exploring sciatica & back pain agrasen hospital gondia vidarbha dr sandeep c agrawal gondia...

www.drsandeepagrawal.com AGRASEN HOSPITAL DR SANDEEP AGRAWAL GONDIA www.agrasenortho.com!!

Dr.Sandeep Agrawal Consultant Orthopedic Surgeon MS,DNB Agrasen Hospital Gondia Maharashtra India www.agrasenortho.com www.drsandeepagrawal.com [email protected] 09960122234

EXPLORING SCIATICA (BACK PAIN )

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• Conservative treatment – Alters the natural history ?

• Foraminal epidural steroid injection – Positive response: more than 50% leg pain

improvement – 3 to 4 times in one year

• Absolute indication for surgery – Bladder and bowel symptoms – Progressive neurologic deficit

• Relative indication for surgery – Intractable pain more than 6 weeks

• Three sciatica episodes -> 100% future episodes • Gold standard: laminotomy + discectomy • Extraforaminal disc: Wiltse paraspinal approach

• Bed Rest (80% resolution within 6 weeks), herniated disc reduced in size over time ( water content loss, inflammatory cytokines reduction)

• Medication • Activity modification • Steroid injection => improved symptoms • Chymopapain –Possible anaphylatic shock

Lyman Smith, 1963


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exploring sciatica & back pain agrasen hospital gondia vidarbha dr sandeep c agrawal gondia...

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