Decompression is a surgical procedure that is performed to alleviate pain caused by pinched nerves (neural impingement).
During a lumbar decompression back surgery, a small portion of the bone over the nerve root and/or disc material from under the nerve root is removed to give the nerve root more space and provide a better healing environment.
There are two common types of spine surgery decompression procedures:
Microdiscectomy
A microdiscectomy (a microdecompression) is typically performed for pain from a lumbar herniated disc. The surgery is considered reliable for leg pain caused by the herniated disc, most commonly called sciatica by patients, and most commonly referred to by medical practitioners as a radiculopathy.
Read more about Microdiscectomy Surgery
Lumbar Laminectomy
A lumbar laminectomy (open decompression) is typically performed for pain from lumbar spinal stenosis. The goal of the surgery is to allow more room for the nerve root, thus reducing pain (and potentially any leg weakness or neurological symptoms) and restoring the patient’s ability to participate in everyday activities.
See Considerations for Lumbar Laminectomy (Open Decompression) in Treating Spinal Stenosis
See Laminectomy and Spinal Stenosis: Risks and Complications
In addition to the above conditions, a variety of lumbar spine problems can cause nerve pinching that can be treated by a lumbar decompression surgery. These include conditions such as:
- Isthmic or degenerative spondylolisthesis
- A synovial cyst or a fracture with bone filling the spinal canal
- A spinal tumor (rarely)
Alternatives to Microdiscectomy and Laminectomy
While the above 2 procedures are considered the gold standard for surgical decompression of the spine, there are a few variations and/or alternatives available to decompress the spine. For example:
- Corpectomy - The vertebral body can be removed through an anterior incision to decompress a canal. The surgery involves removing part of the vertebra in order to decompress, or relieve pressure on, the spinal cord and/or spinal nerves. This surgery is used most commonly in cervical surgery, although occasionally it is useful in the thoracic spine. It is almost never necessary for in the lumbar spine, except in cases of tumors or fractures.
- Laminotomy - this surgery is essentially the same as a laminectomy, with the exception that a hole is made in the lamina (as opposed to removing the entire lamina).
- Interspinous process spacer - a possible alternative to a laminectomy, the goal of the interspinous process spacer surgery is to relieve spinal stenosis symptoms with a less invasive surgery.
In addition, newer procedures are always being developed. Patients are well advised to research newer procedures carefully, as less data are available regarding effectiveness and long term outcomes.
