons will perform a laminectomy in conjunction with spinal fusion, as the latter does not inherently decompress the spinal column.
During fusion, a bone graft is positioned between the vertebrae, which, over 3-6 months, will “fuse” or integrate the vertebrae into a single bone unit. The bone graft might be sourced from the patient’s hip bone during surgery, from a cadaver, or in some cases, it might be synthetic. Bone grafts, while essential, have been known to introduce complications into spinal surgeries, making it imperative to discuss potential risks with your surgeon.
If the bone graft successfully integrates, the vertebrae fuse into one continuous bone, eliminating vertebral motion and subsequently pain. To facilitate a successful fusion, surgeons may use metal plates, rods, or screws during the procedure to maintain proper healing alignment. Techniques to foster a biological response that encourages bone growth between the vertebrae, leading to eventual bone fusion, are also employed by surgeons.
More About Sciatica Surgery
This section contains everything you need to know about Sciatica Surgery.
Risks of Sciatica Surgery
The risks associated with sciatica surgery vary with the surgical procedure, but some of the most common risks include infection, nerve damage, spinal fluid leaks, and the formation of scar tissue.
More invasive surgeries carry a higher risk of these complications. A particularly concerning outcome is failed back surgery syndrome (FBSS), where patients continue to experience pain after surgery.
Procedures such as Deuk Laser Disc Repair have a 99.6% success rate. While the complication rate for cervical fusion is between 25-50% and the complication rate for lower back and basic spine surgery is between 5-50%, Deuk Laser Disc Repair has a complication rate of 0%.
Sciatica Surgery Side Effects
Side effects from sciatica surgery can range from temporary to long-lasting and vary depending on the type of surgery performed.
Common side effects can include:
- Pain at the Surgery Site: Patients often experience pain around the incision area. While this is typically temporary, it can be significant immediately following surgery.
- Nerve Damage: There’s a risk of accidental nerve damage during surgery, which can lead to weakness, pain, or loss of sensation in the legs or feet.
- Scar Tissue Formation: Scar tissue can develop around the nerve roots and may lead to persistent pain after surgery.
- Infection: As with any surgery, there’s a risk of infection at the incision site or within the spine itself.
- Spinal Fluid Leaks: Surgery on the spine can sometimes lead to leaks of spinal fluid, which may require additional procedures to correct.
- Recovery Complications: Some patients may experience difficulties in the recovery process, including prolonged pain, limited mobility, or the need for further surgical or non-surgical treatments.
The common side effects can be mitigated by choosing a minimally invasive surgery like Deuk Laser Disc Repair which has a 99.6% success rate and 0% complication rate.
Recovery Time for Sciatica Surgery
Recovering from sciatica surgery is complex and varies significantly based on the type of surgery and adherence to postoperative guidelines. Not following a doctor’s advice can delay recovery. Despite perfect adherence, surgeries like discectomy, foraminotomy, and laminectomy can still fail due to re-herniation or new disc herniation near the surgical site.
Spinal fusion, in particular, may lead to accelerated degeneration in adjacent spinal levels, potentially necessitating further surgeries. The success of sciatica surgery greatly depends on accurate diagnosis and the surgeon’s skill.
How Effective is Sciatica Surgery?
Sciatica surgery can be an effective treatment for sciatica, but it is not always the first course of action. In general, surgery is considered after non-surgical treatments, such as physical therapy and medication, have failed to provide relief.
The effectiveness of sciatica surgery can vary depending on the severity of the condition and the type of surgery performed.
Deuk Laser Disc Repair is the most effective surgical procedure for curing Sciatica. It has a 99.6% elimination of disc pain.
Sciatica Surgery Cost
The cost of sciatica treatment varies widely, especially when it comes to surgery. For patients without health insurance, surgery costs can range from about $20,000 to $90,000 or more, depending on the procedure and facility.
Even with health insurance, patients may face significant out-of-pocket expenses, including copays and coinsurance. It’s important to consider all potential costs, including medications and physical therapy, which can add to the overall expense of treatment.
Is Sciatica Surgery Dangerous?
While sciatica surgery, like any surgical procedure, carries risks, including nerve or spinal cord damage, infection, and the potential for continued symptoms post-surgery, it’s considered safe when performed by experienced surgeons.
The decision to undergo surgery depends on the severity of symptoms, other health conditions, and failed responses to nonsurgical treatments. The specific risks vary by the type of surgery performed.
Procedures such as Deuk Laser Disc Repair have a 0% complication rate and a 99.6% success rate.
Long-term Outcomes after Sciatica Surgery
Long-term outcomes after sciatica surgery suggest that while surgery may provide a significant reduction in pain and improvement in function for up to 1 year compared to nonsurgical treatments, the benefits may diminish over time. In the long term, spanning 4 to 10 years, the results for surgical and nonsurgical approaches usually converge, indicating that the advantages of surgery might not be permanent for all individuals.
How Do You Know If You Need Surgery for Sciatica
Determining the need for sciatica surgery involves considering several factors:
Who is a Good Candidate for Sciatica Surgery?
Ideal candidates have not found relief from non-surgical treatments, experience significant pain that affects daily activities, and have diagnostic imaging confirming nerve compression.
How is Sciatica Affecting Your Quality of Life?
Sciatica can significantly impact your quality of life, manifesting as persistent and sometimes debilitating pain that radiates from the lower back down through the leg, affecting mobility and daily activities.
The condition often leads to discomfort during prolonged periods of sitting or standing, making routine tasks and work commitments challenging to maintain. The constant pain can also interfere with sleep, leading to fatigue and affecting overall well-being. Furthermore, sciatica can limit physical activity levels, reducing engagement in exercise and recreational activities, which are vital for physical and mental health.
Which Treatments Have You Already Tried?
Before surgery, treatments like physical therapy, medications, and possibly steroid injections should be attempted. Surgery is usually the last resort after these treatments have failed to provide adequate relief.
Get a Free MRI Review to See If You’re a Candidate for Sciatica Surgery
Are you or a loved one experiencing severe sciatica symptoms like weakness or numbness in the foot, tingling, or shooting pain down the leg? At Deuk Spine Institute, our focus is on healing your pain permanently, not just offering temporary relief. We recognize the significant impact of a doctor’s expertise and care approach on your recovery process. That’s why we’re dedicated to providing treatments that seek to permanently eliminate your pain.
Start your treatment with us today by submitting your MRI online for a free remote review to determine your candidacy for surgery. During a Deuk Spine MRI review, you will be asked to include both your actual MRI images (DICOM format strongly preferred) and the report. Once this is done, Deuk Spine Institute and our team of doctors will review it and provide a customized plan on how to eliminate your pain.