Chronic back pain affects a large portion of the adult population. In fact, an estimated 16 million adults undergo persistent or chronic back pain that limits their day-to-day activities.
For most patients, chronic back pain is effectively managed with non-surgical treatment methods. However, in more severe cases, surgery is required to give the patient lasting pain relief.
Spinal decompression is one of the most common surgical procedures used to resolve chronic pain. In this article, we’ll explain the ins and outs of this procedure, as well as the conditions that it’s used to treat.
The Low-Down on Spinal Decompression
Spinal decompression surgery is a procedure used to alleviate lower back pain caused by spinal cord or spinal nerve compression. During the procedure, the surgeon removes the tissue that’s compressing the spinal cord or nerves. This relieves pain and neurological symptoms while allowing the inflamed nerve tissue to heal.
There are a few different procedures that fall under the category of spinal decompression surgery. These procedures include:
- Laminectomy and laminotomy
Laminectomy and laminotomy are surgical procedures that involve the lamina. The lamina is a piece of bone that, as part of each vertebra, creates the “roof” of the spinal canal. By removing some or all of the lamina, your surgeon can make more space in the spinal canal for relief from nerve impingement.
During a laminectomy, the surgeon takes out most of the lamina. During a laminotomy, the surgeon creates a hole in the lamina to remove only a small portion of the bone.
Intervertebral foramen are the openings between vertebrae that create space for spinal nerves to travel throughout the spine. During a foraminotomy, the surgeon enlarges the foramen, which makes more space around the spinal nerve roots as they exit the spinal canal. This procedure can alleviate symptoms of foraminal narrowing in the sine.
Damaged intervertebral discs can compress nearby nerves, leading to persistent back pain and discomfort. During a discectomy, the surgeon removes some or all of a damaged intervertebral disc to resolve symptoms of nerve compression.
What Are The Steps of Spinal Decompression?
The steps of spinal decompression can differ depending on the exact procedure. However, the procedure generally involves the following steps:
1. Prepare and administer anesthesia
The first step of spinal decompression is to administer anesthesia and prepare the patient. You’ll be under anesthesia (and therefore, asleep) for the entire procedure.
2. Create the incision
With the incision site cleaned and fully prepped, your surgeon will make an incision. The traditional location for the incision is on the patient’s back, above the spine. However, to reduce blood loss, surgeons are now utilizing other approaches (with an incision on the front or side of the body) when possible.
3. Access the spine
After the incision has been made, your surgeon will move organs, blood vessels, and other tissues out of the way as needed to access the spine.
4. Decompress the spinal nerves
With access to the spine established, your surgeon can alleviate spinal nerve compression by removing the necessary bony or soft tissues.
5. Perform fusion (if needed)
If fusion is being performed, your surgeon will place bone graft material between the targeted vertebrae. The segment may be reinforced with rods, screws, and/or cages.
6. Close the incision
To complete the procedure, your surgeon will place any tissues that were moved aside back into their proper positions and close the incision with sutures.
Which Conditions Does Spinal Decompression Surgery Cure?
Spinal decompression surgery may be used to cure a broad range of spinal conditions and disorders, including:
Spinal stenosis is a common condition that occurs when the spinal canal becomes narrower, usually due to age-related degeneration. With less space in the spinal canal, it’s more likely for the spinal cord and/or spinal nerves to become compressed.
Degenerative Disc Disease and Herniated Disc
Degenerative disc disease is used to describe back pain caused by age-related wear and tear on an intervertebral disc. A herniated disc can result from degenerative disc disease and occurs when the soft disc interior protrudes from a crack in the tough disc exterior.
An injured intervertebral disc can press on nearby nerves, leading to back pain along with neurological symptoms like weakness, numbness, and tingling in the extremities.
A fractured vertebra can cause spinal nerve impingement. Spinal decompression surgery may be used in patients with spinal fractures to resolve persistent pain and neurological symptoms.
Spondylolisthesis is a condition that results from spinal instability. With this condition, one vertebra slips out of place and rests on the bone directly below it. This may cause nerve compression and require spinal decompression.
Spinal Decompression and Spinal Fusion
Since spinal decompression surgery involves removing certain bony and soft tissues in the spine, it can contribute to spinal instability. Any instability in the spine poses the risk of further injury and pain for patients with back problems. To offset this risk, spine surgeons typically perform spinal fusion at the same time as spinal decompression.
Spinal fusion prevents instability by fusing two or more vertebrae into one bone. Unfortunately, this process eliminates all motion at the fused segment.
Is Spinal Fusion Always Necessary During Spinal Decompression?
The restricted mobility and risk of adjacent segment degeneration associated with spinal fusion have led to an investigation into alternative options. With innovations in the medical field, patients now have access to treatments that stabilize the spine after spinal decompression without the need for fusion.
The Premia Spine TOPS System is one such alternative. It’s a mechanical implant device that takes the place of tissues removed during spinal decompression. It allows movement in all directions while protecting the spine by creating a controlled range of motion.
Non-fusion spine implants paired with spinal decompression can offer relief from debilitating back pain and neurological symptoms without limiting patients’ movement. If you’re a candidate for spinal decompression surgery, consider speaking to your surgeon about the complete variety of treatment options available.