What exactly is Sciatica?
Sciatica is actually a symptom rather than a condition and it relates to a wide range of leg pains that can be felt in a variety of different ways, ranging from a bad cramp to an excruciating pain that makes standing or sitting virtually impossible. The pain can get worse when you move or even when you sneeze or cough. In many cases the patient may feel weakness, numbness, burning or a tingling ‘pins and needles’ sensation. Sometimes it causes problems in bending the knee or moving the foot or toes.
What causes Sciatica?
Sciatica can be a symptom of a pinched or trapped nerve inside or outside the spinal column. Often this is because of a slipped disc, a muscle problem in the buttocks or a narrowing or slippage of one of the vertebrae in the spine so that it is out of line. However, it is widely accepted that the pain of Sciatica is relates to the soft tissue ‘discs’ that separate and cushion the vertebrae, to the facet joints at the back of the spinal column and to the network of nerves that populate and surround the spinal area.
Why is diagnosis difficult?
Until the advent of aware state surgical examination, the sources of Sciatica were hard to define and surgeons engaged in pre-operative ‘guesstimation’ based on the results of clinical examination, X-rays, MRI scans and CAT scans. The complexity of the spinal region means that a wide range of possible conditions exist to confound diagnosis. Also, the spine is subjected to the stress and strain of everyday living and in time the discs can become damaged and distorted, bone structures and the facet joints can change and nerves can be trapped, pinched or irritated; all of which are potential sources of Sciatica.
Can the sources of pain be pinpointed?
Aware state surgical examination enables the patient to give the surgeon feedback, guiding him or her to the point that is responsible for the pain. This ‘live’ approach allows the causal level of Sciatica to be accurately defined and then viewed using endoscopic instruments through a tiny incision. In this way, neural anomalies and strange nerve combinations can be detected and diagnostic errors avoided. Thus, the surgeon is guided to the precise source of pain at that specified inter-vertebral point and the understanding of the actual mechanisms underlying the causation of sciatica.
Is accurately targeted treatment possible?
Single targeted surgery enables Sciatica to be precisely treated with the minimum of damage to tissues, reduced patient risk and enhanced long-term outcome. This treatment, which is called ‘Foraminoplasty’ because it is carried out in the gaps or ‘Foramen’ between the vertebrae, allows the nerve to thoroughly liberated. This is only possible by the use of Endoscopic Minimally Invasive Spine Surgery where the full length of the exiting nerve can be explored and the points of irritation clearly demonstrated..
What is wrong with conventional surgery?
Multi-level open surgery including microdiscectomy, open decompression, solid or flexible fusion and disc replacement is an ‘overkill’ with negative side-effects including blood loss, potential nerve and tissue damage, extended post-operative care and unnecessarily operating on pain-free levels. It is not as effective as Foraminoplasty in addressing and ameliorating Sciatica, rather it runs the risk of increased complications including recurrent disc bulging, infection, nerve damage and scarring round the nerve, implant failure, major vessel damage or sexual dysfunction. Microdiscectomy for instance runs the risk of causing long standing back pain even when leg pain is reduced.