Results of Microdiscectomy for Sciatica
By gathering the results of a particular type of surgery, health care providers are better able to guide back patients through an array of treatment choices. One procedure with few long-term studies is microsurgery for sciatic pain that hasn't gotten better even after a lot of nonsurgical treatment.
Sciatica is the name given for pain that runs from the lower back down the leg. The cause of sciatica can be hard to pinpoint. If the nerve is being pinched from a herniated disc, surgery may be needed to remove the pressure. Microsurgery to remove part or all of the problem disc in the low back is categorized as lumbar microdiscectomy.
This study followed about 250 sciatica patients in Austria. All patients had some type of lumbar microdiscectomy. Although there are several reasons a person might need this procedure, the only factor for surgery in this group of patients was sciatic pain.
An average of seven years after surgery, one fourth of the patients were free of pain. Over 65 percent were much improved, leaving about 10 percent that were no better or were worse.
The authors also checked on the patients' work history. About 65 percent of patients had returned to their jobs. Of the remaining patients, 15 percent had been forced to change jobs because of their sciatica, 14 percent were forced to take early retirement, and 6 percent were unable to work.
The authors noted that patients who'd had prior back surgeries and patients who had sciatica for longer than three months were the least likely to get better. They conclude that intensive conservative therapies are the front-line treatment choice when sciatic pain from a herniated disc is not causing worsening neurological symptoms. However, they balance this conclusion by commenting that if sciatic pain has been present longer than three months, the surgical results are generally not as good.
A. Schoeggl, et al. Outcome After Chronic Sciatica as the Only Reason for Lumbar Microdiscectomy. In Journal of Spinal Disorders. October 2002. Vol. 15. No. 5. Pp. 415-419.