Description
Sciatica is the irritation of the largest nerve in the body, the sciatic nerve. The sciatic nerve begins with several nerves in the lower back and travels down the legs. This irritation can stem from a disc herniation, inflammation, bone spurs or foraminal stenosis. Pain occurs when any or all of these conditions compress the nerve roots or spinal cord.
Symptoms
- Irritation in one leg often down to the foot
- Shooting leg pain
- Weakness or numbness
- Burning leg pain
- Pain is usually worse when sitting
Causes
- Degeneration or rupture of a disc
- Development of bone spurs or thick ligaments
- Normal aging process
- Sudden twisting
- Episode of heavy lifting
- Other physical trauma
Possible Treatment Options
Non Operative Treatment
Medications, physical therapy or spinal cortisone injections are indicated for pain relief. Surgery can be considered for those who do not improve.
Decompression
This surgical procedure involves removing all or portions of the lamina, removing bone spurs and/or enlarging foramina to relieve pressure or compression on the nerve roots or spinal cord. This pressure is often the cause of the pain.
Decompression & Posterolateral Fusion
Often times, in addition to a decompression, your surgeon will perform an instrumented posterolateral fusion by inserting a series of screws and rods coupled with the placement of bone graft. This fusion provides increased spinal stability.
Anterior Lumbar Interbody Fusion (ALIF)
The surgical approach is from the front of the abdomen. Once the exposure is made, surgical instruments are used to remove the disc material causing the nerve compression. Once this material is removed, an interbody cage or bone spacer is placed at the disc site filled with bone graft. The vertebral bodies above and below are frequently put under compression to aid in the subsequent spinal fusion.
Posterior Transforaminal Interbody Fusion
The same procedure as the ALIF but the approach and exposure are performed from the back. Just as in an ALIF, the disc material is removed and an interbody device is inserted. Compression through the use of pedicle screws is frequently achieved to aid in fusion.
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