Best management of sciatica (leg pain, numbness, tingling, or weakness) caused by a herniated disc in the lumbar spine is challenging. We spine surgeons incorporate several factors into our decision-making: severity and duration of symptoms as well as imaging findings just to name a few. At East Bay Brain & Spine/BASS Neurosurgery we aim to avoid surgery when a patient will likely improve with physical therapy and other “conservative” treatments. On the other hand, we perform surgery when discectomy will improve a patient’s pain, numbness/tingling, and strength outcome.
This recent study from the New England Journal of Medicine studies patients (a randomized trial) who have sciatica from a herniated disc and do not undergo surgery right away. When these patients do undergo discectomy surgery four to twelve months from when the leg symptoms began, their sciatica, back pain, and level of disability improve as compared to others who were assigned physical therapy, epidural steroids, or other non-surgical treatments.
This study provides further evidence that surgery for persistent sciatica and herniated disc in the low back is better than non-operative treatment.
Dear patients,
If you develop new or quickly worsening neurologic symptoms please contact our office. If you cannot reach our office please present to an emergency room for evaluation.
We thank you for your understanding as we respond to these unusual circumstances.
Sincerely,
Max Merkow M.D. and Matt Piazza M.D.
Dr. Merkow addresses the philosophy behind modern spine procedures that are commonly classified as “minimally invasive.” The tenets of these surgeries include minimizing tissue injury, utilizing neuronavigation (computer/imaging guidance), and maintaining normal spine motion. Examples include tubular retractor systems, artificial disc replacement, and lateral approaches to the spine. These surgeries shorten traditional recovery times. Dr. Merkow believes, when used appropriately, minimally invasive spine surgery improves clinical outcomes by decreasing pain, increasing strength, and raising one’s overall quality of life. East Bay Brain & Spine surgeons couple the latest in surgical technology with sound clinical judgment to better the lives of their patients.
Dr. Merkow was featured today in a KRON4 news story about deep brain stimulation in the East Bay. He explains that this procedure can improve the lives of many patients with Parkinson’s Disease and essential tremor. Vicki Goodwin graciously discusses her experience undergoing the procedure.
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