Surgery for Sciatica

4 situations when sciatica surgery may be necessary.

Most patients with sciatica respond well to nonsurgical treatments (eg, medication, epidural spinal injection), so spine surgery is seldom needed to treat low back and leg pain caused by sciatic nerve compression. However, there are situations when you may want to go ahead with spine surgery:

Surgeon adjusting surgical lamp.There are several types of surgical procedures used in spine surgery, and your spine surgeon will recommend the best procedure to treat your sciatica. Photo Source: 123RF.com.

  • You have bowel or bladder dysfunction. This is rare, but it may occur with spinal cord compression.
  • You have spinal stenosis, and your doctor feels that surgery is the best way to treat it.
  • You are experiencing other neurologic dysfunctions, such as severe leg weakness.
  • Your symptoms become severe and/or non-surgical treatment is no longer effective.

There are several types of surgical procedures used in spine surgery, and your spine surgeon will recommend the best procedure to treat the cause of your sciatica. His or her recommendation will be based on the spinal disrder causing your sciatica, and the entire procedure should be clearly explained to you. Don't be afraid to ask any questions you need to in order to better understand the surgeon's recommendation.

And remember, the final decision to have surgery is always up to you. You may find it useful to get a second opinion on the recommended spine surgery before deciding. 

Two common spinal surgeries for sciatica are:

  • Discectomy or Microdiscectomy: In both of these procedures, the surgeon removes all or part of a herniated disc that's pushing on your sciatic nerve and causing your sciatica symptoms. The difference between the procedures is that a microdiscectomy is a minimally invasive surgery. The surgeon uses microscopic magnification to work through a very small incision using very small instruments. Because the surgery is minimally invasive, you should recover more quickly from a microdiscectomy.
  • Laminectomy or Laminotomy: These procedures both involve a part of the spine called the lamina—a bony plate that protects the spinal canal and spinal cord. A laminectomy is the removal of the entire lamina; a laminotomy removes only a part of the lamina. These procedures can create more space for the nerves, reducing the likelihood of the nerves being compressed or pinched.

Recovery from Surgery to Relieve Sciatic Nerve Pain
After your surgery, you are not going to instantly feel better. Depending on the complexity of your spine surgery, you may be sitting upright the same day and likely walking within 24 hours. A short course of pain medications help your manage postoperative pain. You will receive instructions on how to carefully sit, rise, get out of bed, and stand. It's important to give your body time to heal, so your doctor may recommend that you restrict your activities: in general, don't do anything that moves your spine too much. You should avoid contact sports, twisting, or heavy lifting while you recover.

After surgery, be vigilant. Report any problems—such as fever, increased pain, or infection—to your doctor right away.

Will Spine Surgery Relieve Sciatica?
The surgeon will work to provide you with, in general, pain relief and better mobility (although the specific goals can vary based on your symptoms and needs).  By removing whatever is pressing on your sciatic nerve (a herniated disc, for example, or a bone spur), the end goal is to decompress that nerve, which should relieve your sciatic pain.

The majority of patients experiencing sciatica don't need spine surgery, but if you do, know that many other patients have found pain relief through surgery. 

Updated on: 07/02/19
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Outpatient Minimally Invasive Lumbar Laminectomy
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Outpatient Minimally Invasive Lumbar Laminectomy

If you experience low back and leg pain and haven’t found relief through nonsurgical treatments like medication or physical therapy, your spine doctor or surgeon may recommend lumbar laminectomy.
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