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Sciatica causes shock-like pain along the back of the hip, thigh and legs into the sole or along the outer part of the thigh and leg into the top of the foot. Rarely, this pain can be associated with the weakness of the leg or foot and involvement of bowel or bladder control. It is difficult to say that the sciatica can be cured permanently because it can happen at multiple levels and can have recurrence at the same level and on either side. Even after the surgery, there are chances of recurrence at the same level as well as on the other side or at other levels, which may or may not be related to the initial sciatica. Rarely, the patient may have recurrence of pain once the effect of the steroid injection weans away. Patient may need other medical equipment like walker or a stick. Patients who do not get relief may also need cortisone injection in the form of epidural or selective nerve root block. This nerve root can be inflamed due to compression possibly due to disk herniation or a synovial cyst or an osteophyte.

Though wear and tear of the disk is contributory to the cause of disk prolapse or disk herniation as well as osteophytes and synovial cyst, it is difficult to predict a flare up of sciatica in any patients. This may be caused due to injury to the nerve root or more commonly due to disk herniation that causes pressure on the nerve root and ischemia and chemical injury leading to radiculitis. Such patients may be amenable for surgical treatment in the form of microdiscectomy or tubular discectomy to remove the herniated disk and thereby remove the pressure over the nerve root. Spine surgeries like discectomy and laminectomy usually last about one to one and a half hours. What is the difference between a laminectomy and discectomy? Apart from the usual risks of having some back surgery, the risk of laminectomy includes injury to the nerve roots of the spinal cord, bleeding, injury to the sac, covering the spinal root or spinal cord leading to leakage of the fluid, persistence of pain or worsening, temporary or permanent worsening of symptoms. Post laminectomy pain syndrome usually involves the lower back and presents in patient who have undergone laminectomy for spinal stenosis.

The diagnosis of Lumbar disc disease is made by history and examination of the patient. What is degenerative disc disease? Special tests may be needed in some patients if the physician has suspicion of some other disease. This surgery is performed from the back of the neck and does not involve fusion of the neck thereby decreasing the restriction of movement of the neck as may be present after laminectomy and fusion surgery. Common complications of a low back spine surgery are bleeding, infection, leak of cerebral spinal fluid temporary or permanent neurological deficits, blindness, worsening of pain, failure of fusion, failure of implants. It also carries sensations from the foot to the spinal cord and to the brain. Sciatic nerve carries the nerve fibers from the lower back to the muscles of the leg and foot. The sciatic nerve essentially supplies the muscles below the knee and controls the movement of the foot and toes. Lumbar instability means that the spine is not stable and there is excessive abnormal movement between two vertebrae. This sciatic nerve travels along the back of the hip and the thigh up to the knee where it is divided into two main nerves, the common peroneal nerve and the tibial nerve.

General surgical risks of low back surgeries include bleeding, infection, persistence of pain, reversible/irreversible nerve damage leading to tingling, numbness, or weakness down the legs or involvement of bowel or bladder, failure of resolution of symptoms, failure of fusion, failure of implants. Obviously, the low back pain and sciatica may sometimes be difficult for patients who have low back pain and sciatica to sleep. Also using a thick pillow under the knee or sleeping by the side in a curled up position can help in relieving the pain of sciatica as well as low back pain and allowing sleep. What are the possible surgical complications from a low back surgery? When should I consider surgery for the back pain? Walking does not cause deterioration of sciatica, though excessive walking may cause pain and patients may need to rest. Sciatica is essentially treated symptomatically initially, but may need surgical treatment to remove the compression on the nerve root.

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