Have you scheduled a surgical consultation for sciatica? Are you fully prepared to make one of the most important decisions of your life? We certainly hope so. Spinal surgery is a very serious proposition that is taken far too lightly by many patients. Furthermore, even if surgery is right for you, are you ready to investigate which surgeon should perform the procedure, rather than passively accepting the first doctor you consult with?
Sciatica surgery is very commonly utilized in patients who have not found relief from more conservative methods of care. Unfortunately, surgery is rarely effective in terms of ending symptoms, especially when evaluated over timelines of 7 years. The reasons why sciatica surgery is so ineffective are obvious to us, but continue to elude many patients who invest themselves, their health and their very lives in these barbaric interventions that rarely succeed.
This dialog provides an objective look at the surgical consultation process for sciatica patients. We will discuss whether surgery is actually necessary, the effectiveness of the most common surgical techniques and the alternatives to surgery that may provide much better therapeutic outcomes.
Necessity of a Surgical Consultation for Sciatica
Spinal surgery is often suggested to patients who can not find relief using more conservative methods of care over the first year of suffering. If symptoms continue beyond 6 to 12 months, there is a very good chance that the doctor handling the case will recommend consulting with a surgeon. This advice already imparts a substantial nocebo effect to cope with and often escalates anxiety and pain in the majority of people who receive a prescription to see a surgeon.
There are very, very few cases where spinal surgery is deemed to be medically necessary. In the vast majority of patients, surgery is optional and offered simply as another option. Although conservative care has failed, many patients believe that an escalation of care to surgical intervention may provide better results. Why they think this is beyond our logic, since statistics point to the exact opposite pattern. Most surgeries fail to deliver satisfying therapeutic outcomes and a great number of patients are actually worsened by spinal procedures each year.
Therefore, the very first point that needs to be firmly established is that spinal surgery is virtually never needed and is simply another avenue to try when it comes to curing sciatica. The exceptions to this rule include cases of cauda equina syndrome or significant spinal cord compression that might be considered medical emergencies requiring invasive decompression treatment.
Surgical Success Rates
If surgery is indeed performed, how well can a patient expect it to go? Well, this depends much on the underlying source of symptoms. There are many possible causes of sciatica and some of these are more readily treatable than others. When it comes to true spinally-motivated sciatica, surgical treatment produces the following results according to the latest statistics:
Lumbar spinal stenosis is usually treated by laminectomy and features some of the best therapeutic outcomes. More than 60% of treated patients do well following spinal canal enlargement, although most will still suffer at least some degree of symptoms postoperatively.
Lumbar herniated discs feature the worst results for resolving sciatica. Virtually all disc surgeries are not necessary, since most herniated discs are not even accurately diagnosed as the true sources of pain. The vast majority of herniated disc surgeries yield poor outcomes over timelines of 7 years, with continued pain, re-herniation and other factors being commonly cited for their disappointing results.
Spondylolisthesis, lumbar scoliosis, severe hyperlordosis and severe hypolordosis are commonly treated using spinal fusion. Spondylodesis surgery is the most invasive and also demonstrates terrible curative results, with few patients finding pain relief and many suffering horrific consequences. Spinal fusion is also the most commonly reported reason for subsequent spinal operations.
The second major point that needs to be stressed is that spinal surgery is rarely effective at ending sciatica and actually escalates pain in almost as many patients as it completely cures.
Alternatives to a Surgical Consultation for Sciatica
Just because your pain has not resolved does not mean that you require surgery. No one wants to suffer, but surgery is far from guaranteed to work and there are other therapy choices that definitely provide better curative outcomes:
Spinal decompression offers hope for true curative care without surgery. Decompression is best suited for disc-related sciatica, but can also be used for several different types of lumbar arthritis that may be causative or contributory to pain.
Symptomatic care might not provide a cure, but at least can be performed without compromising overall health and wellness, as long as the patient agrees to use only constructive methods of care, like massage, chiropractic, acupuncture and others. Patients should avoid the more common utilization of drug and injection therapies, as these are also very dangerous and damaging.
Knowledge therapy always earns recommendation based on its excellent curative statistics. The reason it works is because most chronic sciatica is misdiagnosed and not caused by structural irregularity in the spine. If it were, then surgery and the many others treatments that act on the spine would be far more effective than they are. Meanwhile knowledge therapy is cited as being the most effectual all around treatment for chronic pain, with most patients reporting complete cures.
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