Spinal (lumbar) Decompression
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Spinal decompression is a type of back surgery used to release trapped nerves in the lower (lumbar) spine.
Why might I need spinal decompression surgery?
If you suffer from spinal stenosis (a narrowing of the spinal canal), decompression is performed to release nerves trapped by this narrowing. The spinal canal contains the nerves that leave the spinal cord. A combination of arthritis in the spine or bulging (herniation) of the discs or (in rarer cases) spondylolisthesis (where a vertebra slips forward or backward) or spinal tumours can cause this narrowing.
Spinal injuries, slipped discs and sciatica can also be treated with spinal decompression surgery.
Usually, spinal surgery is only recommended when non-surgical treatments have failed to relieve your symptoms. Many people who have the operation notice their pain significantly improves. People who found walking difficult before surgery because of leg pain or weakness are often able to walk further and more easily after the operation.
Initially your consultant may recommend anti-inflammatory medication for pain. If you have pain down your leg that is caused by pressure on the nerve in your lower back (sciatica), your surgeon may recommend a steroid injection in your spine.
What happens during lumbar spinal decompression surgery?
You will probably have an MRI scan to confirm the diagnosis and help your surgeon plan your operation.
Decompression is usually performed under general anaesthetic. Your surgeon will make an incision (cut) in your lower back. They will remove enough bone and tissue to free the trapped nerves. They will close the incision with stitches and dress the wound.
To treat your trapped nerves, your consultant will usually perform one or more of the following procedures:
- Spinal fusion - where two or more vertebrae are joined together with a section of bone to stabilise and strengthen the spine
- Laminectomy - an area of bone from one of your vertebrae (bone in your spine) is removed
- Discectomy - where a section of damaged disc is removed to relieve nerve pressure
After your spinal decompression
Immediately after your surgery you will be taken to the recovery area. Staff will monitor your blood pressure, heart rate and breathing. If you are in any pain be sure and tell the recovery room staff. When you are stable a nurse will take you to your room.
Back in your room
Once you are back in your room, our nursing team will continue to check on you to make sure you are recovering well. After you’ve recovered from any effects of the anaesthetic, you can have something to eat and drink. Be sure and tell us if you are in any pain.
Some patients have difficulty passing urine after decompression surgery. If you are in any discomfort please tell a member of our Healthcare Team.
You will be encouraged to get up and move around as soon as possible - usually within 24 hours of your operation. Please wait for a member of our Healthcare Team to help you out of bed for the first time.
A physiotherapist will visit you to advise you on any restrictions and give you exercises to help you regain mobility. You may be advised to avoid bending, twisting or lifting anything heavy for the first six weeks following surgery.
Recovery after spinal decompression
The length of your stay in hospital will depend on the degree of decompression performed. Most patients spend 1-4 nights in hospital and your consultant and nursing team will make sure you're safe and ready to go home.
Most people can walk on their own the day after surgery, however you may need to avoid strenuous activities for about 6 weeks.
You will not be able to drive or return to work until you are released to do so at your follow-up appointment with your consultant. Please arrange for someone to take you home on the day of your discharge.
Any stitches or staples will be removed 10 - 14 days after your operation.
You may feel very tired and sore for the first few weeks. It is important to rest and allow your body to heal.
You will be encouraged to walk during your recovery. Start with short distances and build up slowly. Avoid sitting for long periods. Keeping mobile will help you to avoid DVT (deep vein thrombosis).
Risks and complications of spinal decompression surgery
Most people make a good recovery and return to normal activities following spinal decompression. As with any surgery there can be complications:
- Infection of the surgical site (incision)
- Blood clots (DVT - deep vein thrombosis)
- Difficulty passing urine
- Chest infection
- Damage to the spinal cord or nerves
Specific complications of spinal decompression:
- Bleeding in the spinal column
- Continued pain or numbness
- Loss of bladder or bowel control
- Infection in the spine
- Nerve damage
- Leaking of spinal fluid
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