Spine Decompression: A Corrective Surgery
Decompression surgery is a corrective surgery which to give enough space for the spinal cord and the nerve to pass through it. Spine decompression surgery is mainly performed in cases of stenosis/narrowing of the spinal canal which if not treated causes pain, numbness or weakness of muscles, especially of hands and legs.
If the symptoms are not subsided after medication and physiotherapy only then the surgeon thinks of surgery.
Decompression surgery is a corrective surgery can be done anywhere along the cervical spine to lower lumbar spine, where there is stenosis of the spine. Stenosis usually occurs as an age-related complication, arthritis, enlargement of joints, bone spurs, bulging disc, and thickened ligaments. The different types of spine decompression surgeries are:
In some cases, fusion is also done to bring stability to the joints.
Who can undergo this procedure?
Surgery is for those patients who have undergone mediations and physiotherapy without much relief to their symptoms. The patients who can undergo the surgery are:
- Significant pain, numbness or weakness in legs and feet.
- Pain in lower extremities, pain in extremity more severe than the back.
- Pain unmanageable even with medicines.
- Stenosis is prominent in the spine in CT scan and MRI.
- Difficulty in walking or standing because of the pain in the lower extremity.
Contraindication for the surgery?
The surgery is not performed in the following conditions:
- If the person is having cauda equina syndrome.
- In people who have rapidly progressing neurological deficit
- In very young people
Before the surgery the patient is advised:
- To undergo pre-surgical blood tests
- Stop smoking or chewing tobacco at least two weeks before the surgery
- Stop taking steroids two weeks before surgery
- Stop taking alcohol two weeks before the surgery
- Stop blood thinners and non-steroidal anti-inflammatory drugs one week before the surgery.
- Do not take food or fluid at least 8 hours before the surgery.
What to expect during surgery?
- After checking the vitals, anesthesia is administered to the patient. After administering anesthesia, the patient is turned on their stomach supported by pillows on the sides.
- The surgeon makes an incision in the middle of the back at the desired level of the vertebrae that must be operated.
- The incision site is confirmed by taking an x-ray.
- The surgeon then removes the whole or a part of the lamina and or ligament flavum.
- After removing the lamina and ligament flavum the surgeon decompresses the spinal cord followed by decompression of the spinal nerve.
- If necessary, then the surgeon can opt for the fusion of the adjoining vertebrae to give extra stability.
- The muscles and skin are then sutured together.
After an operation, the patient is kept in the ICU overnight. After two to three days the patient is discharged only if the vitals are normal.
- Avoid lifting heavyweight for a month after surgery.
- Avoid bending and twisting back for a month post-surgery.
- Avoid nicotine products
- Avoid strenuous work including sex for a month.