Spinal Decompression or Nerve Decompression

Disease Overview

The spinal cord passes through the vertebral column, which forms a bony protective cover. However, many conditions can cause parts of the vertebrae to compress the spinal cord or the nerves that branch out through them, leading to pain, loss of sensation and/or motor function in the part of the body supplied by the compressed nerve.

What is Spinal Decompression or Nerve Decompression?

Spinal decompression is a surgical procedure to release pressure on the compressed nerve (nerve decompression) and restore function.

Indications for Spinal Decompression or Nerve Decompression

Decompression surgery is considered when conservative treatments fails to relieve symptoms, you are healthy enough to undergo the surgery, and your surgeon can exactly locate the cause for pain. It is indicated for:

Herniated disc: bulging of the soft intervertebral disc
Spinal stenosis: narrowing of the space around the spinal cord
Sciatica: pain in certain regions of the leg
Metastatic spinal cord compression: secondary cancer in the spine
Spinal tumor: primary tumor in the spine
Spinal injury: swelling of tissue, bone dislocation or fracture

The following are common techniques for spinal decompression or nerve decompression:

Laminectomy: the entire lamina, a part of the enlarged facet joints and the thickened ligaments are removed to relieve pressure
Laminotomy: just a section of the lamina and ligament is removed
Foraminotomy: increases the space where the spinal nerve roots leave your spinal canal to avoid compression
Laminoplasty: indicated in conditions such as cervical spinal stenosis to relieve the pressure off the spinal canal by increasing the space within the spinal canal
Discectomy (disc decompression): whole or a portion of the intervertebral disc is removed
Corpectomy: vertebral bone along with the intervertebral disc is removed

Spinal Decompression or Nerve Decompression Procedure

Spinal decompression is usually performed under general anesthesia. You will lie face-down on the operating table and your surgeon makes a small incision over the vertebra causing the compression. A tubular retractor is then inserted to hold back the surrounding muscles and form a narrow tunnel through which the surgery can be performed. Small surgical instruments are then inserted through the retractor to remove a portion of the lamina (bony arch of the vertebra that covers the spinal cord) to allow a clear view of the spinal cord and the damaged area. The nerve is retracted, and the herniated disc or lamina causing the compression is removed. The disc is replaced with bone graft. Decompression may also involve the removal of extra bone, tissue or tumor, to release the pressure off the spinal cord and nerves. Once the surgery is complete, the retractor is removed and the incision is closed with sutures or staples.

What to Expect After Spinal Decompression or Nerve Decompression

Depending on the extent of the surgery, you will be able to go home one or two days after the surgery. From the day of surgery, you are encouraged to move around and will be gradually taught certain exercises to improve strength and mobility. You will be able to resume work four to six weeks after the procedure.