Leg weakness after microdiscectomy
For people with sciatica, conservative treatments such as physical therapy, chiropractic care, and non-surgical decompression are usually sufficient. Minimally invasive microdiscectomy is a common surgical procedure performed in those whose pain has not been relieved by conservative means, or in those with severe symptoms such as incontinence that require immediate intervention.
A common cause of sciatica is a herniated disc in the lumbar spine. As the outer ring of the disc weakens, the fluid in the center of the disc begins to leak out and irritate the nerves leading out of the spine. The roots of the sciatic nerve exit the spine from the L4 to S3 vertebrae. Nerve irritation causes sharp pain radiating from the lower back to the legs, muscle weakness, and numbness.
Microdiscectomy involves the removal of the small piece of disc material responsible for impacting the nerve. Many who have undergone surgery find that although pain levels improve, strength does not return to the muscles in the affected leg.
Surgeons report that the success rates for microdiscectomy and other spinal surgeries are around 95%. However, these rates often reflect that the surgeon was successful in removing a disc piece or that the bones were fused together in a spinal fusion procedure. Actual patient relief is not always included in the definition of the success of a procedure.
A study of 91 patients with herniated disc and leg paresis (mild paralysis / weakness) who underwent microdiscectomy showed that success rates, in terms of regaining strength, were far from 95%. Only 75% of the study patients had regained strength in the affected leg one year after surgery. Although this represents a majority, a quarter of the participants did not regain strength; this is a remarkable percentage. See a summary of the study at http://www.ncbi.nlm.nih.gov/pubmed/22193841.
Microdiscectomy is often successful in relieving pain, but it cannot reverse nerve damage that was done before the procedure. If the sciatic nerve suffered damage that interfered with its ability to send motor and sensory impulses up the leg, this will not spontaneously recover after surgery. This means that if you have severe muscle weakness to begin with, microdiscectomy may not be a better option than conservative treatments for relieving pinched nerves. Decompression, traction, and exercise therapies should be performed rigorously before considering surgery.
Nervous regeneration
Nerve damage is usually permanent; There is no standard treatment to regenerate the sciatic nerve once damage has occurred. Experimental treatments such as stem cell therapy and growth factor therapy are promising options, but access to them is limited. Your best option for these treatments is to seek trial studies to participate or travel out of the country for treatment.
Consuming omega-3 fatty acids, either from food or supplements, can stimulate nerve repair soon after injury. See http://www.sciencedaily.com/releases/2012/01/120111103856.htm for more information on this.
Electrical stimulation of the nerves can also help them repair and grow back. This method has been tested on severed sciatic nerves in rats and has been shown to promote regeneration. Check with physical therapists, chiropractors, and other local health professionals about the availability of functional electrical stimulation in your area.
Microdiscectomy treatment is not likely to relieve severe leg weakness, as it is often caused by nerve damage. While it is important to resolve the cause of sciatic nerve impingement, a surgical procedure may not be the best option due to cost, recovery time, and risks. While severe nerve damage is often permanent, new methods of nerve regeneration are being explored.
