Spinal decompression surgery is a general term that refers to various procedures intended to relieve symptoms caused by pressure, or compression, on the spinal cord and/or nerve roots. Bulging or collapsed disks, thickened joints, loosened ligaments and bony growths can narrow the spinal canal and the spinal nerve openings (foramen), causing irritation.

Symptoms of spinal nerve compression include:

• Pain
• Numbness
• Tingling
• Weakness
• Unsteadiness

In severe cases, pressure on the spinal nerves can cause paralysis and problems with bladder and/or bowel function.

The following are common techniques for decompression:

Diskectomy

This involves removing a portion of a disk to relieve pressure on the nearby nerve roots.

Laminotomy

These procedures involve removing a small part of the bony arches of the spinal canal, called the lamina. During a laminotomy, just a section of the lamina is removed. During a laminectomy, the entire lamina is removed. Removing the lamina increases the size of the spinal canal, relieving pressure.

Foraminotomy

Both procedures are performed to expand the openings for the nerve roots to exit the spinal cord by removing some bone and other tissue. A foraminectomy generally refers to a procedure that removes a large amount of bone and tissue.

Osteophyte Removal

This involves removing bony growths called osteophytes or bone spurs.

Corpectomy

This is surgery to remove the body of a vertebra, as well as the disks.

A combination of techniques may be used; and in some cases, fusion of the vertebrae also is needed to stabilize the spine.

Spinal Decompression Candidates

You may be a candidate for decompression if you have:

• significant pain, weakness, or numbness in your leg or foot
• leg pain worse than back pain
• not improved with physical therapy or medication
• difficulty walking or standing that affects your quality of life
• diagnostic tests (MRI, CT, myelogram) that show stenosis in the central canal or lateral recess.
  

Spinal Decompression Outcome & Benifits

Surgery to relieve pressure on the nerve roots is successful in relieving pain in 80% to 90% of patients. Surgery does not correct the underlying degeneration of the vertebrae due to wear and tear of aging, however, so a return of symptoms is possible.

Prepare for Spinal Decompression

Decompression surgery for spinal stenosis is elective, except in the rare instance of cauda equina syndrome or rapidly progressing neurologic deficits.Your doctor may recommend treatment options, but only you can decide whether surgery is right for you. Be sure to look at all the risks and benefits before making a decision. Decompression does not cure spinal stenosis nor eliminate arthritis; it only relieves some of the symptoms. Unfortunately, the symptoms may recur as the degenerative process that produces stenosis continues.

Spinal Decompression Surgery Overview

With modern spine surgery techniques, both a microdiscectomy and laminectomy can usually be done with a minimum amount of morbidity (e.g. post-operative discomfort) and a high degree of success in alleviating lower back pain and/or leg pain.

Sometimes in addition to the decompression procedure, a spine fusion surgery is also necessary in order to achieve adequate decompression of a nerve root. This is especially true if the nerve root is compressed as it leaves the spine (in the foramen), known as foraminal stenosis.

Foraminal stenosis is difficult to decompress simply by removing bone because if the bone is fully removed in the location of the foramen it is generally necessary to also remove the facet joint. Removing the facet joint leads to instability, so a spinal fusion is necessary to provide stability.

The foramen can be opened either through an anterior approach (by "jacking" open the disc space in the front of the spine) or by distracting between two pedicle screws inserted posteriorly (through the back of the spine). After the foramen is opened up, a spine fusion is also done to keep it open so the instrumentation does not fail and the stenosis does not return later.

As an alternative to spinal fusion, interspinous process spacers may be implanted to open the central canal and foramen, and address motion restrictions and pain from spinal stenosis. For more information, see Interspinous Process Spacers.

Spinal Decompression Recovery

You will stay in the hospital for four or five days, depending on the extent of your surgery. You will be given medication to control pain. Rehabilitation may be lengthy and will likely include a program of physical therapy.

Spina Decompression After Care

Many patients are surprised to learn that they will be encouraged to mobilise fairly soon after surgery (providing there are no surgical or post-operative complications) and some patients are on their feet in just 24 hours. You will be visited by a physiotherapist in the days following your operation who will determine how quickly you should mobilise. You will be given advice and instructions on the best ways to slowly start walking again and these should be followed properly to avoid any unnecessary complications.

It is unlikely that you will be permitted to drive or return to work until 3 to 6 weeks have passed and you have been seen by your doctor who will have liaised with the physiotherapists regarding your recovery.

Spinal decompression surgery is a fairly common way of treating back pain caused by nerve compression when other forms of treatment have failed. In most cases it is successful with most patients being relieved of most if not all of their pain and discomfort prior to the surgery.

Spinal Decompression Possible Risks

The risks associated with spinal decompression surgery include:

• Infection
• Bleeding
• Blood clots
• Nerve or tissue damage
• Allergic reaction to anesthesia