6 Types of Spinal Decompression Surgery

Spinal nerve compression can cause pain, weakness, and other serious neuromuscular issues. For some, the best answer to ensure symptom relief is spinal decompression surgery.

Of course, surgery can be intimidating—especially when it involves the spine. What exactly happens when you undergo surgery for your spinal nerve compression? Spinal decompression surgery actually refers to a variety of procedures. The best procedure for you will depend on the cause of your symptoms.

Let’s take a look at what causes spinal nerve compression. Then, you can get a better understanding of the types of surgeries that can relieve this painful (and sometimes dangerous) condition.

What is Spinal Nerve Compression?

A variety of factors can cause spinal nerve compression. In general, doctors refer to any condition that applies pressure to the spinal cord or nerve roots as spinal nerve compression.

As you probably know, the spinal cord is a bundle of nerves that carries messages between your brain and the rest of the body. The spinal cord is protected by a series of bones known as vertebrae. Collectively, these bones make up the spinal column. The spinal column contains a “tunnel”—known as the spinal canal. This passageway houses the spinal cord. In addition, nerves radiate outward from the spinal cord to the rest of the body through openings in our vertebrae.

Spinal nerve compression can occur in different parts of the spine, including the lumbar spine.

Sometimes known as spinal stenosis, spinal nerve compression occurs when the spinal canal narrows. This reduced space can cause a pinched nerve (known as radiculopathy). In general, this process occurs in older adults as the bones and joints start to suffer from wear and tear—a condition referred to as osteoarthritis. Other factors can affect the narrowing of the spinal canal including:

• Injuries or trauma to the spine
• Spinal tumors
• Rheumatoid arthritis
• Spinal infections
• Misalignment of the spine
• Bulging or herniated disc
• Degenerative disc disease

Symptoms of Spinal Nerve Compression

In the case of osteoarthritis, symptoms may take years to develop. Other forms of spinal compression, however, can have a relatively quick onset of symptoms. The most common symptoms of compression include:

• Pain in the neck or back
• Radiculopathy—radiating pain that spreads to other areas of the body
• Sciatica—burning pain that originates in the buttocks and spreads down the legs
• Cramping, weakness, or numbness in the extremities
• Difficulty with coordination, especially in the hands or legs
• Foot weakness that causes you to limp (aka foot drop)

Severe cases can cause loss of bowel or bladder control, numbness in the legs, and difficulty walking. If you experience any of these symptoms, seek medical attention immediately. Your symptoms could indicate the onset of cauda equina syndrome—a very serious condition that can lead to permanent paralysis. Lumbar decompression surgery is often recommended for severe symptoms in the lower back.

Is Spinal Decompression Surgery Right for Me?

Before choosing to undergo surgery, your doctor may recommend several conservative treatments. These may include physical therapy or managing your pain with medications. In fact, spinal surgery is often considered a last resort to nerve pain unless you show signs of cauda equina syndrome or unresolved pain.

Good candidates for spinal decompression surgery often experience:

• Little to no relief after conservative treatments
• Significant and disabling pain
• Weakness or numbness in the leg or foot
• Symptoms that become rapidly worse
• Difficulty standing or walking
• Declining quality of life
• Diagnostic imaging that indicates a narrowing of the central canal

Types of Spinal Decompression Surgery

If your condition warrants spinal decompression surgeries, then you will want to consult with a board-certified spine surgeon. Your surgeon will conduct pre-surgical and diagnostic tests to help determine the best procedure for you. The primary goal of these surgeries is to relieve pressure on the affected spinal nerve. The most common decompression surgeries include:

Laminectomy or Laminotomy

The lamina is a bony arch at the back of the vertebrae. It helps to shape the spinal canal. In some cases, abnormal bone growths—known as bone spurs—decrease the opening of the spinal canal. Bone spurs can develop for a variety of reasons, including arthritis of the facet joints, heredity factors, or injuries.

A laminectomy involves removing the entire lamina to make more space for the spinal canal. In addition, your surgeon may elect to only remove part of the lamina—for example, to remove bone spurs. This procedure is called a laminotomy. One significant benefit of a laminotomy over a laminectomy is the decreased chance of developing spinal instability.

Both procedures also remove portions of ligaments—known as the ligamentum flavum, which runs over the spinal nerves and cord.

Laminaplasty

If your compression involves the cervical (neck) area of the spine, then your surgeon may choose to perform a laminoplasty. This procedure allows for expansion of the spinal canal by cutting the cervical vertebrae such that they swing open like a door. Then, small bone wedges are placed in the open space. Once the bone “door” is closed by the surgeon, the wedges stop it from closing too much.

Discectomy

The natural aging process or trauma can damage the circular discs between the vertebrae. When these discs lose shape, the spine can become unstable. This, in turn, can lead to nerve compression.

During a discectomy, the surgeon removes portions or the entirety of a damaged disc. In some cases, removing only a small piece of a disc may be the best solution. Known as a microdiscectomy, this procedure involves the excision of the parts of a damaged disc that press on a nerve. Microdiscectomies may not require any further surgical intervention. When the entire disc is removed, however, the surgeon may perform additional procedures to stabilize the spine (discussed later).

Foraminotomy

Nerve roots pass through an opening in the vertebrae known as the foramen. A foraminotomy involves removing some bone on the edge of the foramen to make more space for the nerves. If an intervertebral disc presses against the nerve root, then a portion of it may be removed during this procedure.

Spinal Fusion

Removing discs from one or more vertebrae, as well as other more complicated procedures, may require spinal fusion surgery. A fusion surgery stabilizes the spine with bone grafts and surgical hardware. In time, the vertebrae fuse together as one solid bone. This increases the stability of the spinal column and may prevent further instances of nerve irritation.

Recovery from Cervical or Lumbar Decompressive Surgery

Most of these procedures require general anesthesia. After surgery, you will be transferred to a recovery room where your vital signs will be monitored until the anesthesia wears off. Depending on the surgery, you may spend a day or two in the hospital to ensure that you are stable and the surgery was a success. Before being released from the hospital, you will receive a full set of discharge instructions.

Pain medications may help with any discomfort after surgery. In addition, you may need to ice the incision area a few times a day to reduce pain and swelling. The surgeon will let you know when you can resume normal activities. Physical therapy may also be part of the recovery process, especially for lumbar spine surgeries, which often require specific exercises to aid in lower back recovery.

Following your discharge instructions and any therapy recommendations will increase the likelihood of a successful surgery. A majority of people undergoing spinal decompression surgery report pain relief and better nerve function in the long-term.

Ready to Take the Next Steps for a Better Future?

If you are looking for solutions to your neck or back pain, consulting with an orthopedic doctor can be the first step in helping you live a better life. An orthopedic doctor can accurately diagnose the cause of your pain and empower you to choose the best conservative and/or surgical options.

The team at Orthopedic & Laser Spine Surgery uses the latest research-based treatments to ensure that you receive the care you need. If surgery is necessary, then we specialize in minimally invasive procedures. Using the latest equipment and techniques, we can reduce scarring, internal damage, and postoperative pain. As a result, you feel better quicker and need less time before you can resume your normal activities.

A life-changing consultation is only a phone call away. Call us at 407-712-8789 and find out how our board-certified experts can help.