If you’ve ever considered surgical treatment for chronic back pain, you’ve likely heard of spinal decompression surgery. This type of surgery is commonly used to alleviate back pain from spinal conditions like spinal stenosis, disc herniation, and degenerative disc disease.
Before undergoing any form of surgery, it’s important to understand what’s involved in the procedure. Here, we’ll explore spinal decompression surgery, what it entails, and the options that you have as a patient.
Table of Contents
- Defining Spinal Decompression Surgery
- Types of Spinal Decompression Surgery
- Spinal Decompression Surgery With Fusion
- Fusion Alternatives For Spinal Decompression
Defining Spinal Decompression Surgery
Spinal decompression surgery refers to surgical procedures that relieve spinal nerve compression and treat chronic back or neck pain. There are several different approaches to this and, as a result, multiple spinal decompression procedures.
Types of Spinal Decompression Surgery
The main types of spinal decompression surgery include:
A laminectomy is the most commonly performed surgical procedure for spinal stenosis. This procedure aims to create more space in the spinal canal by removing the lamina of the affected vertebrae.
The lamina is a part of the vertebra that covers and protects the back of the spinal cord. Often described as the roof of the spinal canal, this plate of bone supports the spine as a whole.
The Steps of Laminectomy
- The first step of a laminectomy is to make an incision, typically in the patient’s back.
- After moving the back muscles to the side, the surgeon will use small surgical instruments to extract the targeted lamina.
- Lastly, the surgeon will move muscles and soft tissues back into their original positions and close the incision.
Minimally invasive forms of laminectomy can also be implemented and involve smaller incisions than a conventional laminectomy.
Discectomy is a form of spinal decompression that involves removing some or all of a damaged intervertebral disc. Specifically, a discectomy is most commonly performed for a herniated disc.
When a disc is herniated, it means that the jelly-like disc interior has protruded from a crack in the disc exterior. This tends to occur as a result of age-related spinal degeneration, although overuse and repetitive motions can contribute to disc herniation.
The Steps of Discectomy
- First, the spinal surgeon will make an incision to access the spine.
- Next, the surgeon will remove a section of the lamina to gain access to the intervertebral disc.
- The surgeon will then remove disc tissue to alleviate pressure on the spinal nerves. The surgeon will try to remove as little disc tissue as possible while completely resolving the pinched nerve.
- Finally, the surgeon will place all muscles and soft tissues back in their original positions and close the incision.
What is a Microdiscectomy?
Also known as spinal microdecompression surgery, a microdiscectomy is a minimally-invasive form of spinal decompression. It involves small incisions positioned to minimize damage to the back muscles. Once the surgeon has accessed the spine, they’ll remove only small portions of the damaged disc to relieve pressure on the spinal nerves.
Foraminotomy is a type of spinal decompression surgery that involves broadening the neural foramina in the spine. Neural foramina are openings in the spine through which the nerve roots exit the spinal canal. Typically performed to alleviate pain from spinal stenosis, foraminotomy may be done at any level of the spine (cervical, thoracic, or lumbar).
The Steps of Foraminotomy
- The spinal surgeon will create an incision, typically in the back.
- Next, the surgeon will move muscles and ligaments out of the way to access the spine.
- To widen the foramen, the surgeon will shave or cut some bone tissue. Additionally, the surgeon may remove disc fragments and a portion of the lamina.
- The surgeon will close the incision.
Spinal Decompression Surgery With Fusion
Spinal decompression surgery is typically paired with spinal fusion. The goal of fusion is to stabilize the spine and prevent further injury.
The spinal fusion process involves positioning bone graft material in between two vertebrae with the help of implants, such as rods, cages, and plates. With time, the bone graft material causes the vertebrae to fuse into one bone.
Although spinal fusion does effectively prevent re-injury after surgical spinal decompression, it’s associated with several notable risks and downsides.
Perhaps the most significant downside of spinal fusion is limited mobility and flexibility in the back.
Spinal fusion eliminates motion at the fused spinal segment. For many patients, this makes for a dramatic reduction in the flexibility of the back.
With a reduced ability to twist, bend, and flex the spine after fusion, patients may no longer be able to partake in certain sports and activities. Some patients may even lose the ability to bend over and pick up items off of the floor.
Spinal fusion significantly increases the recovery period for spinal decompression surgery. After the procedure, patients may need to spend up to four days in the hospital. Additionally, patients typically must wait four to six weeks before returning to work that doesn’t require physical exertion.
Patients may need a full year to make a full recovery after spinal fusion.
Adjacent Segment Disease (ASD)
Adjacent segment disease is a potential complication of spinal fusion. It occurs when the spinal segments above and below the fused segment undergo additional stress. This leads to degeneration in the adjacent segments and symptoms including back pain, stiffness, and neurological symptoms.
Fusion Alternatives For Spinal Decompression
Patients who want to steer clear of the downsides of fusion can consider spinal fusion alternatives for decompression procedures, such as spinal laminectomy. A non-fusion spine device, like the Premia Spine TOPS System, can shorten spine surgery recovery and preserve patients’ mobility.
If you’re suffering from chronic back pain that doesn’t respond to non-surgical treatments, your doctor may recommend spinal decompression therapy. Make sure to ask a spinal specialist about all of the treatment options available to you before undergoing a course of treatment.