Surgery for lumbar radiculopathy / sciatica

Radiculopathy is a painful condition resulting from compression or inflammation of spinal nerves. Lumbar radiculopathy is a condition in which the spinal nerves around the lumbar region (lower back) are compressed or pinched leading to pain, numbness or weakness, and tingling sensation.

Causes

Lumbar radiculopathy is caused by compression, inflammation and/or injury to the nerve roots in the lumbar region (lower back). Conditions such as herniated or damaged disc, narrowing of spinal canal (spinal stenosis), bony spurs or outgrowths, and arthritic changes can compress the spinal nerves. Infection and tumor in the lumbar region are less common causes for lumbar radiculopathy.

Symptoms

Symptoms of lumbar radiculopathy include pain, numbness or weakness, and tingling sensation in the lower back and buttocks that radiates down to the legs. The symptoms often resemble sciatic pain due to inflammation of the sciatic nerve.

Diagnosis

Your physician diagnoses lumbar radiculopathy based on symptoms, medical history, and a complete physical examination of the lower back (lumbar spine). A confirmed diagnosis can be made based on the findings from imaging studies such as X-ray, CT (contrast tomography) and MRI (magnetic resonance imaging), nerve conduction studies, and electromyography.

Treatment

Treatment of lumbar radiculopathy depends on the actual cause of radiculopathy and includes both non-surgical and surgical approaches.

Non-surgical therapy

Resting, using braces for support, and regular physical therapy and exercise are the available non-surgical treatment options. Physicians may also recommend use of medications to relieve pain and inflammation (anti-inflammatory drugs), and muscle strain (muscle relaxants). Steroid injections are used for acute relief of severe pain.

Surgical therapy

Your physician recommends surgery only after non-surgical treatment fails to relieve the symptoms. The available surgical options to treat lumbar radiculopathy include laminectomy and/or discectomy or microdiscectomy. The surgical procedure involves removing pressure on the spinal nerves by cutting or removing part of the lamina (the bony roof over the disc) or any disc material that is compressing the spinal nerve structures.