Discectomy for Sciatica

The symptoms of sciatica are largely due to the compression of nerves and blood vessels in and around the spine by the bulging matter of the intervertebral disc, the presence of osteophytes (bone spurs), calcified tissue, or spinal instability and curvature.  In a spinal treatment to address sciatica it is important that the material causing the compression is removed and the spine is stabilized so as to reduce the risk of further stenosis occurring.  A discectomy for sciatica is the excision of a fragment of herniated or bulging disc material or the whole of a disc that has degenerated and herniated which was pressing on a nerve.  This can decompress the lumbar spine and allow the nerves to begin healing, where possible.  Compression at L2-S1 may cause sciatica symptoms and a number of levels may require the removal of material pinching the nerves.

Traditional open discectomy is a back surgery that involves the surgeon making an incision in the back, just above the problematic disc, and the moving aside of the muscles, nerves, and ligaments to gain access to the herniation and remove the disc or disc fragments.  It is often necessary in this open procedure to sever some muscle and ligaments to gain access to the disc.  A microsurgery technique may be available depending on the location of the disc bulge or herniation and is, in most cases, preferable to the traditional open technique.  Most surgeons will use a posterior approach for the removal of bulging or herniated disc material in the lumbar spine as the compression usually occurs at the back of the spine.  An anterior approach may be used for disc herniation in the neck but is rare in a discectomy for sciatica.