Sciatica treated with minimally invasive laser spine surgery
Sciatica is nerve pain from an injury or irritation to your sciatic nerve. In addition to pain, it can involve tingling or numbness in your back or butt that may also radiate down your leg. More severe symptoms are also possible. Your sciatic nerve is the longest and thickest nerve in your body. It’s up to 2 centimeters wide (a U.S. penny or a United Kingdom 1 pence coin are about the same width). Despite its name, it’s not just one nerve. It’s actually a bundle of nerves that come from five nerve roots branching off from your spinal cord. You have two sciatic nerves, one on each side of your body. Each sciatic nerve runs through your hip and buttock on one side. They each go down the leg on their side of your body until they reach just below your knee. Once there, they split into other nerves that connect to parts farther down, including your lower leg, foot and toes. Having sciatica means you can experience mild to severe pain anywhere with nerves that connect to the sciatic nerve. The symptoms can affect your lower back, hips, buttocks or legs. Some symptoms may extend as far down as your feet and toes, depending on the specific nerve(s) affected.
Sciatica is also referred to as;
- Sciatic nerve Neuropathy
- Sciatic nerve dysfunction
- Low back pain (LBP) – sciatica;
- LBP – sciatica
- Lumbar radiculopathy – sciatica
In severe cases, you may experience weakness or numbness of any part of your legs.
The common symptoms of sciatica include;
- Pain. Sciatica pain happens because of pressure on the affected nerve(s). Patients describe sciatica as a constant aching pain or sharp burning sensation that shoots down one of your legs like an electric shock, possibly all the way to your toes, is the primary symptom. Some describe it as a burning or tingling (“pins and needles”) feeling. It may develop gradually or pop up suddenly; varying from a mild cramp to excruciating pain. Prolonged sitting, sneezing or coughing can aggravate the pain.
- Tingling or “pins and needles” (paresthesia). This is similar to the feeling you have when a leg falls asleep because you sat cross-legged.
- Numbness. This is when you can’t feel sensations on the skin in the affected areas of your back or leg. It happens because signals from your back or leg are having trouble reaching your brain.
- Muscle weakness. This is a more severe symptom. It means that muscle command signals are having trouble reaching their destinations in your back or legs.
- Urinary incontinence or fecal incontinence. This is a very severe symptom. It means signals that control your bladder and bowels aren’t reaching their destinations.
Types of Sciatica:
There are two types of sciatica. Regardless of what type you have, the effects are the same. The types are:
- True Sciatica: This is any condition or injury that directly affects your sciatic nerve.
- Sciatica-like conditions. These are conditions that feel like sciatica, but happen for other reasons related to the sciatic nerve or the nerves that bundle together to form it.
Causes of sciatica:
Common causes of sciatica include;
- Slipped or herniated disk
- Degenerative disk disease
- Spinal stenosis
- Foraminal stenosis
- Osteoarthritis
- Conus medullas syndrome
- Cauda equina syndrome
- Spondylolisthesis
- Piriformis syndrome (a pain disorder involving the narrow muscle in the buttocks)
- Pelvic injury or fracture
- Pregnancy
- Tumors
- Cysts
Procedure:
- The patient is put in prone position. The skin is cleaned and prepped, and the target is found using fluoroscopy. A small amount of local anesthetic is injected subcutaneously at the point of needle insertion.
- The introducer needle is then inserted through the skin, subcutaneous tissue, and muscle toward the target using fluoroscopy to guide the trajectory.
- Once the tip of the needle is placed satisfactorily close to the target, the active electrode is inserted through the needle.
- Sensory stimulation is used at first to recreate the painful symptoms that the patient experiences, thus locating the target.
- This is followed by motor stimulation to ensure that the active tip is not close to the motor nerves.
- Once confirmed, the generator produces a continuous output of voltage at the tip of the electrode. It will be kept at 80 degrees Celsius for approximately one minute, creating a zone of thermally induced coagulation
Complications:
- Anaesthesia-related complications.
- Infection
- Cerebrospinal fluid (CSF) leak
- Nerve root injury
- Burns
- New onset neuropathic pain
Frequently asked questions about laser spine surgery
What workup is needed for Laser spine surgery?
You will need routine haematological tests, X ray of spine and MRI of spine.
How many sessions are needed for Laser spine surgery?
Depending upon severity of symptoms and radiology, the number of sessions may vary.
What is expected time to recovery after Laser spine surgery?
After Laser spine surgery, patient is discharged on the same evening.
Does Dr Ammar Anwer accept insurance?
Yes, Dr Ammar Anwer accepts insurance.