Discectomy
The tough outer layer of a disc tears or weakens, causing pain going down the leg (sciatica) although it can cause some back pain.
When to Consider Discectomy, and When Not
The majority of acute episodes of sciatica will settle on their own. If it does not do so within a reasonable period of time, or if the symptoms are unacceptable, surgical removal of the protruding or bulging disc material is appropriate.
What constitutes a reasonable period of time, and what are unacceptably severe symptoms, are of course subjective matters and will vary from one person to another. If improvement is going to occur it will usually be evident within the first six weeks and the patient should be showing good signs of recovery by three months. Not everybody can wait this length of time for symptoms to settle. If this is the case, or if symptoms have failed to show the expected improvement, discectomy may be appropriate.
If symptoms are deteriorating rather than improving, or if there is a gradually developing loss of feeling or weakness superimposed on the sciatic pain, earlier surgery may be appropriate.
Sciatic pain can have other causes, and these may be shown on your MRI scans. If the cause is not a disc protrusion, alternative treatments or other forms of surgery would be more appropriate.
Very occasionally a disc protrusion may badly damage a nerve root, causing loss of sensation or weakness, sometimes with remarkably little sciatic pain. In these circumstances discectomy won't greatly improve the chances for recovery. The principal reason for surgery is to relieve leg pain.
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In memory of Nick Boeree
Following the sudden death of Nick Boeree we have set up a tribute page to allow you to share your memories, thoughts, and feelings. Click here.
I was quite sure, when I came along to the clinic, that I was headed for surgery. I’d tried various things in the past and had even gone through physiotherapy, or so I thought! The regime I went through in The Spine Clinic took this to an entirely different level. And what a difference it has made!
Mark Maskey
