Sciatica surgery
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Sciatica Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Sciatica surgery On the Web |
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American Roentgen Ray Society Images of Sciatica surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Surgery
Invasive therapies
Minimally invasive procedures
Intradiscal Electrothermoplasty (IDET)
A needle is inserted into the affected disc, guided by x-ray. A wire is then threaded down through the needle and into the disc until it lies along the inner wall of the annulus. The wire is then heated which destroys the small nerve fibers that have grown into the cracks and have invaded the degenerating disc. The heat also partially melts the annulus, which triggers the body to generate new reinforcing proteins in the fibers of the annulus.
Radiofrequency Discal Nucleoplasty (Coblation Nucleoplasty)
A needle is inserted into the affected disc, although instead of a heating wire, a special RF probe (radio-frequency) is used. This probe generates a highly focused plasma field with enough energy to break up the molecular bonds of the gel in the nucleus, essentially vaporizing some of the nucleus. The result is that 10-20% of the nucleus is removed which decompresses the disc and reduces the pressure both on the disc and the surrounding nerve roots. This technique may be more beneficial for sciatica type of pain than the IDET, since nucleoplasty can actually reduce the disc bulge, which is pressing on a nerve root. The high-energy plasma field is actually generated at relatively low temperatures, so danger to surrounding tissues is minimized.
Alternative therapies
The approach to treating Sciatica is to reduce the compressive forces causing the pressure upon the sciatic nerve. This can be accomplished through traction and realignment therapeutic procedures in the case where the sciatica is spinal-related.
- Acupuncture
- Chiropractic manipulation for the restoration of normal joint biomechanics and reduction of histochemical irritation to the involved nerves. [1][2][3]
- Massage therapy to the involved lumbopelvic muscles.
- Structural Integration A systematic approach designed to reorganize major joints, and body segments (such as the lower back region and sacrum), while releasing the chronically held tension and torsion patterns. The goal is to achieve a rapid change in structural mechanics and correction of chronic musculoskeletal pain or dysfunction.