Sciatica – Lumbar Radiculopathy
Lower back pain resulting in pain that shoots down the leg is usually referred to as sciatica. This is usually a result of a disc herniation which compresses one of the nerves in the lower lumbar spine.
Initially, this compression on the nerve causes inflammation. The severity of the pain that shoots down the leg depend on the nerve affected.
Large disc bulges can result in numbness or weakness of the muscles. In rare cases a large disc bulge can cause compression onto several nerves in the low back. This devastating condition called cauda equina syndrome, results in numbness, weakness and pain in both legs. It can also affect the nerves that control the bowel and bladder. If these nerves are permanently damaged, it results in a complete loss of control of these organs.
The confirmatory diagnosis of disc prolapse resulting in lumbar radiculopathy is to perform an MRI scan.
There are various treatment options for this condition. These depend on the extent of the symptoms and the size and degree of the disc prolapse.
Less invasive treatment options include:
- pain relief medications
More invasive techniques of treatment include:
CT guided injections
Performing a lumbar microdiscectomy operation
In the majority of cases, pain relief medication and lifestyle modifications will resolve the symptoms. If symptoms still persist despite conservative treatment, surgery becomes an option. Only a very small proportion of patients will need surgical intervention.
A lumbar microscopic discectomy is performed if there is a concern of impending nerve damage due to the extent of disc prolapse. Where there are signs of early nerve damage even at the first presentation, surgical treatment is recommended.
The lumbar microscopic discectomy is a minimally invasive procedure. The surgeon makes a corridor of entry into the lumbar spine using small tubes. He or she will remove the offending disc fragments to free the nerve. Removing the compression upon the nerve results in an improvement of pain symptoms. This minimally invasive surgery helps the patient return back to normal activities early.
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