In his latest installment to the Total Spine series of instructional videos, Dr. Paul McCormick describes retropleural thoracotomy, a surgical technique used to treat complex spinal conditions of the thoracic and lumbar spine. “Retropleural thoracotomy is an important...
Sciatica is pain that starts in the lower back and radiates through the buttock and down the back of the leg.
Sciatica is caused by compression of the sciatic nerve in the lumbar (lower) spine. The sciatic nerve is the largest single nerve in the body. It begins in the lumbar spine and runs through the buttock, down the back of the leg, and into the foot. When the root of the sciatic nerve is compressed at its exit from the spinal cord, the symptoms can radiate along the entire length of the nerve.
The technical term for compression of a nerve root is radiculopathy. Sciatica is one type of radiculopathy.
Sciatica can cause a variety of symptoms, which may include:
|Causes and Risk Factors|
Sciatica describes pain that comes from a problem with the lumbar and sacral nerve roots that make the sciatic nerve. Sciatica is always caused by something–it is a symptom of another problem.
A common cause of sciatica is a herniated disc in the lumbar spine. A herniated disc occurs when the fibrous outer portion of the disc ruptures or tears and the soft cartilage core herniates out. The protruding section of the disc can compress the sciatic nerve root.
Sciatica can also be caused by lumbar spinal stenosis, which is a narrowing of the spinal canal in the lumbar spine. This narrowing can also compress the sciatic nerve root.
The chances of developing sciatica are highest in middle age. After 50 years old, the chances of developing sciatica declines.
|Tests and Diagnosis|
If a patient presents with symptoms associated with sciatica, the doctor may order any of the following diagnostic procedures:
For the most part, symptoms of sciatica go away in a few weeks with conservative (non-operative) treatment.
Nonoperative treatments include:
However, surgery may be considered if sciatic pain does not respond to nonoperative measures, if pain is severe, or if a patient experiences progressive numbness or weakness.
If sciatica is due to a herniated disc, the surgeon will perform a procedure known as a microdiscectomy.
If sciatica is due to lumbar stenosis, the surgeon will perform a procedure known as a laminectomy.
In some cases, the surgeon may need to perform a combination of microdiscectomy and laminectomy. The surgeon will tailor the treatment to each patient and each condition.
|Preparing for Your Appointment|
Drs. Paul C. McCormick, Michael G. Kaiser, Peter D. Angevine, Alfred T. Ogden, Christopher E. Mandigo, Patrick C. Reid and Richard C.E. Anderson (Pediatric) are experts in treating underlying conditions that cause sciatica. They can also offer you a second opinion.
Helpful Surgery Overviews
Dr. McCormick will choose the treatment method specific to each patient and situation. Some of the condition’s treatment options may be listed below.
Dr McCormick video on microsurgical resection of a synovial cyst causing severe lumbar spinal stenosis published in Operative Neurosurgery
Synovial Cysts are a benign and fairly common condition in adult patients. They can arise in most joints throughout the body. In most cases they are asymptomatic but in the spine they can enlarge to produce severe spinal stenosis and pressure on the spinal nerves...
Dr. McCormick invited speaker at 37th Annual Meeting of the Joint Section on Disorders of the Spine and Peripheral Nerves
Dr. McCormick was a featured speaker at the recent 37th Annual Joint Spine Section Annual Spine Summit meeting held in San Diego. He presented at the Innovative Technology Special Session: Operative Video Segments. His presentation was entitled “Intramedullary Tumor,...