Lumbar decompression surgery is a type of spinal surgery used to treat some types of back and leg pain, which have failed to respond to other treatments.
The spine
The spine is made up of 24 individual bones called vertebrae, which are stacked on top of each other. In between each vertebrae is protective, circular pads of tissues known as discs. The discs help cushion the vertebrae during activities such as walking and running.
Running through the centre of the spine is a bundle of nerve fibres known as the spinal cord. These help relay signals from the brain to the rest of the body.
The spinal cord is located inside a hollow cavity known as the spinal column which helps protect the nerves from damage.
Why do I need spinal surgery?
Decompression surgery is most commonly used is to treat a condition called spinal stenosis. This is when a section of the spinal column becomes narrowed placing pressure on the nerves inside, leading to persistent pain and numbness and weakness in the lower back, buttocks and legs.
Other conditions that can be treated with decompression surgery include:
- slipped disc – where one of the discs becomes damaged and in some cases begins pressing down on an underlying nerve
- spinal injury
- to relieve pressure on the spinal cord that is caused by an abnormal growth of tissue (tumour) – spinal tumours can be both cancerous and non-cancerous (benign)
- to relieve pressure on the spinal cord that due to cancer spreading into the spine - this is known as metastatic spinal cord compression
Read more about why lumbar decompression surgery is necessary.
What happens during spinal surgery?
There are three main techniques used during spinal surgery:
- laminectomy – where a section of vertebrae (the lamina) is removed to relieve pressure on the affected nerve
- discectomy – where a section of a damaged disc is removed or destroyed to relieve pressure on a nerve
- spinal fusion – where two or more vertebrae are jointed together with a section of bone to strengthen the spine
In many cases a combination of these techniques may be used.
For example, the surgeon may perform:
- a laminectomy to gain better access to a damaged disc
- then a discectomy to remove a section of the disc
- and then finally spinal fusion to reduce the chance of the spine becoming damaged again in the future
Read more about what happens during lumbar decompression surgery.
Recovering from lumbar decompression surgery
Depending on the complexity of the surgery, the time it takes before you are well enough to leave hospital can range anywhere from 1-10 days.
You will need to avoid strenuous activities for around six weeks and most people can then return to work after this time.
Read more about recovering from lumbar decompression surgery.
Results
There is good evidence that decompression surgery can be an effective treatment for people with severe pain related to compressed nerves. Four out of five people treated with surgery will experience a significant improvement in pain.
Complications
An infection at the site of the incision is the most common complication of lumbar decompression surgery and will need to be treated with antibiotics. Post-operative infection occurs in around 1 in 25 cases.
More serious complications are rare and include:
- damage to the spinal cord resulting in some degree of paralysis (inability to move one or more parts of the body) – which is though to occur in around 1 in 300 cases
- death, due to an unforeseen complication, such as a blood clot – this is thought to occur in around 1 in 350 where surgery is being used to treat spinal stenosis and 1 in 700 cases where surgery is being used to treat a slipped disk
Read more about the complications of lumbar decompression surgery.
