Sciatica treatment Brisbane

When is surgery needed for sciatica?

Left part of K
When your pain is excruciating or your pain has been dragging on for quite a while, you might consider sciatica surgery. In this article, I’ll explain a case study here at my practice in Brisbane and the important aspects of sciatica treatment.
sciatica treatment brisbane

Sciatica surgery Brisbane

Why would I need surgery for sciatica?

Many cases of sciatica don’t need surgery. It just comes down to your quality of life. 

There are 3 reasons to perform surgery for sciatica.

  1. Severe nerve pain. Many patients come in and simply could not last another day with severe pain. Surgery will usually stop the pain immediately. It is purely a quality-of-life operation.
  2. Pain is less severe, but dragging on, and on, and you just need it to end so you can get back to normal life. Once again, a quality-of-life operation.
  3. Weakness in the muscles from the compressed nerve in the spine.

Successful sciatica treatment does not depend on what you say about your symptoms, or what your scan shows. Successful sciatica treatment depends on the two matching up. The disaster stories you may hear about, often happen when not enough detective work has been done in order to find that match. 

Dr Alex Koefman | Brain and Spinal Surgeon Brisbane
Dr Alex Koefman

Neurosurgeon Brisbane

If you are coping reasonably ok, then it is fine to continue with other sciatica treatments like physio and painkillers. Yet if the pain is seriously affecting your quality of life, then I recommend sciatica surgery. Your quality of life will often dramatically improve, and often this is obvious as soon as you wake up from surgery. Remember, most people who warn you not to have surgery for severe sciatica are usually people that have never had sciatica. It’s all about you and your quality of life.

Sciatica case study

Case study: What to do if your excruciating sciatica pain is not going away?

In this case study, I am presenting a patient who came in with sciatica pain that had lasted for 3 months. The sciatica was quite bad and I was surprised that they were able to put up with this awful pain for so long.

The patient had tried physiotherapy plus painkiller medication and had been recommended to have a spinal fusion at a different spine surgery practice. Because the patient’s symptoms and scan results matched perfectly, it was easy to see exactly where the problem was in the spine, down to the millimetre. This meant I was confident of a fast and successful outcome.

Spinal fusion was not required, and instead, the problem could be fixed through a small 15mm minimally invasive fibre-optic tube, with a quick return to normal function. 

Dr Alex Koefman | Brain and Spinal Surgeon Brisbane
Dr Alex Koefman

Spinal surgeon Brisbane

sciatica treatment brisbane

The patient woke up pain-free. I encouraged them to remain active immediately after the surgery, as this significantly improves overall recovery. The only restriction was to limit excessive bending and twisting for 6 weeks. Outside this, walking, jogging, swimming, and riding were all encouraged as soon as they left the hospital.

Spinal surgeon and sciatica treatment Brisbane

How important is the quality-of-life aspect?

Here’s what it boils down to when we choose the best sciatica treatment options for you: 

  • your quality of life,
  • working out if there is a good match between your symptoms and your scan,
  • looking at effective, low-risk keyhole options over more invasive spine surgery options.


The quality of life issue is particularly important. Quality of life is 3 things; it is being pain free, being off medication, and doing the things you want to do. When I see patients with sciatica they are usually striking out on all 3. Surgery can fix all 3 quite quickly.

I often operate quite early for sciatica. Some people say that’s just because I’m a spinal surgeon and I like to do surgery. That’s true, but it’s not the reason I operate early.

Let’s not underestimate what nerve pain does to your brain: emotionally, mentally and psychologically. Operating early often nips all this potential trouble in the bud. It’s all about the quality of life. And that is the main reason to operate early for sciatica. 

Dr Alex Koefman | Brain and Spinal Surgeon Brisbane
Dr Alex Koefman

Spinal surgeon Brisbane

If you are in severe pain or your symptoms have been dragging on for a while, please contact my team and book an appointment to see me. Obtaining the best information is the best place to start 

Ready to make an appointment?

Alex consults at Queensland Neurosurgery & Spine Surgery (QNS).
Dr Alex Koefman

Ramsay Specialist Centre
Suite 325
Newdegate St
Greenslopes QLD 4120

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(07) 3397 4185