Surgery for sciatica

In January, with pain in my hip and thigh haunting me all day and waking me up in the middle of the night, I struggled to stay positive. My blood pressure was up from the constant discomfort. I had planned to embrace the winter stomping along Boston’s Emerald Necklace in snow shoes, but instead, I spent hours soaking in a hot tub with a novel to relieve the sciatica.

My doctor sent me to a neurosurgeon, who showed me scary images of my vertebrae with a blob bulging between them where it clearly didn’t belong. This was the infamous herniated disc. And there was something else I had long suspected. Anatomy books show the vertebrae stacked up neatly like poker chips, but my lower ones were skewed in a spiral shape.

It explained why I tend to lean to one side, and why my blouses always look a bit crooked. I’m a bit crooked.

I’m also a poor candidate for the surgery usually done for sciatica, in which part of the bone is removed to give the nerve root extra space and relieve the pressure. The surgeon thought this was a bad idea for me because the joints in my spine don’t meet up quite right, and hollowing out a bit of bone (called a laminectomy) would make them too unstable. He would have to fuse a couple of vertebrae together, a more extensive operation with greater risks.

Although my surgeon did not suggest them, there are a couple of other surgical procedures for sciatica caused by herniated discs:
Discectomy, removing the damaged disc and fusing the vertebrae. The pesky discs may slip and cause trouble, but they are the spine’s shock absorbers, and if one is removed, the adjacent bones have to be joined.
Disc replacement. This is a new procedure, replacing the bad disc with an artificial one.

Like my regular doctor, the surgeon was concerned about the lack of reflex when he tapped my knee with the hammer. That, he said, combined with the MRI image, would prompt a less conservative surgeon to schedule the procedure immediately.

But he wanted to try physical therapy first. In spite of the pain, I was still walking to work and had not lost bowel or bladder function, and weakness in my right leg was negligible.

I started physical therapy two days later, and it worked. Last weekend, 12 weeks after I fell in December, I hiked seven miles.