Spinal Decompression
Medically, spinal decompression is an operation to relieve pressure on the spinal cord or on the nerve roots emerging from it. Spinal decompression may be suggested to someone who is diagnosed with spinal stenosis. There are various approaches for spinal decompression which we will discuss later in this article.
This condition is often painful, although in some people it causes no symptoms at all.
Spinal stenosis or vertebral stenosis is a condition in which spaces in your spine become too narrow. Think about an hourglass, it is broad at the top and bottom, but narrows down in the middle. That’s what exactly happens in spinal stenosis. As a consequence, bones or other parts of the spine start pressing on your spinal cord and other nerves. All the blood supply to those nerves gets squeezed. These nerves go down your leg and so the primary complaint of people with spinal stenosis is pain in the leg.
Symptoms are often felt in the arms, legs, and back, and usually consist of the following:
- Pain
- Numbness
- Weakness
- Cramping.
The age group that is mostly affected by spinal stenosis is over age 50. Younger people may develop it if they have certain diseases, get injured, or are born with a narrower-than-usual spine.
Spinal stenosis can happen anywhere along your spine, and its causes and symptoms may be different depending on where the narrowing occurs. It is a common condition that primarily affects us when we are older. The American Academy of Orthopedic Surgeons estimates that spinal stenosis affects 8 to 11 percent of the population, and it’s most common in baby boomers over 50.
Who Would Need Spinal Decompression?
Candidates requiring spinal decompression usually suffer from pain, numbness, and tingling which radiates down to an arm or a leg. More advanced symptoms are weakness, difficulty walking or standing, or loss of bladder and bowel control and are strong indications for spinal decompression.
Simple back or neck pain without other symptoms is not an indication for spinal decompression because it rarely relieves such pain.
How is Spinal Decompression Done?
Nonsurgical Decompression
Nonsurgical therapy for Spinal Decompression involves stretching the spine, using a traction table or similar motorized device, with the goal of relieving back pain and/or leg pain. This procedure is called nonsurgical decompression therapy.
Surgical Decompression
Surgical spinal decompression involves removal of some bone and tissue to open the spinal canal. This gives the spinal nerve roots more room and increases blood flow, which helps relieve pain. The decision to move down to surgery is based on what your past treatment has been and how successful have they been. If you have tried anti-inflammatory medications, spinal injections, and physiotherapy, and none of them seems to be working or have worked at a time and no more effective anymore, your surgeon may suggest you a surgical decompression.
Surgical Spinal Decompression Types and Techniques
To remove the tissue that’s pressing on a nerve, your spine surgeon may perform one of the following types of Spinal Decompression Surgery.
Foraminotomy
If part of the disc or a bone spur (osteophyte) is pressing on a nerve as it leaves the vertebra (through an exit called the foramen), you may have a narrowing of the nerve opening (foraminal stenosis), and a foraminotomy may be done. Foraminotomy is a type of spinal decompression surgery that widens the opening in your back where nerve roots leave your spinal canal.
Laminotomy/Laminectomy:
Laminotomy is the partial removal of the lamina. Laminectomy is the complete removal of the lamina. It is important to know that the terms are often used interchangeably. Sometimes, when a laminotomy is not sufficient, the surgeon may need to remove all or part of the lamina, and this type of spinal decompression procedure is called a laminectomy. This can often be done at many levels without any harmful effects.
What are the Risks and Complications of Spinal Decompression Surgery?
Risks associated with spinal decompression surgery include:
- Infection
- Bleeding
- Blood clots
- Nerve or tissue damage
- Allergic reaction to anesthesia
Postoperative Expectations and Recovery Period Following Spinal Decompression Surgery
You will stay in the hospital for four or five days, depending on the extent of your spinal decompression surgery. You will be given medication to control pain. Rehabilitation following spinal decompression surgery may be lengthy and will likely include a program of physical therapy.
Although the specific details of your recovery might differ depending on the type of spinal decompression surgery you undergo, almost all minimally invasive spinal decompression surgeries allow for about a 12-week recovery period. Prior to your minimally invasive decompression surgery for spinal stenosis, your surgeon or nurse will explain the postoperative guidelines to help you recover in a healthy and timely manner. You and your care partner may be provided with a postoperative guide book to help you through the process.
The day of discharge brings a flurry of activity. Prescriptions are provided and discharge instructions reviewed. You are allowed to ride in a regular car but make sure it is one that is easy to get in and out of. And of course, you will not be allowed to drive your own vehicle home. At this time, it is a good idea to schedule your next appointment and set up your first office visit which should ideally occur in roughly 10 days.
In conclusion, spinal decompression will never guarantee you a pain free life ahead. It is always wise to try conservative treatments first and then think about a surgical spinal decompression if your case requires it. In many cases, patients may still have back pains, which may be different than what they experienced prior to surgery. Best practice is to discuss all the risks and benefits with your spine surgeon to make your decision to undergo a spinal decompression therapy/surgery.
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