Sciatica surgeries help reduce pressure on the nerve roots in your spine. There are different types of sciatica surgery available, including disk replacement surgery and spinal fusion.
Sciatica surgery may be a good option for people who don’t respond well to conservative therapies such as physical therapy and corticosteroid injections.
Sciatica refers to symptoms caused by injury or compression of the sciatic nerve in your lower back. It can be a symptom of many conditions, such as a herniated disk, a spinal canal narrowing, or disk degeneration.
As many as
This article looks at the types of surgery that treat sciatica and who makes a good candidate for each procedure.
Sciatica surgery is a procedure that helps take the pressure off your sciatic nerve. There are several different types of surgery for sciatica. The type of surgery you need depends on where the nerve is compressed and the underlying cause of your symptoms.
The goal of sciatica surgery is to help relieve pain and inflammation. It can also help protect your spine from further damage.
Before trying surgery to relieve your symptoms, doctors often recommend trying more conservative options, such as:
- rest
- exercises and stretches
- heat and cold therapy
- pain relievers such as nonsteroidal anti-inflammatory drugs
- other medications
- physiotherapy
- steroid injections
Many people with sciatica never need surgery, and as many as
Doctors use different surgical techniques to treat sciatica depending on the underlying cause of your symptoms.
Laminectomy
A laminectomy involves removing part or all of the lamina in one of your vertebrae. The lamina is a part of your vertebrae that often compresses nerve roots. Removing some or all of a lamina in the offending vertebra will help reduce pressure on your nerve and help relieve pain.
Laminectomy is one of the
Discectomy
A discectomy involves removing part of a herniated disk between two vertebrae compressing your spinal cord. About
In some cases, doctors may remove your entire disk and replace it with an artificial disk. They may also perform spinal fusion after removing a disk to permanently join two vertebrae.
A discectomy can be performed as an open surgery, or a surgeon can perform a minimally invasive procedure with a tool called an endoscope. In a
Microdiscectomy
A microdiscectomy is a similar procedure to a discectomy. A microdiscectomy involves the use of magnification so that doctors can make a smaller incision.
Spinal fusion
Fusion surgery involves joining two or more vertebrae together so that they’re no longer movable. Spinal fusion may be combined with discectomy. It’s usually only performed when other surgeries aren’t an option because it can lead to certain biomechanical changes that can cause difficulties later in life.
A doctor may recommend spinal fusion if you have compression of your spinal cord combined with joint instability.
Foraminotomy
A foraminotomy involves the removal of bone around the space between the vertebrae where the nerve root exits the spinal canal. This provides more space around the nerve root, which may help lower compression.
Doctors generally recommend sciatica surgeries for people who don’t find relief from conservative treatment options after a few months. They usually recommend starting with the
A doctor may recommend surgery as the
- cauda equina syndrome
- sciatica on both sides
- spinal tumor
- severe spinal fracture
- leg weakness, foot drop, or a loss of normal reflexes
- incontinence
People with poor overall health or with multiple other health issues, such as unmanaged diabetes or high blood pressure, are generally considered poor candidates.
The surgeon’s technique will depend on where your sciatic nerve is being compressed. Here’s a rough idea of what to expect.
- The surgeon might tell you to avoid eating or drinking anything on the day of your surgery. You may have to stop taking certain medications, such as blood thinners, a week or more before your surgery.
- For most surgical techniques, you’ll receive general anesthetics to put you into a sleep-like state of nonfeeling or sedation through an intravenous (IV) line. The area around the surgical site may also be numbed with an injection.
- Depending on what type of surgery you’re receiving, the surgeon will make either one or more large incisions for open surgery or small incisions for an endoscopic procedure.
- The surgeon will decompress the area around your sciatic nerve by removing a piece of bone or other tissue.
- You may be able to go home on the day of your surgery, or you may need to stay in the hospital for a short time.
The recovery time for sciatica varies depending on the type of surgery you get and your overall health. It usually takes about 4–6 weeks to regain your mobility and function.
Doctors usually recommend starting to move the day after your surgery. You may have to stay in the hospital for 1–3 days.
Surgery can relieve sciatica symptoms and possibly cure it entirely.
Studies report varying success rates depending on what the researchers consider a successful outcome. This can include things such as regaining mobility, complete or partial pain relief, or the amount of time you remain pain free.
Cure rates range from
A small
Lumbar decompression surgery is generally safe, but all surgeries come with some degree of risk.
Risks of sciatica surgery include:
- blood clots
- heart attack
- infection
- damage to your spinal cord or other nerves
- reactions to the anesthetics or sedatives
In a
| Risk | Discectomy | Microdiscectomy | Microendoscopic discetomy | Full endoscopic discectomy |
|---|---|---|---|---|
| Recurrent disk herniation | 4.1% | 5.1% | 3.9% | 3.5% |
| Reoperation | 5.2% | 7.5% | 4.9% | 4% |
| Wound risks | 3.5% | 3.5% | 1.2% | 2% |
| Tear of the protective covering of the spinal cord | 6.6% | 2.3% | 4.4% | 1.1% |
| Neurological risks | 1.8% | 2.8% | 4.5% | 4.9% |
| Nerve root injury | None reported | 0.3% | 0.8% | 1.2% |
Doctors usually recommend conservative treatments for sciatica before moving on to surgery. But they may recommend surgery if you have severe neurological symptoms or if conventional therapies haven’t helped your pain.
Depending on the cause of your sciatica, a surgeon may recommend several different surgical techniques. If your sciatica is caused by a herniated disk, a surgeon will typically recommend removing part of the damaged disk.