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 drsandeep123@gmail.com 09960122234

EXPLORING SCIATICA (BACK PAIN )

Visit us at: www.drsandeepagrawal.com

www,agrasenortho.com

• 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

This presentation is for doctors and students in general.!. Graphics,Images and jpeg files are taken from Google and yahoo Image to heighten the specific points in this presentation. !• If there is any objection/or copyright violation, please inform drsandeep123@gmail.com for prompt deletion. !• It is intended for use only by the doctors of orthopaedic surgery.!. Views expressed in this presentation are personal. • .For any confusion please contact the sole author for clarification. !• Every body is allowed to copy or download and use the material best suited to him. !There is no financial involvement.! • For any correction or suggestion please contact drsandeep123@gmail.com.!

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

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