WHO IS A CANDIDATE FOR MINIMALLY INVASIVE ENDOSCOPIC SURGERY?

Those who possess the following symptoms:

°          radiation of leg pain either right, left, or both aggravated by sitting or walking

°          weakness in lifting the toe or heel with leg pain

°          numbness or tingling in either legs

°          back pain with radiation into the buttock muscles

°          inability to straighten up

°          numbness into the side of the leg or foot

°          pain into the testicles or down the front of the leg

WHAT TESTS SUGGEST THAT I MAY BE IN NEED OF A MINIMALLY INVASIVE SPINE SURGERY?

After you physician has examined you, there are numerous tests that confirm your problem:

°  an absent reflex

°  a positive straight leg raise test

°  atrophy of a muscle in the leg

°  inability to raise the big toe or heel walk

°  a positive MRI scan for a disc herniation or degenerative state

DO I NEED TO GO IMMEDIATELY TO SURGERY IF THE TESTS ARE POSITIVE?

No.  For example, I had a middle aged patient who as a child had a club foot.  He had atrophy of the leg and weakness into the calf muscles. These signs may not have been  from the disc problem, rather the foot problem as a young child. Therefore your physician must thoroughly exam you.  A complete history must be taken.  After your physician exams you then surgery may be an option.  However lets look at the alternatives to surgical intervention.

-epidural: this is where a needle is placed into your epidural space.  The epidural space is an empty covering surrounding  the disc and the nerves running into your legs. A steroid is injected in the sac.  The steroid is meant to reduce the inflammation around the nerve. 

-physical therapy:  this includes  traction, electrical stimulation, galvanic stimulation, ultrasound, and manual stretching.  The purpose of course is to reduce the swelling around the nerves by having the muscles function better. Patients with back problems generally have weak abdominal muscles.  The front muscles are the support muscles of the lumbar spine.