What is lumbar spinal decompression?
Lumbar spinal decompression is a type of surgery that’s performed to treat compression of the spinal cord or the nerves surrounding the spine. This surgery is usually recommended when non-surgical methods are no longer effective.
It’s often performed to treat spinal stenosis (where the space in the centre of the spine narrows), which can affect the way you walk.
What causes spinal stenosis?
A combination of arthritis in the spine, thickening of the ligaments, and bulging of the discs can cause spinal stenosis. The nerves can get trapped in the spinal canal or where they leave the spine, which can cause weakness or pain in your legs
What are the aims of lumbar decompression surgery?
Essentially, the aims of surgery are to take away the pressure on the spinal cord and nerves. Removing this pressure can also help to resolve any sciatic leg pain you may be experiencing. After successful surgery, you should be able to walk further without getting pins and needles, numbness or weakness down your legs.
Are there any alternatives to spinal stenosis surgery?
Surgery is an option and there are alternatives available. If your symptoms are mild, you may not need treatment and it’s unlikely that your symptoms will get worse quickly. You may even get better with time.
For leg pain caused by pressure on a nerve in your lower back (sciatica), a steroid injection in your spine may help to alleviate pain. Your symptoms can also be managed with painkillers or physiotherapy sessions.
If your symptoms are severe, a lumbar spinal decompression could relieve your pain and pressure, and help you to return to normal activities.
What does the operation involve?
The operation is carried out under general anaesthetic, however a variety of anaesthetic techniques are available.
During surgery, you’ll usually be lying on your stomach. Your surgeon will make a cut in the centre of your lower back. Small retractors are used to hold the muscles in place while bone around the spinal cord is removed. Sufficient bone and ligament tissue will be removed from the back of the spine to free trapped nerves. Your surgeon may need to join the bones using a bone graft. Sometimes metal screws and rods will be used.
The operation usually takes between an hour and an hour and a half.
How painful is it?
After the operation you will be in some pain. However, this will primarily be located in the back where the operation was carried out. You may also experience leg pain, but this won’t be as bad as the pain you were in before operation.
The initial pain will last between 5-7 days. By two weeks most of the pain should have disappeared, and within 3 months you should feel nearly back to normal.
Any pain you experience following surgery can be well managed by the anaesthetist and you will be given painkillers to help reduce pain throughout your recovery.
What complications can happen?
General complications of any operation
- Infection in the surgical wound
- Unsightly scarring
- Blood clots
- Difficulty passing urine
- Chest infection
- Heart attack or stroke
Specific complications of this operation
- Continued pain or numbness
- Numbness between your legs, loss of normal bowel and bladder control and, in men, problems with having an erection
- Tear of the thin membrane that covers the nerves in your spine
- Infection in the spine
- Damage to the spinal cord (rare)
How soon will I recover?
Everyone is different and the length of recovery can vary from person to person. Most people will normally be able to start walking on the first day after surgery and after three to five days you should be able to go home. After three months you should be almost back to normal.
Physiotherapy sessions will usually be required to help build up strength and confidence. Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, it’s important to ask a member of your healthcare team for advice. Patients with screws and rods may need additional physiotherapy sessions for up to six months after surgery.
You may still experience back ache due to wear and tear in your spine. However, most people can expect to make a good recovery from lumbar decompression surgery.