The Lowdown on Low Back Pain
(and Other Aches)


I have sciatic nerve pain. Do I need surgery?


Sciatica is the name of a type of leg pain. It is usually caused when a bulging or ruptured disc pinches one of the nerves that goes to the legs.

Injections, epidurals, or nerve blocks, are performed using X-ray guidance. The surgeon injects cortisone, a potent anti-inflammatory, around the painful and inflamed nerve.

For a ruptured disc (where a piece has broken off), an open, microscopic surgery may be needed. When the disc is “bulging” or “prolapsed” but not broken off, research has shown that some percutaneous (needle) procedures may work.

With percutaneous needle surgery, there is no incision and only a local anesthetic is required. The needle is positioned with the help of X-ray. A laser is then used to remove a portion of the damaged disc through the needle. The procedure takes 20 to 45 minutes, and hospitalization is not needed.

The laser needle procedure will be successful 75 to 90 percent of the time in good candidates. Surgery can be avoided if the pain is relieved. Common sense dictates that the least invasive, and the least risky treatments, should be tried first.



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Last modified: 07/27/08