Sciatica or sciatic neuralgia is a commoncondition in which one of the spinal nerve roots of the sciatic nerve is compressed resultingin lower back, buttock and leg pain. Sciatic nerve is a large nerve derived from 5 spinalnerve roots: L4, L5, S1, S2 and S3. It runs from the lumbar spine through the buttockdown the leg and the foot on the posterior aspect. There is one sciatic nerve on eachside of the body. Typically, only one side of the body is affected.A typical sciatica pain is described as a sharp shooting pain in the lower back, downthe buttock, thigh and leg on one side of the body. There may also be numbness, burningand tingling sensations. The pain can get
worse with sitting, moving, sneezing, or coughing.The patterns of pain depend on which nerve root is compressed, and follow the dermatomedistribution. The most common cause of sciatica is a herniatedspinal disc. The spinal disc is a soft elastic cushion that sits in between the vertebraeof the spine. With age, the discs become rigid and may crack, the gellike center of thedisc may protrude out and become a herniation outside the normal boundaries of the disc.Disc herniation presses on the nerve root as it exits the spine.In majority of the cases the condition resolves by itself after a few weeks of rest and conservativetreatment. Pain relief, nonsteroidal antiinflammatory
drugs and muscle relaxants may be prescribed.Stretching exercises and physical therapy may be recommended.Surgery may be needed if the pain doesn't go away after 3 months or more of conservativetreatments. The herniated disc may be removed in a procedure called discectomy. Or, in anotherprocedure called laminotomy, part of the bone of the vertebrae may be cut to make room forthe nerve.
Minimally Invasive Lumbar Spine Fusion Surgery El Camino Innovates
Silence gt;gt; Well, there are approximately 500,000 spine operations done per year, and these are a spectrum from what we call simple back surgery for a lumbar disk to more a complex procedure, such as lumbar spine fusion surgery. And lumbar spine fusion surgery makes up a minority of all of spine operations, but at the same time, it's one of the most serious operations you can do, and certainly, in that context, you want to be absolutely sure that you need that surgery. The vast majority of patients get better with conservative measures, such as physical therapy,
lumbar spine injections, or other types of treatments. But for that small percentage of people who, in fact, do need spine surgery, and that's typically when they have persistent pain and xrays or other types of radiographic studies that demonstrate either abnormal movement or an injury to the elements of the spine that make it stable. And in that instance, when all other measures fail, surgery is really indicated. Typically, when one does a spinal fusion surgery, at least in quote unquote, the old days, it would require a very large operation and disruptive of a lot
of the elements of the spine itself. The muscles are pulled widely apart, there's a significant blood loss, and the recovery period can be six months to a year. Over the last decade or so, new techniques have been developed, and we're fortunate in that we have a number of surgeons at El Camino who specialize in spine surgery; specifically, lumbar spine surgery, and now we're able to do these surgeries in a manner we call minimally invasive. And that's where small incisions are used, minimal blood loss, minimal tissue disruption,
and for many of these patients, they go home the same day or within a day or so after surgery compared to what used to be five, seven, to even ten days to two weeks in the prior to this time. Well, the period of time for the fusion to heal hasn't changed. Typically, we use the number around 12 weeks when the patient's bones have really healed and the fusion is solid. But for many of these people, they begin a physical therapy regimen and start becoming quite active within three to four weeks after the surgery,
and essentially all of them are up walking the night of the surgery. For the right indications, the vast majority of patients, 85 to 90 percent, have what we say is an excellent to good result, and that means they're able to return back to an active lifestyle, they're taking minimal medication or completely off of medication, and they've returned to a full life. Well, certainly having appropriate training is important. Experience is important. And I would say that they should feel comfortable with their surgeon,
and because this is a major operative procedure, they should obtain more than one opinion regarding having such a surgery as this. And the patient should also feel that the physician is interested in giving them all the information and will spend adequate time with them so that they feel comfortable with their decision and that they should not feel rushed to make a decision. One of the nurses at El Camino , she had sustained an injury at work, and as a result, had an unstable spine.