Before resorting to sciatica surgery it is in your best interest to consider all non-surgical options, such as, physiotherapy, lumbar traction, and living an active healthy lifestyle. This is because your body tends to heal itself better naturally rather than with invasive surgery. With that said, we should be grateful for the option of surgery because in critical situations this can save you from losing important bodily functions.
When to have Sciatica Surgery
After all non-surgical options have been exhausted especially physiotherapy and lumbar traction and still yet after months of treatment your symptoms persist you can begin to discuss your condition with a spine surgeon who will either encourage you to continue with non-surgical modalities or provide you with your surgical options. This is because sciatica pain relief is best done non-invasively.
Sciatica surgery typically will be considered immediately if the bulging disc in your back is deemed critical. This means you need to advise your doctor or physiotherapist immediately if you experience symptoms of numbness or pain in your groin area and/or loss of bladder or bowel control. If the symptoms are just in your leg and lower back then you should be doing what you can to recover and stop the condition from getting worse. The more your intervertebral disc bulges out the more your sciatic nerve gets pinched and it can literally choke the life out of it.
How Sciatica Surgery Compares to Lumbar Traction
Even if you are getting frustrated with your situation, avoiding surgery is by far your goal because it is the best way to get full pain free recovery. Using a lumbar traction device like the Saunders Lumbar Traction unit at home or with your physiotherapist would be a safe and non-invasive method.
Sciatica surgery on the other hand is invasive in that it is cutting through all your muscle tissue and tendons and even part of your bone in your back to get to the injured disc to take it out. Once that intervertebral disc is removed you will never have it again (it won’t grow back) and your chance of restoring its health with lumbar traction is over.
What is done in Sciatica Surgery
Typically in this type of surgery the whole intervertebral disc will be removed (referred to as a Discectomy) and the vertebrae above and below will either be screwed in place or fused together with a bone graft so that segment of your spine can no longer move. The result of removing the bulging disc is to take pressure off the sciatic nerve so it no longer will be getting pinched.
Artificial Intervertebral Disc
A new modality that you can ask your spinal surgeon about is the option of getting an artificial disc put in rather than fusing the vertebrae together. This will allow for more range of motion and allow for a more even distribution of weight. The artificial disc is designed to bend and twist. There are different types of artificial discs that you can ask your surgeon about, some with more range of motion and shock absorption than others.
Microdiscectomy vs. Discectomy Sciatica Surgery
Another method still in its infancy is microdiscectomy sciatica surgery that removes only the bulging portion of the herniated disc rather than the whole intervertebral disc. This surgery is less invasive then the full discectomy because the surgeon removes less tissue and makes a much smaller incision. The advantage of this surgery is that you get to keep your intervertebral disc rather than an artificial disc or no disc at all.
Risks Involved With Sciatica Surgery
Traditional sciatica surgery that involves fusing the bones together so the vertebrae above and below the site can no longer move is a risk to you in the future for developing another herniated disc above that site. This is because without the natural flexibility of this level the level above will have to compensate more and take more of the load when bending or lifting. In turn this added weight can make it easier for the intervertebral disc above to start to break down from this added wear and tear and lead to another herniation. There is also the risk of getting a different pain after the surgery that won’t go away.
With regards to the artificial disc rather than fusion there is always the risk of the artificial disc slipping out and then hitting your spinal cord. This, however, could only happen with high impact in most cases. Therefore you will be advised to refrain from high impact sports.
The risks involved with microdiscectomy are the potential for the disc to re-herniate after the surgery which is avoidable with proper care after surgery.
Recovery in any sciatica surgery is going to take at least six weeks of rest before gradually returning to full activities. Some people notice a clearing up of their sciatica right after surgery but the majority need a couple weeks to heal or longer depending on the severity and length of symptoms. Physiotherapy is highly recommended after surgery to regain strength in affected leg and increase flexibility. You will also need to practice proper body mechanics when lifting and bending. At this point it is important to focus on healing because blood supply to that area will be limited due to less movement it can take several months for scar tissue to develop in the area to fully protect it.
Take Into Consideration all your Non-Invasive Options
Before seriously deciding to take on sciatica surgery consider all you non-surgical options first. Even if you are frustrated with your situation there are a number of effective treatments that are helpful:
- Stretching and strengthening
- Physiotherapy with Intramuscular Stimulation (IMS)
- Lumbar Traction
When choosing lumbar traction, talk to your physiotherapist to see if their office has one for you to use or consider purchasing the Saunders Lumbar Traction for at home use. The goal of lumbar traction is to restore the shape and strength of your intervertebral disc that has been compressed and deformed from all the stress put on it over the years. The lumbar traction unit gently stretches the lumbar spine to increase the separation between your vertebrae. This then creates a suction that pulls in your damaged disc and gives your disc hydration and nutrients. Over a few weeks of use you will typically see a reduction in symptoms down your leg and an increase in your range of motion.
You can learn more about the Saunders Lumbar Traction device by clicking here.