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[Atypical sciatica. Decreasing pain and increasing paresis--a serious sign]
1Nevrokirurgisk avdeling, Haukeland Sykehus, Bergen.
Summary
Prompt surgical intervention for lumbar disc herniation is crucial. Early surgery for sciatica with paresis significantly improves motor function and prevents permanent nerve damage.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Neurology
Context:
- Lumbar disc hernias can cause sciatica and subsequent motor deficits.
- A subset of patients experience pain relief preceding paresis, indicating potential nerve compromise.
Purpose:
- To evaluate the efficacy of surgical intervention in patients with lumbar disc hernias presenting with sciatica and paresis.
- To determine the optimal timing for surgery to preserve motor function.
Summary:
- Fourteen patients with lumbar disc hernias and sciatica were studied.
- Ten patients with significant paresis underwent surgery, with 90% showing motor improvement.
- Four patients with mild or no paresis were not operated on, experiencing residual deficits or no change.
Impact:
- Early surgical intervention for lumbar disc hernias with marked paresis is essential for optimal motor function recovery.
- Delayed surgery or non-operative management in cases of significant paresis may lead to persistent neurological deficits.