Sciatica is characterized by pain starting in the back and radiating down the back of the leg to the foot. It is associated with numbness in the little toes of the foot and plantar flexion weakness (that is weakness when standing and walking on your tip toes). The sciatic nerve is made up of spinal nerves exiting the lower spine. After exiting the spine it travels though the pelvis and down the leg. Sciatica is commonly caused by a slipped herniated disk in the back between the L5 and S1 vertebrae. Other causes of sciatica include stenosis, bone spurs, slippage of the spine (called spondylolithesis), fracture, tumor and infection.
Sciatica is initially treated conservatively without surgery. Common treatments includes rest, anti-inflmmatory medicine, steroid medicine, pain medicine, physical therapy, steroid injections and spine surgery. Traditional surgery involved a large incision, significant muscle dissection, retraction and injury and removal of a lot of bone called a laminotomy. All these destructive changes may lead to scar tissue, spinal weakness (called instability) and chronic pain. Today lumbar disk herniations may be removed minimally invasively with the spinal endoscope. The spinal endoscope is a very small tube (7 mm) with a camera at the end of it. Using x-ray guidance it can be placed directly to the herniated disk in the spine. The disk can then be removed with tiny instruments under direct visualization.
The procedure takes 1 hour and patient is discharged home after 1 to 2 hours. There is less blood loss, tissue damage and pain compared to traditional open surgery. Most patients have a quicker recovery and return to work. For more information please contact Executive Spine Surgery at 908-452-5612.