What is sciatica?

sciatica

Everyone has heard of sciatica, but few people know what it actually is – or isn’t. Sciatica is not a spinal condition, or a disease, but a set of symptoms associated with a variety of spinal conditions, characterized by irritation or compression of the sciatic nerve. The longest nerve in the body, the sciatic nerve extends from the base of the spine through the hips and buttocks and down the legs to the tips of the feet. Symptoms of compression or irritation of the sciatic nerve can include radiating pain, numbness, muscle weakness, a tingling sensation along the length of the nerve, and lower back pain.

Several spinal conditions can cause sciatica. A herniated disc or a ruptured disc in the lower back – the lumbar spine – can press against or leak fluid into the spinal canal, putting pressure on the sciatic nerve. Traumatic injuries such as car accidents or falls can cause compression or irritation of the sciatic nerve roots or the nerve itself. A slipped disc, or spondylolisthesis, can also cause sciatica if it impinges on any part of the sciatic nerve. Lumbar spinal stenosis – the narrowing of the spinal canal in the lower back – can also compress or irritate the sciatic nerve.

Conservative, non-surgical treatments typically include physical therapy, non-steroidal anti-inflammatory drugs (NSAIDs), and low-impact exercises. Alternative methods such as massage therapy, acupuncture, chiropractic adjustments, and acupressure may also be employed. However, surgery for sciatica, such as a discectomy or foraminotomy, may be required for relief of sciatica in the most severe cases of unrelenting and debilitating symptoms. Spinal decompression surgery relieves the pressure, and is often paired with spine fusion surgery to stabilize the spine after decompression. But fusion eliminates the independent mobility of the fused vertebrae. Now there’s an alternative spinal surgery proven to provide better clinical outcomes than fusion, which preserves the patient’s natural range of motion of the individual vertebrae – the TOPS Posterior Arthroplasty procedure. This is one of the exciting advances bringing new hope and treatment options to patients with moderate to severe spinal conditions that do not respond to conservative treatments. We at Premia Spine are on the forefront of developing advanced surgical treatments for spinal disorders. We encourage anyone with lower back pain to investigate all their treatment options.

Choosing a Spinal Surgeon

Surgeon

Choosing a spinal surgeon is among the most important medical decisions a patient can make. A spinal surgeon does more than perform an operation. A spinal surgeon consults with you, explains options and answers questions, and plans your treatment and recovery. You need to trust your spine surgeon, and to feel free to discuss all medical matters frankly.

You should choose a spinal surgeon who is board certified or board eligible, and trained in a fellowship program. If possible, choose a surgeon who specializes in the area of the spine that requires treatment– for example, a lumbar spinal surgery specialist if your problem is in the lower back. Alternatively, choose a spine surgeon who specializes in treating the specific condition affecting you, such as spondylolisthesis or spinal cord injuries.

Recent years have witnessed tremendous advances in treatment of spinal conditions, such as minimally invasive procedures that provide better outcomes than traditional open back surgery. It is essential that you choose a back surgeon that has experience with advanced procedures, to ensure you have access to the very latest treatments and the greatest spectrum of surgical options. For example, surgery to treat spinal stenosisslipped disc and a variety of other conditions that can result in pinched nerves, have often utilized spinal fusion back surgery as a means of stabilizing the spine, following spinal decompression therapy. Today the TOPS ™ (Total Posterior Solution) System provides a clinically proven superior alternative to spinal fusion surgery. Moreover, the TOPS implant preserves the full range of movement of the spine’s individual vertebrae, whereas spinal fusion eliminates the spine’s natural motion between fused vertebral segments. Examples like this illustrate why it’s important to work with a spine surgeon who can offer a complete range of surgical options. Thoroughly investigate all your treatment options as well as the qualifications of the specialists you consider working with, and you’ll be sure to make a wise choice when it comes to selecting a spinal surgeon.

What should I expect the day of my spinal surgery?

Day of Surgery

This is the big day, the day your spinal surgery will be performed and your back condition – be it facet arthrosis or lumbar radiculopathy – gets effective treatment. You’ve had your pre-operative appointment a day or so ago, and had your pre-operative physical assessment and other pre-operative workup. You’ve also met with an anesthesiologist team member to talk about your anesthesia.

Of course you’ve followed your orthopedic surgeon’s directions for the night before your back surgery. You didn’t eat or drink anything after midnight. You’ve consulted with your doctor about medications you are taking, and you’ve complied with all your physician’s directives. You prepared whatever you will bring with you last night, so you don’t feel rushed in getting to the facility at the appointed time. If there’s a keepsake that’s important that you want to bring with you – a ring for example – leave it at home.

If your family is coming with you, you already know where the waiting area is – they’ve probably seen it themselves – and you don’t have to worry about them. The staff will make sure they’re kept informed and comfortable. Following the surgery you will be taken to a recovery room. Much of what happens after the surgery – whether performed for a pinched nerve or an injury of the spinal cord – depends on factors including the severity of your condition, the effort you put into your post-operative physical therapy, and the surgical treatment you selected. Today advanced spine treatments are providing new options with better outcomes for some spinal surgery patients. Not all orthopedic surgeons are familiar with fully approved advanced surgical options such as the TOPS™ (Total Posterior Solution) System. TOPS is an approved implant that provides clinically proven superior outcomes to spinal fusion back surgery after spinal decompression therapy has been performed. Moreover, the spine’s natural range of motion is preserved with the TOPS System, unlike a spinal fusion procedure, which eliminates independent motion of the joined vertebrae, and can lead to deterioration of the adjacent vertebrae.

What’s most important to remember about your day of surgery, is all the care and thought you, your surgeon and your loved ones put into determining the best course of action. You’ve prepared, gotten ready, and now you’re finally moving forward! Congratulations!

Having a Pinched Nerve in Your Lower Back

Lower Back Pain

A pinched nerve can cause pain and restrict one’s mobility. The condition occurs when surrounding bone, muscle, cartilage or other tissue impinges on a nerve. Though pinched nerves can occur almost anywhere, the spine, and in particular pinched nerve in the lower back, or lumbar region, accounts for a significant percentage of cases. That’s because of the spine’s complex skeletal structure and the stresses placed on the lower back. This condition is referred to as a pinched lumbar nerve. Nerves of the lumbar spine extend throughout the pelvis, legs, pelvis and feet. The sciatic nerve, for example, is the longest nerve in the body, and a pinched sciatic nerve can cause a variety of pain, tingling, and other symptoms that are referred to as sciatica. Depending on the exact nerve and the extent of the pressure, a pinched nerve can cause symptoms from mild discomfort to sharp, shooting pains, tingling, weakness, loss of reflexes and motor skills, and atrophy, or withering of affected muscles.

If the pressure on the nerves is only temporary, the symptoms of pinched nerve will resolve on their own, and full functioning will return. When the condition fails to resolve without intervention, treatment options for pinched nerve therapy include rest, special exercises, manipulation to relieve pressure on the nerves, and medication to relax muscles and reduce inflammation of affected nerves. The best therapy is preventive. Pinched nerve and many other spinal problems can be avoided by maintaining good posture, remaining fit and at a reasonable weight, and avoiding unnecessarily straining the back. In cases where preventive or conventional therapies are ineffective, surgery for pinched nerve is an effective option.

Spinal decompression surgery is recommended for some patients who don’t respond to conservative treatments. Spinal decompression therapy can have a dramatic affect on relieving the symptoms of a pinched nerve in the lower back. Typically, spinal fusion back surgery is performed in conjunction with decompression surgery to stabilize the spine. Today, the TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion. Unlike spinal fusion, TOPS preserves the full range of the spine’s natural motion, and has been shown to provide better outcomes than fusion in clinical studies performed around the world. This represents a great new option for some individuals affected by pinched nerves in the lower back.