Causes and surgery lumbar pain and sciatica

Written by: Dr. Javier Cobo Soriano
Published: | Updated: 19/05/2018
Edited by: Top Doctors®

Over time, almost all humans, probably due to overload in the lumbar spine by standing, chemical changes occur within the disk, leading to dehydration. Dehydration alters the properties of the hydraulic mechanism having a healthy disc. When disc damper loses its function, the distribution of the load is transferred to the vertebral joints and ligaments which can react hipertrofiándose and narrowing the channel where the nerve roots run. Besides mechanical alterations occur in mobility between the vertebrae.

root compression

radicular compression 2

The first image is a drawing in which different degenerative manifestations that produce nerve root compression are represented. The second image is an MRI of a case with degenerative problems and hernias in the last two lumbar levels.

These morphological and functional manifestations define "lumbar spine arthrosis". The discs and the joints become inflamed and irritated cause lumbar pain, better known as lumbago. Specialists explain Traumatology when nerve roots are irritated sciatic pain or sciatica occurs.

 

When to operate?

In most cases there is no need to follow any surgical treatment for the ailment disappears with conservative treatments. It is therefore advisable to wait some time (at least three months) before deciding surgery. However, in many patients the pain persists over time and need to operate.

The decision to go into surgery taken with "common sense" as other major life decisions: considering the pros and cons. Consider especially future expectations and quality of life. The decision was taken when the symptoms are sufficiently important and the patient knows that will not improve if you do not operate.

removal

 

Objectives of surgical treatment of lumbar radiculopathy:

atrodesis Surgery has two objectives:

  • Decompression. To decompress the nerve roots laminectomy, facetectomías, flavectomías, foraminotomías or disk removal (diskectomy) are performed. These actions aim to liberate the roots of compressions (Figure 2).
  • Fusion or arthrodesis. Frequently, unzipping also need to merge. Fusion is the preferred method for stabilizing the lumbar levels. By this method we immobilize the vertebral levels whose mobility is sick and painful. For this purpose implants placed in the vertebrae and bone graft osteoconductive substances associated with calcium.

Thanks to the technological development of the last decade, both the descompresióncomo for the merger, we have significantly reduced the surgical aggressiveness, making it less invasive surgery using special separators, which allow much smaller incisions.  

*Translated with Google translator. We apologize for any imperfection

By Dr. Javier Cobo Soriano
Orthopaedic Surgery

The prestigious Dr. Cobo Soriano is a specialist in pathology and Spinal Surgery. With almost 20 years of experience is an expert in surgery of lumbar and cervical disc herniation, spinal arthritis, deformities, osteoporosis, fractures and tumors. Practice minimally invasive techniques, especially kyphoplasties, neurological decompression and spinal instrumentations. He received additional training in various hospitals of international prestige. She combines her clinical work with teaching, lecturing at the Faculty of Medicine of the University of Alcala de Henares. He is the author of numerous articles published in books and magazines of national and international scope.

*Translated with Google translator. We apologize for any imperfection

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