Sciatica occurs because the outer membrane which surrounds the spinal disc is loose, or ruptured, allowing the disc to protrude through the membrane.  A herniated or ruptured disc presses on the sciatic nerve, the large nerve that extends down the spinal column to its exit point in the pelvis and carries nerve fibers to the leg. This compression causes pain down the legs and numbness of the feet.

The symptoms include:

- Burning low back pain down through the leg
- Numbness from the waist down through the leg and back of the foot
- Weakness of the leg muscles
- Abnormality in the control of bladder and bowel

Causes

1. The disc can be damaged from an accident or when people move their spines in the wrong way, for example when heavy lifting, incorrect lifting, exercising wrongly or over exercising.

2. Aging process, sedentary life style with too little exercise or over use of the spine can cause deterioration of the discs until they impinge upon the nerve.

Treatment Options

Treatment without surgery

This is suitable for patients with not very serious symptoms.  The treatment can include:

 -Taking pain relief medication
 -Physical therapy
 -Selective nerve root block

Treatment with surgery

1. Nucleoplasty is the name of the procedure used to describe disc decompression using medical technology to ablate and remove tissue in the nucleus pulposus of the disc.  Because tissue removal is achieved by inserting a small needle together with local anesthetic, damage to surrounding tissue is minimized.  Nucleoplasty is also less expensive than the operation for disc removal.

2. Minimally invasive surgery (wound size under 3-5 centimeters long) is done by using Fluoroscopic X-ray C-Arm examinations to identify the anatomical position.  This can be carried out only by physicians specially trained in fluoroscopic diagnostic procedures, radiologists and other specialists.  In some cases, minimally invasive surgery is done using the microscope so the nerve can be clearly viewed and damage to surrounding tissue is minimized.

3. Full Endoscopic Spinal Surgery:  The surgery is done with the aid of the endoscope (Full Endoscopic Lumbar Discectomy).  The technique is to insert the endoscope (diameter of 8 mm) through the muscle.  The lens is attached to the end of the endoscope.  After the endoscope reaches the damaged area, the surgical equipment is inserted through the endoscope and corrects the disc pathology.  In this procedure, the muscle tissue needs not to be detached from the spine and the bone is not cut.
For more information, please contact Orthopedic Center, or call the hospital’s Contact Center at 1719.