Lumbar Radiculopathy (“Sciatica”) and Herniated Disc

Lumbar radiculopathy/sciatica is term used to describe radiating leg pain, tingling, numbness, or weakness caused by inflammation or compression of a spinal nerve in the lower back. Lumbar radiculopathy can result from a Degenerated disc,herniated disc, Spondylolisthesis or spinal canal stenosis (narrowing of the lumbar spine).

Herniated Disc

  • Tear in the outer wall (annulus) of the disc allows the inner gel (nucleus) to protrude into the spinal canal

Natural History (“Doing Nothing”)

  • Not all degenerated discs are symptomatic
  • Symptoms may resolve with rest and conservative treatment of 2-3 weeks.
  • Herniated material may get shrink over time.

“Cauda Equina Syndrome”

  • Emergency 
  • Loss of bowel and bladder function, weakness or perianal numbness due to pressure an all of the nerves running through the spinal canal
  • Caused by large herniated disc
  • Surgical treatment needed urgently

Three Phases of Treatment for Lumbar Disc Herniation:

  • Phase I – Non-Invasive Treatments
  • Phase II – Interventional Pain management/ Spine injections
  • Phase III – Surgery (Endoscopy/MIS)
  • Goals of Each Phase:
  • Relieve Pain
  • Improve Function

Treatment Options for Lumbar Disc Herniation: Phase I

  • Rest
  • Oral Medications
  • Steroids
  • Non-Steroid Anti-Inflammatories (NSAIDs)
  • Physical Therapy and Home Exercise
  • Ice and Heat

Treatment Options for Lumbar Disc Herniation: Phase II

  • Epidural Steroid Injections
  • Day care procedure
  • Done with x-ray guidance

Treatment Options for Lumbar Disc Herniation: Phase III – Surgery

1)Transforaminal Endoscopic Lumbar Dissectomy

2) Interlaminar Endocopic Lumbar Dissectomy

3) MicroLumbar Dissectomy

Emergency Medical Assistance

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