What is sciatica?
Sciatica is a term used to describe the presence of symptoms affecting the low back and legs. Symptoms are caused by an irritation or compression of one or more of the nerve branches in the lower back that join to form the larger sciatic nerve. The sciatic nerve may also be compressed by muscles as it extends down the leg.
Often originating in the spine, sciatica can have several different causes. They include:
What are the symptoms of sciatica?
Symptoms of sciatica can include:
- Pain in the buttock (usually only on one side), which often increases with sitting
- Burning, tingling, or searing pain in your leg
- Weakness, numbness, or difficulty moving the leg or foot
How is sciatica diagnosed?
To diagnose sciatica, your physician will review your health history and perform a physical examination. Your doctor may also recommend diagnostic imaging, such as an X-ray or MRI, to assist in diagnosis.
How is sciatica treated nonsurgically?
Most people find relief from their sciatica with nonsurgical methods. These treatments include:
What are the surgical treatment options for sciatica?
If you are not finding relief from your sciatica with nonsurgical methods, it may be time to consider surgery. The specific surgical procedure your doctor recommends will depend on what is causing your sciatica symptoms.
Common surgical options to relieve sciatica include:
- Disc replacement surgery
- Lumbar Interbody fusion (transforaminal lumbar interbody fusion, oblique lumbar interbody fusion, or anterior lumbar interbody fusion)
- Decompression surgeries, including laminectomy and foraminotomy
The most common surgery for herniated discs is called a “microdiscectomy.” In this surgery, a one- to two-inch incision is made in your spine on the side of the herniation. The surgeon then finds the herniation and removes the herniated piece. The surgery usually lasts about one to two hours, and many people feel better right upon waking up.
Disc replacement surgery
Disc replacement is most effective when the source of the pain is contained in the disc and the disc alone, and when the patient meets other qualifications, including a healthy weight, no prior major spine surgery, and no deformity in the spine.
More resources on disc replacement surgery:
- Read the article: Benefits of Cervical Disc Replacement
- Summit Orthopedics: A Leader in Total Disc Replacement Surgery
- Get the question answered: Who Is a Good Candidate for Disc Replacement Surgery?
Lumbar Interbody Fusion
The goal of a transforaminal lumbar interbody fusion (TLIF) is to restore spinal stability.
How is a TLIF performed?
- First, your surgeon will make a small incision in the skin of your back over the vertebra(e) to be treated.
- After the spine is accessed, the lamina (the “roof” of the vertebra) is removed.
- The facet joints, which are directly over the nerve roots, may be trimmed to give the nerve roots more room.
- The nerve roots are then moved to one side and the disc material removed from the front (anterior) of the spine.
- A bone graft is then inserted into the disc space. The bone graft material acts as a bridge, or scaffold, on which new bone can grow.
- Screws and rods are inserted to stabilize the spine while the treated area heals and fusion occurs.
- Your surgeon will then close the incision.
The goal of laminectomy is to relieve the pressure on the spinal nerves that is causing your symptoms.
How laminectomy works
- Your orthopedic surgeon will make an incision near the center of your spine.
- Through this incision, any bone spurs and damaged disc material are removed.
- Then, the incision is closed with sutures.
- As you heal in the weeks following surgery, the muscles and ligaments of the back will fill in the space where the lamina used to be.
Summit Orthopedics offers comprehensive spine expertise
Summit’s spine care team is recognized by the National Committee for Quality Assurance for the comprehensive expertise of our patient-centered care. Our back specialists diagnose spine problems and design custom treatment plans built on a conservative, nonsurgical approach. Most patients find relief through treatments including guided injections, specialized physical therapy, biofeedback, exercise, activity modification, and medication. When conservative care does not relieve symptoms, our highly skilled surgeons offer proven, evidence-based surgical options. Together with you, we will determine the right course of action.
Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MN, Vadnais Heights, MN, and Woodbury, MN, as well as additional community clinics throughout the metro and southern Minnesota.
More resources for you:
When you have pain caused by a pinched nerve, it can be challenging to evaluate your treatment options. Although nonsurgical treatment is effective for 90 percent of spine pain, there are some specific conditions that are best treated by surgery.
Radiculopathy is a spinal nerve root condition caused by nerve compression, inflammation, or injury that can trigger back and leg pain. When this injury is located in the lower part of the spine, it is called lumbar radiculopathy. Spine surgeon Dr. Wills explains how lumbar radiculopathy is diagnosed.
Our nerves transmit information to our brains. Spine surgeon Dr. Nicholas Wills reviews the relationship between our nerves and our spinal cord, and explains how pressure can disrupt nerve function, causing arm or leg pain.