Sciatica is a painful condition that can be alleviated through surgery. It results from sciatic nerve compression, which is made up of multiple nerve roots that travel from the spine to the lower back. Sciatic surgery Los Angeles is provided by the LAMIS Institute to treat chronic and severe sciatic issues. Our team will work with you to determine the best course of action for your particular circumstance and give you the best care for a speedy recovery.
Understanding Sciatica Surgery
This type of surgery seeks to reduce strain on the sciatic nerves caused by nerve root compression, and the resulting pain. A sciatic nerve, which originates from the lumbar spine of the sacrum and lower back, is the thickest and longest nerve in the human body. It has five roots found on the spinal column's bottom.
Starting at the lumbar region, it descends through the hips and thighs to the area below the knees, where it divides into the peroneal nerve and the tibial nerve. Sciatica surgery is performed to alleviate pressure on the nerve root that makes up the sciatic nerves.
Various Sciatica Surgery Los Angeles Techniques
Based on the underlying reason for your sciatica, your physician may recommend one of the following surgical procedures:
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Discectomy
This is a surgical technique that involves the removal of damaged discs between the spine's vertebrae. It could be necessary to get rid of the tiny pieces of the discs that are compressing the nerve roots as a result of a herniated or bulging disc to release strain on the adjacent structures.
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Foraminotomy
This is a surgical operation that is used to enlarge the foramina, which are the apertures in the spine’s vertebrae in which the nerve's roots exit if they've been narrowed. The foramina are enlarged using a surgical drill to lessen compression of the exiting spinal nerves.
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Laminectomy
This is an operation used to remove a section of the vertebrae, particularly if there's a bone spur caused by degenerative and arthritic changes, to relieve nerve root compression.
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Spinal Fusion
This operation involves joining multiple vertebrae with screws and metal rods. It could be necessary if a disc causes major compression of the nerve roots and has to be removed if:
- Several laminectomies have been performed, leading the spine not to be stable.
- A single vertebra slips over another, prompting stabilization.
Risks of a Sciatica Treatment Los Angeles
Although sciatica treatment is the most effective and safe, there are some risks involved with spine surgery, such as:
- Infection—an infection at the site of the incision is possible, but it's treatable using antibiotics.
- Nerve injury—this could occur during the operation, resulting in weakness or numbness in one or both feet after the operation. Paralysis is a rare but potentially fatal condition.
- Blood clots—clots are likely to form after the operation is done, particularly in the legs. Staying active while recovering or putting on compression stockings to enhance blood circulation can lower the risks of blood clots. This condition is also referred to as vein thrombosis.
- Recurrence—some symptoms of sciatica could persist or return years later after surgery. Nonsurgical therapies are normally explored first to address the problems, although additional surgery could be required.
The Objective of Sciatica Treatment Los Angeles
This type of surgery is often not advised unless conservative methods such as medicines, physical therapy, and cortisone injections have failed to relieve symptoms. If the pain gets worse, you experience severe weakness in the lower body muscles, or you've lost control of the bowel or bladder, your physician may recommend surgery. Sciatica surgery Los Angeles is usually considered within a year of persistent symptoms.
To make a diagnosis and assessment of the nature of your sciatica condition, your healthcare professional will conduct imaging tests such as CT scans, MRIs, and X-rays to help identify the problem's root cause.
You would need more intensive therapy and a quicker recovery time from surgery if your pain was severe and persistent and was hindering you from functioning or standing. If cauda equina syndrome is to blame for the loss of bowel or bladder control, emergency surgery would be necessary.
Surgery Preparation
Surgical procedures for sciatica usually last between one and two hours, with spinal fusion procedures taking up to four hours. In some cases, you could be required to check in at the surgery center as early as one to two hours before surgery to complete any necessary documentation and have a physical examination.
Before Surgery
You'll go through a quick physical examination in a pre-op room. To administer medications and fluids like an anesthetic, a nurse would insert an IV into your hand or arm. Your surgeon would transport you to and from the operating room in the hospital bed.
To ensure that you feel nothing at all during the operation, you would be put to sleep under an anesthetic. After you've been put to sleep, a tube would be inserted and linked to the ventilator to enable you to breathe while the procedure is being performed.
Additionally, you'll be turned onto your belly while having pillows supporting your sides and chest. The surgeon will sanitize the skin around your back's incision site and cover you with sterilized sheets to maintain a clean surgical area.
During the Operation
If you're having surgery, the surgeon would make a vertical incision along the spinal column to reach the affected nerve roots. It's possible to conduct several operations simultaneously. As a result, discectomy, foraminotomy, and laminectomy are finished first.
Discectomy
Disc removal surgery can be conducted either openly or through a minimally invasive incision. When performing a discectomy, a surgical incision measuring one to two inches is made along a single spinal level. The back muscles are flexed to one side, exposing the spinal column.
Minimally invasive techniques involve incisions of less than an inch created along one side of the spinal column, and a thin tube is placed into the area between the patient's vertebrae to perform a discectomy. The surgeon would use this tube to cut a tunnel in the patient's back, into which they can insert a light, camera, and surgical instruments to extract the targeted disc piece.
Foraminotomy
Similar to a lumbar discectomy, a tube is placed into the patient's back to isolate the muscle tissue and expose the spine. The foramina are enlarged by slicing away bone with a surgical drill, which relieves pressure on the nerve roots as they leave the spine.
Laminectomy
To reach the afflicted vertebrae, a 1-2 inch long incision will be created along the spinal column. The precise position will be determined by x-rays. Spinous processes (the bony projections at the rear of every vertebra) and laminae (the flat surfaces of the vertebrae) will be removed one at a time using a bone drill.
Additionally, the damaged spinal segments will have the ligamentum flavum, which is the thick ligament that joins one vertebra to the next, clipped and removed. Bone spurs and other forms of overgrowth also will be eliminated.
Spinal Fusion
When a patient undergoes a spinal fusion procedure, the disc between two vertebrae is surgically withdrawn and the bones are fused using screws and metal rods. A bone graft is necessary for spinal fusion surgeries because it serves the purpose of a spacer in between the spine’s vertebrae after the disc has been removed. When laminectomies are done, the bone fragments that are removed might be used to fill the gaps left between the spinal vertebrae.
On the other hand, a tiny incision could be made along the upper end of your hip to access the iliac crest to remove a fragment of bone. The vertebrae are drilled to introduce screws and metal rods that will assist hold the graft in place and help connect the two vertebral pieces.
When all of the procedures have been finished, the incision will be closed using stitches, and a bandage will be applied over the region.
Following the Surgery
Once the incision has been stitched up, the patient will no longer be placed under anesthesia. As you start to regain consciousness, your breathing tube is withdrawn, and you’ll be sent to the recovery room in which your vital signs (including heart rate, blood pressure, and breathing) are monitored.
After the procedure, you will be sent to the recovery area where you will remain for some time and have access to hospital staff around the clock to tend to your needs. A physiatrist, an expert in rehabilitation medicine, will see you following surgery to assist in pain and symptom management.
A physiotherapist will check in with you to see how well you are moving around after surgery. This includes sitting up, walking, standing up, and getting into or out of bed. To ensure you can be discharged securely, they also will inquire about your housing situation at home. You can be transferred to a subacute treatment center if you stay alone or require a lot of assistance with daily activities.
Recovery
The duration of time required to recuperate can range anywhere from 2 to 4 weeks or even less to return to work in a physical job to anywhere between eight and twelve weeks for jobs that are more physically challenging and need heavy lifting. If you've had a spinal fusion, you won't be able to return to work for approximately 4 to 6 weeks. It could take between 6 months and one year to fully recuperate from spine fusion surgery before resuming regular activities.
To help your spine heal over the first 2 weeks after surgery, you'll have to adhere to a number of restrictions.
- Do not bend, lift, or twist.
- You are not allowed to lift anything that is heavier than 5 lbs.
- You must refrain from any physically demanding activities, such as working out, performing yard work, or engaging in sexual activity.
- No alcoholic beverages during the first several weeks of recuperation or while using narcotic painkillers.
- You shouldn't get behind the wheel of any automobile until you've talked to your surgeon.
It is important that you adhere to your surgeon's instructions as well as any other recommendations they may provide you.
When sleeping, it's best to keep your spine in proper alignment by either lying on the back with a pillow or cushions under the knees or even on the side with a pillow in between the knees. Sleeping on the stomach puts extra stress on your lower back, which can aggravate existing pain and slow your healing process.
When wearing the back brace, which could be prescribed, you should avoid lying down or sleeping while wearing it. You will receive advice from your healthcare professional once it is time to stop using it.
Dealing with Recovery
Following a sciatica procedure, it's common to experience discomfort, and you'll be subject to limitations until the spine has sufficiently recovered and stabilized. After surgery, a physician will prescribe prescription drugs to manage your pain. To encourage healing and rehabilitation for the optimum outcome, it is crucial to adhere to all recommendations from your physician and physiotherapist about medications and activity.
Get up and move around as much as possible and stick to the workout routine your physiotherapist has laid out for you. Keep your back straight when you're walking, standing, sitting, and lying down to reduce the stress on your spine.
Long-Term Care
Keeping up with your healthy routine after you've recovered will help you avoid a recurrence of sciatica symptoms. Some of these include the following:
- Maintaining an uninterrupted sleep schedule that allows for at least 7 to 8 hours of sleep every night.
- Limiting consumption of processed sugar, foods, refined grains such as corn and wheat, and artificial flavors, sweeteners, food additives, and colors, in favor of a healthy diet rich in whole, natural foods such as meats, chicken, fruits, fish, nuts, vegetables, and starches.
- Maintaining a healthy body mass and weight by engaging in regular physical exercises.
- Staying hydrated.
- Learning adequate lifting skills to use your leg and core muscles to avoid putting extra strain on the spinal cord.
Future Surgery Possibilities
Your surgeon could not be aware of the entire scope of surgical operations required until the procedure begins. You should always double-check with your doctor about the surgery you're about to have and inquire about the possibilities of future surgeries.
It could be necessary to carry out multiple surgeries concurrently to widen the spinal canal sufficiently. If several laminectomies were done, spinal fusion could be necessary to help stabilize the spinal column. If a discectomy or other minimally invasive therapy has already been tried without success, a spinal fusion procedure to get rid of the affected disc in its entirety could be explored.
Find a Sciatica Surgeon Near Me
Patients often experience anxiety before undergoing spinal surgery. While the thought of undergoing surgery to treat sciatica could be terrifying, the procedure often leads to significant pain relief and restoration of normal functioning. At the LAMIS Institute, our team specializes in the evaluation and treatment of spine issues in Los Angeles. When it comes to sciatica surgery Los Angeles, our spine specialists offer comprehensive care. If you have questions about sciatica treatment or would want to set up an appointment, feel free to contact us at 310-734-6088.
