Many patients find that surgery provides effective relief from their painful sciatica symptoms. However, that doesn’t mean there is a single surgery that works for everyone.
Here is why surgery for sciatica is not one-size-fits-all:
Do I need surgery for my sciatica symptoms?
Before we look at why sciatica surgery is not one-size-fits-all, let’s quickly examine the indications for surgery. While this list is not exhaustive, surgery may be an option for you if any of the following statements apply to your symptoms:
- Your leg and/or foot pain is severe and has lasted for more than 4 to 6 weeks.
- You have exhausted appropriate non-surgical treatment options. These may include physical therapy, oral medications, and injections.
- Your functionality is significantly limited. For example, you may no longer be able to complete your daily responsibilities at your job.
However, it is important to remember that surgery for your sciatica symptoms is typically a personal choice. In tandem with your team of medical professionals, you should discuss all of your available options—as well as the various possible outcomes with surgery.
Sciatica is caused by a number of underlying conditions
You might be surprised to learn that sciatica is not a medical diagnosis, but rather a symptom of an underlying lower back disorder. There are numerous lower back conditions that can lead to sciatica, and so there is no one-size-fits-all surgery.
Rather, surgery for sciatica symptoms must address the specific underlying cause of your symptoms. Two of the most common surgeries for sciatica symptoms include the following:
- Microdiscectomy. Often due to wear-and-tear, the tough outer ring of your lumbar disc (also known as the annulus) may bulge or tear. In turn, the bulging or protrusion of this disc can cause sciatica symptoms by aggravating a nearby sciatic nerve root. Alternatively, if the annulus is torn, the inner portion of the disc may leak or herniate out and directly compress or irritate a nerve root. A microdiscectomy procedure may relieve your sciatica symptoms by removing a small portion of the disc material that is compressing your sciatic nerve root.
- Lumbar Laminectomy. Generally a part of the natural aging process, lumbar spinal stenosis involves the narrowing of your spinal canal. This narrowing is often due to the fact that facet joints grow in size as they degenerate, and in turn they can irritate or compress sciatic nerve roots in your lower back. A lumbar laminectomy typically involves trimming the bone spurs that have grown around the facet joints to relieve the pressure on your nerve roots.
While the above surgeries bear some similarities, they differ in that a lumbar laminectomy entails a longer incision and more muscle dissection.
While surgery is typically the choice of the patient when it comes to treating their sciatica, certain sciatica-related symptoms may require immediate surgical intervention.
For example, if you experience bowel and/or bladder incontinence, progressive weakness and/or or loss of sensation in your legs, or tingling and/or numbness in your “saddle area” you should seek immediate medical attention—as you may have a serious condition called cauda equina syndrome.