Laminectomy Health Dictionary

Pain in the distribution of the sciatic nerve. It is often accompanied by pain in the back, or LUMBAGO. In the majority of cases, however, it is due to a PROLAPSED INTERVERTEBRAL DISC in the lower part of the SPINAL CORD. What probably happens is that degenerative changes take place in the annulus ?brosus (see SPINAL COLUMN) as a result of some special strain – caused, for example, by heavy lifting – or spontaneously. The cushioning disc between the two neighbouring vertebral bodies slips through the rent in the annulus ?brosus, and presses on the neighbouring roots, thus causing the pain. The precise distribution of the pain will thus depend on which of the nerve roots are affected. As a rule, the pain is felt in the buttock, the back of the thigh and the outside and front of the leg, sometimes extending on to the top of the foot, the back of the thigh and the calf, and then along the outer border of the foot towards the little toe.

Rare causes include a tumour in the spine or spinal column, tuberculosis of the spine, ankylosing spondylitis (see SPINE AND SPINAL CORD, DISEASES AND INJURIES OF) or a tumour in one of the organs in the pelvis such as the UTERUS.

Treatment consists essentially of rest in bed in the early stages until the acute phase is over. ANALGESICS, such as aspirin and codeine, are given to relieve the pain. Expert opinion varies as to the desirability of wearing a PLASTER OF PARIS jacket or a specially made corset; also, as to the desirability of manipulation of the spine and operation. Surgeons are selective about which patients might bene?t from a LAMINECTOMY (removal of the protruding disc).... sciatica

Surgery to relieve pressure on the spinal cord or a nerve root emerging from it (see microdiscectomy). Pressure may have various causes, including a disc prolapse, a tumour or abscess of the spinal cord, or a tumour, abscess or fracture of the vertebrae. Any of these conditions can cause weakness or paralysis of the limbs and loss of bladder control.

To treat major disc prolapses and tumours, a laminectomy (removal of the bony arches of 1 or more vertebrae) to expose the affected part of the cord or nerve roots may be performed. Recovery after treatment depends on the severity and duration of the pressure, the success of the surgery in relieving the pressure, and whether any damage is sustained by the nerves during the operation.... decompression, spinal canal

(PID) a ‘slipped disc’: protrusion of the pulpy inner material of an *intervertebral disc through a tear in the fibrous outer coat, causing pressure on adjoining nerve roots, ligaments, etc. The condition often results from sudden twisting or bending of the backbone or lifting. Pressure on the sciatic nerve root causes *sciatica, and if severe may damage the nerve’s function, leading to abnormalities or loss of sensation, muscle weakness, or loss of tendon reflexes. 70–80% of patients improve with conservative treatment of rest and analgesics, and traction may help. If these fail, the protruding portion of the disc is surgically removed (see discectomy; laminectomy; microdiscectomy).... prolapsed intervertebral disc