UNDERSTANDING THE PROBLEM
Radiculopathy is a term used to describe conditions which have caused damage to the nerve roots which connect the spine to the rest of the nervous system. A well-known form of radiculopathy is sciatica. Radiculopathy is characterized by pain, numbness, and weakness which radiates from the spine.
UNDERSTANDING WHO SUFFERS
Lumbosacral radiculopathy occurs in approximately 3-5% of the population, and men and women are affected equally, although men are most commonly affected in their 40s, whereas women are most commonly affected between ages 50-60. Of those who have this condition, 10-25% develops symptoms that persist for more than 6 weeks.
POTENTIAL SIGNS AND SYMPTOMS
Lumbar radiculopathy is a classic syndrome of lower lumbar (lower spine) nerve root compression.
- Low back pain that may or may not have been associated with some sort of trauma and is commonly antecedent to the onset of leg pain by days to a few weeks.
- Motor weakness is also seen, but can be missed if dynamic testing is not done.
- Pain down the back of the leg and into the heel or foot.
- Sensory loss, usually over the lateral aspect of the foot.
- A loss of the Achilles reflex, specific to S1 nerve root.
- Weakness in dorsiflexion (backward bending) of the foot.
EXAMINATIONS USUALLY REQUIRED
Plain radiographs are the most common type of imaging modality that is used in the initial assessment of patients with lower back pain (LBP).
CT or CAT scan
CT scanning of the lumbar spine provides superior anatomic imaging of the osseous structures of the spine and good resolution for cases of disc herniation.
Magnetic Resonance Imaging (MRI)
MRI has demonstrated excellent sensitivity in the diagnosis of lumbar disc herniation and is considered the imaging study of choice for nerve root impingement.
PROPOSING TREATMENT AND WHY AIMIS
For initial symptoms, it is usually recommended that a course of nonsurgical treatment potentially including physical therapy, medications, and selective spinal injections, are conducted for six to eight weeks.
When nonsurgical treatment has not alleviated pain, dependent on the problem, surgery may be advised. AIMIS performs a large number of procedures under this disease area including:
- Minimally Invasive Decompression (MID) procedure
- Minimally Invasive Stabilization (MIS)
- Artificial Disc Replacement Surgery
- Facet Thermal Ablation
Commonly, decompressive surgery, such as laminectomy and/or discectomy/microdiscectomy, may be recommended. This type of surgery typically provides relief of radicular pain/leg pain for 85% to 90% of patients. For patients with severe leg pain or other serious symptoms such as progressive muscle weakness, this type of surgery may be recommended from the outset.
The decision to proceed with surgery is based on severity of leg pain and/or the presence of significant muscle weakness.
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REPUTABLE AND PRESTIGIOUS SURGEONS
AIMIS' skilled team of neurosurgeons, orthopaedic surgeons and ancillary professionals has one of the leading experiences in the world for minimally invasive spine surgery. Our full team are consulted with each case to find the most suitable experienced doctor for the patient’s exact issue, to ensure the maximum potential outcome of treatment
GETTING MORE INFORMATION BEFORE MOVING FORWARD
YOU MAY HAVE QUESTIONS LIKE:
- Can I get more information before I commit to this?
- Can I get a second opinion from you before I commit to this?
- How can I find out the cost before I have any obligation?
WHAT AIMIS CAN DO:
AIMIS will provide a full review, diagnosis and potential surgical options for your condition, after receiving the relevant examinations and information from you. They will also provide an estimate for your surgical procedure before you decide.
AIMIS’ mission is to the provision of “true” healthcare for those who require it. It provides world leading surgeons using state of the art procedures to optimize potential surgical outcomes, whilst taking care of all arrangements so as to allow concentration on recovery.
AIMIS provide competitive prices for state of the art procedures. We also work with a large range of Insurance companies where your policy allows you to have surgery abroad.
FURTHER INFORMATION ON THE PROBLEM:
A radiculopathy is caused by compression, inflammation and/or injury to a spinal nerve root in the low back. Causes of this type of pain, in the order of prevalence, include:
- Herniated disc with nerve compression – by far the most common cause of radiculopathy
- Foraminal stenosis (narrowing of the hole through which the spinal nerve exits due to bone spurs or arthritis) – more common in elderly adults
- Nerve root injuries
- Scar tissue from previous spinal surgery that is affecting the nerve root
The condition can also be caused by diseases or bacterial infections, and injuries to the spine, especially injuries which compress the vertebrae.
FURTHER INFORMATION ON INCREASED RISK GROUPS
Dancers are prone to both acute and chronic back problems, including lumbosacral radiculopathy, which develop secondary to the combination of 2 factors that are required in most dance routines: extreme physical flexibility and exposure of the spine to the extremes of its range of motion. Additionally, female dancers are predisposed to disc herniation secondary to the positioning that is required in certain movements, as well as the large jumps that these dancers often perform. Golfers are also very susceptible to disc disease and lumbosacral radiculopathy because of the repetitive torsional motion that is used in the sport. Competitive weight lifters and football linemen have been noted to experience even larger compressive loads.
FURTHER EXAMINATION THAT MAYBE REQUIRED OR REQUESTED
Plain radiographs are the most common type of imaging modality that is used in the workup of patients with lower back pain (LBP). However, radiographs have been overused and are not routinely necessary especially within the first 6 weeks after the onset of symptoms.
The main purpose of plain radiographs is to detect serious underlying structural pathologic conditions. Many changes seen on the radiographs of symptomatic patients with lumbosacral radiculopathy are also seen in the radiographs of patients without symptoms.
CT scanning of the lumbar spine provides anatomic imaging of the spine and good resolution for cases of disc herniation. However, the sensitivity of a CT scan without myelography for detecting disc herniation is inferior to that of MRI.
Magnetic Resonance Imaging (MRI)
MRI has demonstrated excellent sensitivity in the diagnosis of lumbar disc herniation and is considered the imaging study of choice for nerve root impingement. The use of MRI in general is used in symptomatic patients where there is progressive neurologic deficits or cauda equina syndrome, in patients with a presentation that is suggestive of malignancy, in patients with a known history or high risk of malignancy, or in cases in which there is a clinical suspicion to evaluate for a possible inflammatory disease or infection.
WHY AIMIS FOR THIS SURGERY
AIMIS strives for excellence in delivering the best surgical outcomes, via the extensive expertise of its prestige surgeons, its technologies, its highly trained staff and superior facilities to provide an individualized and compassionate experience in a comfortable environment. All patients are treated with the individual care they deserve in an effort to provide the best chance of successful treatment.
OTHER SERVICES PROVIDED BY AIMIS
In addition to its Innovative Healthcare, AIMIS provides seamless service along the way. From the start of your journey you'll know the best flights to take, where you'll be staying, what paperwork you will need. You will have a personal assistant assigned; from your pick up at the airport, to your accommodation, continuous assistance at your pre-consultation, through surgery and in your postsurgical care. Our Patients have said that they feel they have become "part of our family" and some even asked to stay a little longer! AIMIS is here to assist you in an all you requirements, allowing you to focus on your health and recovery.