Newer Surgical Methods for Sciatic Pain

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Surgical Treatments For Sciatica Pain

Besides laminectomy, discectomy and spinal fusion, there are a few other methods of surgery to cure, or if not minimize, sciatica. These surgical options include, among others, percutaneous vertebroplasty, percutaneous kyphoplasty and disc replacement surgery (DRS).

1. Percutaneous Vertebroplasty

Percutaneous vertebroplasty is a surgical procedure prescribed to patients who suffer from spinal fracture on their vertebrae, leading to appearance of sciatic symptoms such as lower back pain, buttock pain and numbness of the lower limbs. Fractured spine is usually resulted from osteoporosis or cancer, causing the vertebrae to gradually collapse overtime due to compression.

Percutaneous vertebroplasty procedure involves injection of artificial, cement-like bone structure into the fractured spine in order to patch up the crack, removing pressure from the fractured bones and, therefore, eliminating sciatic pains. It is a relatively less invasive because it only causes a small puncture to insert the needle through the skin as compared to other common surgical procedures involving open incision on the skin. In fact, percutaneous vertebroplasty does not usually last for more than an hour.

Percutaneous-Vertebroplasty
Surgical Recovery

Bed rest is highly recommended for vertebroplasty patients for at least 24 hours after the procedure has been completed. After this period, despite the potential discomfort on the punctured site, patients can start to progressively perform daily activities or take their routine medications as per normal. In fact, recentresearches have shown that numerous patients have undergone about 90% reduction to complete elimination of sciatic pain within one or two days after surgery and can perform regular activities shortly after. Furthermore, it has also been proven that this significant decrease of pain would last up to three years after the procedure.

With added advantages for the strength and stability of spinal column, percutaneous vertebroplasty has proven that it is highly effective to substantially reduce, or even remove, sciatica.

Surgical Risk

No matter how minimally invasive a surgical procedure is, there is still a risk involved. Regarding performance of percutaneous vertebroplasty in particular, the Food and Drug Administration (FDA) has issued a warning against potential leakage of the bone substitute material—the cement-like bone substance chemically known as polymethylmethacrylate—which may cause further damage to the nerves and soft tissues. Therefore, patients are highly encouraged to ensure that they acquire vertebroplasty surgery from healthcare institutions and medical practitioners who have high success rates performing the procedure.

A case study has been compiled by the University of Washington on the performance of this surgical procedure and it is highlighted on the page below:
http://depts.washington.edu/ccor/studies/vplasty.shtml

2. Percutaneous Kyphoplasty

Unlike vertebroplasty, which injects artificial bone material into the fractured vertebrae, percutaneous kyphoplasty focuses more on restoring the original height of the fractured spine. How does it do so?

Well, kyphoplasty is usually begun by inserting a deflated surgical balloon into the body and inflating it around the compressed vertebrae to create an empty cavity. Subsequently, the artificial, cement-like bone substitute is injected into the void space to strongly support the spine back to its original height and straightness.

Percutaneous-Kyphoplasty
Due to its similarity with vertebroplasty, this surgical procedure therefore has similar recovery of24 to 48 hours of significant pain reduction and potentially up to three years of significant health improvement. The risk of material leakage is, however, also applicable and therefore patients are strongly advised to ensure excellent track records of their healthcare providers and practitioners.

3. Disc Replacement Surgery (DRS)

While both vertebroplasty and kyphoplasty are recommended to restore spine functionality from minor vertebrae fracture, disc replacement surgery (DRS) has become a considerable option for significantly or severely damaged vertebrae. Just like the name implies, DRS involves replacement of the original but damaged organic spinal or vertebral disc with a perfect yet artificial one made of metal. At the same time, if any of the intervertebral discs is also damaged, it will be replaced with manmadecushioning material called disc nucleus.

Disc-Replacement-Surgery
With an objective to remove sciatic pains due to the damaged spine, DRS can be compared to various joint replacement surgeries—hip, knee and shoulder joint replacements—many orthopedists have performed for almost a half of century to eliminate arthritic pain at the joints’ extremities. While they may be similar in concepts, materials and goals, DRS and joint replacement surgery are distinct from each other in terms of the number of joints replaced. Joint replacement surgery involves replacement of all joints that support the corresponding organ, whereas in DRS, only one damaged joint is exchanged with a prosthetic.

As technology advances, there have been two options of technology with which DRS can be performed. The US Government declared and certified the first one safe for general population in August 2004, while the subsequent technology was approved in 2006. Considering such rapid technological enhancement and, therefore, more access to advanced procedure to the public, DRS has become increasingly popular as an alternative surgery to cure sciatica due to damaged spine, another being an older procedure called spinal fusion. While there is no hard evidence showing which one is clearly better than the other, DRS has been shown to allow a certain degree of mobility around the affected area—a benefit not seen from the outcome of spinal fusion surgery.

The Best Treatment for Sciatica

Bearing in mind all the options to relieve or cure sciatica, surgical or non-surgical, it is highly advisable for patients to consult an experienced physician to determine severity and, thus, most appropriate treatment of these nerve-wrecking symptoms. Certain cases of sciatic pains may not require any surgical procedure, whereas other more chronic ones may only be cured by surgeries. In any cases, your physician may perform examinations on your internal organs using MRI, X-Ray, CT scan or even provocative discography in order to decide the extremity of your condition and whether or not surgical procedure is required.

Once he or she has identified the core problem of your sciatic pains, he or she will then be able to present you with some options of feasible and suitable treatments you may acquire.

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