If your sciatic pain has been causing you difficulty and getting progressively worse, one possible treatment option could be a Microdiscectomy. Mr Chris Brown, Consultant Orthopaedic Spinal Surgeon at Circle Reading, talks us through the procedure.
As a Consultant Orthopaedic Spinal Surgeon, it may come as a shock to you that I try to avoid surgery for my patients if at all possible. My patient’s wellbeing is always my first and foremost concern, and I will do whatever I can to help alleviate your symptoms and get you back to normal function. If this can be done with a more conservative approach, avoiding the need for surgery and the heavy toll it can take on your body, I will actively look to pursue this course of treatment.
Sometimes, however, a form of surgery is necessary in order to get the best results. A microdiscectomy is one such surgical procedure which is particularly successful in cases where a patient reports sciatic pain, with the pain radiating down the legs.
At your first consultation with me, I will likely assess your condition with a physical examination and request an MRI to give a clearer indication of any underlying issues. The MRI will show a detailed picture of your lumbar spine, including the space between each vertebrae where the nerves pass through. As such, I’ll be able to see anything from herniated discs to stenosis to pinched nerves and nerve damage, and can take a closer look at the sciatic nerve.
Sciatica is a very common condition involving pain and stiffness in your lower back. The pain can often radiate down one side of the buttocks and into your leg (sometimes both legs, depending on the specific nerve affected). If this mirrors your experience, I would include a Straight Leg Raise (SLR) test as part of your physical examination, checking your range of spinal movement (which may trigger some of your symptoms) along with testing your reflexes, leg strength and sensitivity.
More often than not, non-invasive measures will be enough to help your condition improve; this makes our multi-disciplinary approach at Circle incredibly beneficial, as our physiotherapy team will be on hand from your first appointment and can develop a program designed specifically for your needs. They can suggest certain exercises and stretches to help regain strength and relieve pressure on the sciatic nerve.
If physiotherapy has shown no significant improvement, and you’ve still been in pain for six-to-eight weeks, a microdiscectomy would be a possible next step, especially if you’ve been experiencing pain, weakness and/or numbness radiating down into your legs.
Performed under a microscope for precision and accuracy, a microdiscectomy is where I would make a 1.5-2.5cm cut in the centre of your back to remove a small part of the disc around the affected nerve, relieving any pressure. The surgery is performed under general anaesthetic, and usually takes between 45 minutes to an hour. Due to the need for a general anaesthetic, the operation will normally require a one-night stay in our hospital.
It is important for my patients to be aware of the potential risks, as with any surgery. The risks of any general anaesthetic include blood clots, heart attacks, and strokes; with regard to this specific surgery, there is the possibility of nerve damage in rare cases, and paralysis under very rare circumstances. Whilst these risks should be noted, I commonly perform microdiscectomies and such risks are very rare indeed. Patients also report that the procedure has been very effective for them in reducing their level of pain, helping them to increase their mobility and get back to an active lifestyle.
During your recovery from the surgery, our physiotherapy experts will again work closely with you to keep you as mobile as possible during this time, as this can help reduce recovery time. This is especially effective in the six-to-eight week period after surgery. Although it is wise to limit any unnecessary bending or twisting movements, there is no evidence to suggest that this kind of limitation will prevent any further relapses. Many of my patients feel comfortable enough to return to work within a few weeks, with light exercise being encouraged. It is important not to push yourself too hard, especially in the early days after surgery – pain is a good sign that you should probably stop. Before undertaking any kind of new exercise regime post-operation, it is wise to consult the physiotherapy team, as they can advise on best practice moving forward.
If you’ve been experiencing sciatic pain, you’ll know how debilitating it can be, especially if that pain is radiating into your legs. Why put up with it any longer than you have to? With no waiting lists and a multi-disciplinary team at Circle ready to offer you the best treatment plan, why not book your first consultation with me today? I can offer you all the necessary scans to get you diagnosed quickly, answering any queries you may have along the way, before helping you decide on a plan of action.