Table of ContentsView AllTable of ContentsWhat It IsTypesRisksIndicationsPreparationHow It Is DoneRecovery

Table of ContentsView All

View All

Table of Contents

What It Is

Types

Risks

Indications

Preparation

How It Is Done

Recovery

The sciatic nerve consists of several nerve roots that exit thespinal cordin the lower back. When the nerve is compressed (“pinched”), it can cause sharp, burning, or shock-like pain in the lower back radiating to the buttocks, thigh, and lower leg.

Whensciatica symptomscannot be relieved with conservative treatments, surgery may be recommended. This may involve procedures called discectomy, laminectomy, and spinal fusion surgery.

This article describes the different types of sciatica surgery anorthopedic surgeoncan perform, including the aims, benefits, and risks. It also explains what to expect before, during, and after surgery—including who is a good candidate for sciatica surgery and who is not.

What Is Sciatica Surgery?

The sciatic nerve is the longest and thickest nerve in the body. It consists of five nerve roots that emerge from thelumbar spineof the lower back and the triangular bone situated just below the lumbar spine called thesacrum.

From there, the nerve then travels down the hip to just below the knee where splits into two branches: thetibial nerve(which provides sensation to the back of the lower leg and foot) and thecommonperonealnerve(which provides sensation to the front of the lower leg and foot).

Compression of the sciatic nerve can cause radiating pain to any of these body parts.

Types of Sciatica Surgery

Sciatica surgery is generally recommended when conservative treatments fail to provide relief. This includes conservative treatments like rest,heat or cold therapy,over-the-counter and prescription painkillers,physical therapy,cortisone shots, andnerve pain medicationslike antidepressants and anticonvulsants.

There are several options for surgery based on where the compression of the nerve is located:

Chronic Sciatica Symptoms and Treatment in Later Stages

Risks of Sciatica Surgery

Sciatica surgery can often be effective, but there are certain risks you need to be aware of before undergoing any spinal procedure.

This includes the risk of:

How Common Are Surgical Complications?A 2015 review of studies in theOpen Orthopaedics Journalsuggests that the rate of complications from spinal surgery, both minor and severe, is roughly 23%.For this reason, it is important to weigh the benefits and risks of any spinal surgery before undergoing any such procedure.

How Common Are Surgical Complications?

A 2015 review of studies in theOpen Orthopaedics Journalsuggests that the rate of complications from spinal surgery, both minor and severe, is roughly 23%.For this reason, it is important to weigh the benefits and risks of any spinal surgery before undergoing any such procedure.

Who Is a Good Candidate for Sciatica Surgery?

Sciatica surgery is recommended when conservative treatments fail to improve symptoms, generally for a period of 12 months.

Your healthcare provider may also recommend you as a candidate for surgery if you have these complications or conditions:

To evaluate the severity of your sciatica, your orthopedic surgeon will order imaging tests, includingx-rays,CT scans, andmagnetic resonance imaging, to view exactly how the sciatic nerve is being impinged on.

Sciatica surgery is not a solution for everyone. Among the people who are not good candidates for surgery are those with:

How to Prepare for Sciatica Surgery

Sciatica surgery is performed as anoutpatient procedure. You should expect to stay overnight for at least one night in the hospital.

The length of stay will depend on the type of procedure you are scheduled to undergo. For a discectomy, laminectomy, or foraminotomy, expect to stay at the hospital for one to two days. Spinal fusion surgeries are more involved and typically require three to five days.

You may need to stop taking certain medications as far as two weeks before your surgery to prevent excess bleeding or interaction withanesthesia. These typically include:

What to Expect From Sciatica Surgery

Sciatica surgery is performed in an operating room of a hospital. The surgical team consists of an orthopedic surgeon, ananesthesiologist, asurgical nurse, and possibly asurgical technologist(“scrub”).

The surgery can take anywhere from 30 minutes for an uncomplicated minidiscectomy to up to six hours for spinal fusion surgery.

Before the Surgery

On the day of the surgery, you will be taken to a preoperative room for a physical exam. A nurse will place an intravenous (IV) line in your arm or hand to deliver fluids and medications likeanesthesia. The surgical team will use the hospital bed to transport you in and out of the operating room.

You will be givengeneral anesthesiato put you fully asleep. Once sedated, anendotracheal tubewill be inserted into your mouth and windpipe to deliver oxygen from amechanical ventilator. Your heart rate, blood pressure, and blood oxygen will be monitored the entire time.

During the Surgery

Depending on what type of surgery you’re undergoing, the surgeon will make either one large incision (for open surgery) or several small incisions (for laparoscopic surgery).

Thereafter, the procedures are performed as follows:

After the surgery is completed, the incisions are closed with sutures or glue and the wound is covered with a sterile bandage. You will then be wheeled to the postoperative room to recover from the anesthesia.

After the Surgery

Upon waking, most people will experience pain and wooziness. The pain can be intense for a couple of days, during which time oral or injected painkillers (ranging fromTylenoltooxycodone) may be prescribed.

For people who have undergone extensive spinal fusion, apatient-controlled analgesia (PCA) pumpmay be used to self-administer painkillers (analgesics) on demand.

Moving after spinal surgery is important to prevent blood clots and aid with healing. However, care must be taken to avoid injuring yourself. This may include using a walker or getting out of bed with a special technique—called “log-rolling”—to avoid twisting the spine.

When your vital signs are stable and your care team is confident that you can recover safely at home, you will be discharged under the care of someone who can drive you home.

Recovery From Sciatica Surgery

The time it takes to recover from sciatica surgery can vary.

For a discectomy, laminectomy, or foraminotomy, expect to take anywhere fromtwo to four weeksbefore you can return to work andeight to 12 weeksbefore you can perform heavy lifting.

For spinal fusion surgery, it will take at leastfour to six weeksbefore you can go back to work safely. Full recovery can take betweensix months and one year.

During the first two weeks of recovery, you will need to adhere to certain restrictions to ensure you heal properly, including:

To maintain spinal alignment, either sleep on your back with pillows under your knees or on your side with pillows placed between your knees and behind your back. Avoid sleeping on your stomach as this places strain on the lower back and can hinder recovery.

If you are given a back brace, wear it at all times except when lying down and sleeping. Your healthcare provider will advise you when the brace is no longer necessary.

Summary

Sciatica surgery is an option if conservative treatments fail. There are different approaches to surgery, including discectomy to treat herniated discs, laminectomy to smooth irregularities in the spinal bones, and foraminotomy to widen the space where the sciatic nerve exits the spinal column.

Surgical fusion surgery is also an option, which involves the placement of metal plates, rods, and screws to prevent spinal bones from moving.

Complications from spinal surgery are common, and symptoms may continue even after treatment. It is important, therefore, to speak with your orthopedic surgeon to fully understand the benefits and risks associated with any spinal surgery.

15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Pacaud A, Darloy j, Flipo RM, Paccou J, Assaker R, Cortet B.Frequency and determinants of surgical treatment in patients with uncomplicated disc-related sciatica hospitalized in the Rheumatology Department of Lille University Hospital.J Spine Surg.2022;8(4):453-461. doi:10.21037/jss-22-43Fairag M, Kurdi R, Alkathiry A.Risk factors, prevention, and primary and secondary management of sciatica: an updated overview.Cureus.2022 Nov;14(11):e31405. doi:10.7759/cureus.31405American Academy of Orthopaedic Surgeons.Sciatica.Jensen RK, Kongsted A, Kjaer P, Koes B.Diagnosis and treatment of sciatica.BMJ.2019;367:l6273. doi:10.1136/bmj.l6273Aguilar-Shea AL, Gallardo-Mayo C, Sanz-González R, Paredes I.Sciatica: management for family physicians.J Family Med Prim Care. 2022;11(8):4174-4179. doi:10.4103/jfmpc.jfmpc_1061_21Bailey CS, Rasoulinejad P, Taylor D, et al.Surgery versus conservative care for persistent sciatica lasting 4 to 12 months.N Engl J Med.2020;382(12):1093-1102. doi:10.1056/NEJMoa1912658Ju CI, Ha SW, Kim SW, Lee SM.Contraindications and complications of full endoscopic lumbar decompression for lumbar spinal stenosis: a systematic review.World Neurosurgery. 2022;168:398-410. doi:10.1016/j.wneu.2022.07.066Reis RC, de Oliveira MF, Rotta JM, Botelho RV.Risk of complications in spine surgery: a prospective study.Open Orthop J.2015;9:20–25. doi:10.2174/1874325001509010020Mayfield Clinic.Lumbar discectomy.Mayfield Clinic.Spinal decompression (laminectomy).MedlinePlus.Foraminotomy.McNicol ED, Ferguson MC, Hudcova J.Patient controlled opioid analgesia versus non-patient controlled opioid analgesia for postoperative pain.Cochrane Database Syst Rev. 2015;2020(7). doi:10.1002/14651858.CD003348.pub3Mount Sinai.Spinal fusion.University of Michigan Health System.How to care for yourself after lumbar spinal fusion.University of Wisconsin Health.Home care instructions after lumbar laminectomy, decompression or discectomy surgery.

15 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Pacaud A, Darloy j, Flipo RM, Paccou J, Assaker R, Cortet B.Frequency and determinants of surgical treatment in patients with uncomplicated disc-related sciatica hospitalized in the Rheumatology Department of Lille University Hospital.J Spine Surg.2022;8(4):453-461. doi:10.21037/jss-22-43Fairag M, Kurdi R, Alkathiry A.Risk factors, prevention, and primary and secondary management of sciatica: an updated overview.Cureus.2022 Nov;14(11):e31405. doi:10.7759/cureus.31405American Academy of Orthopaedic Surgeons.Sciatica.Jensen RK, Kongsted A, Kjaer P, Koes B.Diagnosis and treatment of sciatica.BMJ.2019;367:l6273. doi:10.1136/bmj.l6273Aguilar-Shea AL, Gallardo-Mayo C, Sanz-González R, Paredes I.Sciatica: management for family physicians.J Family Med Prim Care. 2022;11(8):4174-4179. doi:10.4103/jfmpc.jfmpc_1061_21Bailey CS, Rasoulinejad P, Taylor D, et al.Surgery versus conservative care for persistent sciatica lasting 4 to 12 months.N Engl J Med.2020;382(12):1093-1102. doi:10.1056/NEJMoa1912658Ju CI, Ha SW, Kim SW, Lee SM.Contraindications and complications of full endoscopic lumbar decompression for lumbar spinal stenosis: a systematic review.World Neurosurgery. 2022;168:398-410. doi:10.1016/j.wneu.2022.07.066Reis RC, de Oliveira MF, Rotta JM, Botelho RV.Risk of complications in spine surgery: a prospective study.Open Orthop J.2015;9:20–25. doi:10.2174/1874325001509010020Mayfield Clinic.Lumbar discectomy.Mayfield Clinic.Spinal decompression (laminectomy).MedlinePlus.Foraminotomy.McNicol ED, Ferguson MC, Hudcova J.Patient controlled opioid analgesia versus non-patient controlled opioid analgesia for postoperative pain.Cochrane Database Syst Rev. 2015;2020(7). doi:10.1002/14651858.CD003348.pub3Mount Sinai.Spinal fusion.University of Michigan Health System.How to care for yourself after lumbar spinal fusion.University of Wisconsin Health.Home care instructions after lumbar laminectomy, decompression or discectomy surgery.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Pacaud A, Darloy j, Flipo RM, Paccou J, Assaker R, Cortet B.Frequency and determinants of surgical treatment in patients with uncomplicated disc-related sciatica hospitalized in the Rheumatology Department of Lille University Hospital.J Spine Surg.2022;8(4):453-461. doi:10.21037/jss-22-43Fairag M, Kurdi R, Alkathiry A.Risk factors, prevention, and primary and secondary management of sciatica: an updated overview.Cureus.2022 Nov;14(11):e31405. doi:10.7759/cureus.31405American Academy of Orthopaedic Surgeons.Sciatica.Jensen RK, Kongsted A, Kjaer P, Koes B.Diagnosis and treatment of sciatica.BMJ.2019;367:l6273. doi:10.1136/bmj.l6273Aguilar-Shea AL, Gallardo-Mayo C, Sanz-González R, Paredes I.Sciatica: management for family physicians.J Family Med Prim Care. 2022;11(8):4174-4179. doi:10.4103/jfmpc.jfmpc_1061_21Bailey CS, Rasoulinejad P, Taylor D, et al.Surgery versus conservative care for persistent sciatica lasting 4 to 12 months.N Engl J Med.2020;382(12):1093-1102. doi:10.1056/NEJMoa1912658Ju CI, Ha SW, Kim SW, Lee SM.Contraindications and complications of full endoscopic lumbar decompression for lumbar spinal stenosis: a systematic review.World Neurosurgery. 2022;168:398-410. doi:10.1016/j.wneu.2022.07.066Reis RC, de Oliveira MF, Rotta JM, Botelho RV.Risk of complications in spine surgery: a prospective study.Open Orthop J.2015;9:20–25. doi:10.2174/1874325001509010020Mayfield Clinic.Lumbar discectomy.Mayfield Clinic.Spinal decompression (laminectomy).MedlinePlus.Foraminotomy.McNicol ED, Ferguson MC, Hudcova J.Patient controlled opioid analgesia versus non-patient controlled opioid analgesia for postoperative pain.Cochrane Database Syst Rev. 2015;2020(7). doi:10.1002/14651858.CD003348.pub3Mount Sinai.Spinal fusion.University of Michigan Health System.How to care for yourself after lumbar spinal fusion.University of Wisconsin Health.Home care instructions after lumbar laminectomy, decompression or discectomy surgery.

Pacaud A, Darloy j, Flipo RM, Paccou J, Assaker R, Cortet B.Frequency and determinants of surgical treatment in patients with uncomplicated disc-related sciatica hospitalized in the Rheumatology Department of Lille University Hospital.J Spine Surg.2022;8(4):453-461. doi:10.21037/jss-22-43

Fairag M, Kurdi R, Alkathiry A.Risk factors, prevention, and primary and secondary management of sciatica: an updated overview.Cureus.2022 Nov;14(11):e31405. doi:10.7759/cureus.31405

American Academy of Orthopaedic Surgeons.Sciatica.

Jensen RK, Kongsted A, Kjaer P, Koes B.Diagnosis and treatment of sciatica.BMJ.2019;367:l6273. doi:10.1136/bmj.l6273

Aguilar-Shea AL, Gallardo-Mayo C, Sanz-González R, Paredes I.Sciatica: management for family physicians.J Family Med Prim Care. 2022;11(8):4174-4179. doi:10.4103/jfmpc.jfmpc_1061_21

Bailey CS, Rasoulinejad P, Taylor D, et al.Surgery versus conservative care for persistent sciatica lasting 4 to 12 months.N Engl J Med.2020;382(12):1093-1102. doi:10.1056/NEJMoa1912658

Ju CI, Ha SW, Kim SW, Lee SM.Contraindications and complications of full endoscopic lumbar decompression for lumbar spinal stenosis: a systematic review.World Neurosurgery. 2022;168:398-410. doi:10.1016/j.wneu.2022.07.066

Reis RC, de Oliveira MF, Rotta JM, Botelho RV.Risk of complications in spine surgery: a prospective study.Open Orthop J.2015;9:20–25. doi:10.2174/1874325001509010020

Mayfield Clinic.Lumbar discectomy.

Mayfield Clinic.Spinal decompression (laminectomy).

MedlinePlus.Foraminotomy.

McNicol ED, Ferguson MC, Hudcova J.Patient controlled opioid analgesia versus non-patient controlled opioid analgesia for postoperative pain.Cochrane Database Syst Rev. 2015;2020(7). doi:10.1002/14651858.CD003348.pub3

Mount Sinai.Spinal fusion.

University of Michigan Health System.How to care for yourself after lumbar spinal fusion.

University of Wisconsin Health.Home care instructions after lumbar laminectomy, decompression or discectomy surgery.

Meet Our Medical Expert Board

Share Feedback

Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit

Was this page helpful?

Thanks for your feedback!

What is your feedback?OtherHelpfulReport an ErrorSubmit

What is your feedback?