What is Lumbar Spinal Decompression?
Lower back pain has long been a prevalent health concern around the world. In 2017, the prevalence of lower back pain was estimated to be approximately 7.5% of the world’s population. This totals about 577 million people.
There are numerous causes of lower back pain, as well as countless treatments that can help relieve it. Lumbar spinal decompression is one treatment strategy for alleviating lower back pain caused by a pinched nerve.
This article will discuss lumbar spinal decompression, when it’s implemented, and what patients can expect from the procedure.
Why is Lower Back Pain So Common?
Imagine if the branches of a tree were as large at the top as they are at the bottom. Now, imagine that a heavy load is placed on the ends of the very highest branches. This would put an enormous amount of stress on the lower portion of the tree trunk.
This is comparable to what we experience as humans with our spinal columns. The human spinal column is like the trunk of a tree, but we’re as large on the top of the trunk as we are at the bottom. This puts a high amount of stress on the lower back, which is also called the lumbar region of the spine.
The strain of lifting objects and twisting the spine over the course of a lifetime is exacerbated by degenerative spinal changes that occur with age. So, it’s not surprising that most of the back problems that bring patients to spinal specialists are centered in the lower, or lumbar, region of the spine.
Lumbar Spine Disorders
The stresses discussed above, along with disease and/or injury, can result in a host of spinal disorders. Bulging or herniated discs, spinal stenosis, and spondylolisthesis are among the most common.
- Bulging disc
A bulging disc is a spinal disorder that occurs when the exterior of an intervertebral disc weakens, typically from the natural aging process. This can cause the disc to bulge out into one side of the spinal canal.
- Herniated disc
A herniated disc is essentially one step further than a bulging disc. It occurs when the soft interior of the disc protrudes out through a crack in the weakened disc exterior.
- Spinal stenosis
Spinal stenosis can result from a bulging or herniated disc, as well as a range of other factors. It’s a spinal condition characterized by an abnormal narrowing of the spinal canal.
Reduced space in the spinal canal can place stress on the spinal nerves or the spinal cord. But, decompression for lumbar spinal stenosis can effectively alleviate this stress.
Spondylolisthesis is a condition that develops when one of the vertebrae is unstable and slips out of its regular position. The displaced vertebra settles on the vertebra beneath it.
These disorders can place unnatural pressure on the nerves that emanate from the spinal column. This may cause pain, restricted mobility, and other symptoms of a pinched nerve.
What is a Lumbar Decompression Surgery?
Spinal decompression is a method of easing pressure on impinged spinal nerves. It can be performed either non-surgically or surgically. Lumbar spine decompression simply refers to decompression procedures performed on the lower portion of the spine.
The surgical solution for a lumbar pinched nerve involves removing a small amount of tissue from vertebrae in the lumbar region. The surgeon will remove the tissue that’s impinging, or putting pressure, on a nerve. This process is referred to as lumbar spinal decompression surgery.
How is Lumbar Decompression Surgery Performed?
There are various types of lumbar decompression surgery that may be implemented for different spinal disorders. The most common forms of surgical lumbar decompression include:
Laminectomy and Laminotomy
Laminectomy and laminotomy are two surgical methods of lumbar decompression that involve the lamina. The lamina acts like the roof of the spinal canal and protects the spinal cord.
- In a laminectomy, the surgeon removes the majority of the lamina at the affected spinal segment.
- In laminotomy, the surgeon only removes a small portion of the lamina.
Laminoplasty is a procedure that involves making two cuts in the lamina so that it swings outward, like a door. After creating a hinge with the lamina of the affected vertebra, the spinal surgeon will position small bone wedges to keep the “door” from closing. Commonly referred to as open-door laminoplasty, this procedure can effectively alleviate pressure on the spinal nerves without removing the lamina.
In foraminotomy, the surgeon creates more space around the area where nerve roots exit the spinal canal. This area is known as the intervertebral foramen. It acts as a passageway, linking the spinal canal to the periphery.
By opening up the intervertebral foramen in foraminotomy, the spinal surgeon can alleviate pressure on the spinal nerves.
Discectomy is a spinal decompression procedure that involves removing damaged intervertebral disc tissue. The spinal surgeon may remove some or all of the damaged disc, depending on the patient’s needs.
Lumbar Decompression Surgery With Spinal Fusion
Removing tissue in lumbar decompression surgery can lead to spinal instability. So, historically, spinal fusion back surgery has been performed in conjunction with lumbar decompression surgery to stabilize the spine.
In spinal fusion, the surgeon places bone graft material in between the affected vertebrae. As weeks and months pass after the procedure, the vertebrae will fuse, forming a singular bone. By completely preventing motion in this segment, fusion effectively prevents instability following spinal decompression surgery.
Unfortunately, lumbar decompression and fusion can have certain negative effects on the body, including:
- Reduced range of motion
The key downside of spinal fusion is that it prevents all motion in the fused segment. This eliminates the patient’s ability to flex, twist, and bend the spine normally. As a result, patients may no longer be able to partake in their favorite sports and activities after spinal fusion surgery.
- Damage to adjacent vertebrae
The spinal segments that are adjacent to the fused vertebrae must undergo additional stress to compensate for the fusion. This can lead to a complication known as adjacent segment disease (ASD), with which the adjacent vertebrae deteriorate at a more rapid rate. ASD can lead to lower back pain, radiating pain, difficulty walking or standing, and neurological symptoms.
Are Alternatives To Spinal Fusion Available?
Today, the TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion that preserves the spine’s natural full range of motion. This advanced spinal implant has been shown to provide better outcomes than fusion in clinical studies performed around the world.
The TOPS™ System provides an important additional treatment option for individuals with moderate to severe pinched nerve symptoms. It can provide a major improvement in lower back pain for patients who don’t respond to non-surgical lumbar spinal decompression therapy.
How Long Does It Take to Recover From Lumbar Decompression Surgery?
The recovery period for lumbar decompression surgery can vary depending on the exact procedure and whether or not spinal fusion is performed. However, patients can generally expect to wait four to six weeks before reaching their expected degree of mobility and returning to work.
Spinal fusion prolongs the recovery process for lumbar decompression surgery. It can take up to a year to fully recover from fusion. With this in mind, the TOPS™ System can significantly reduce the lumbar decompression surgery recovery time, allowing patients to return to physical activity much sooner.
Is Lumbar Decompression Surgery Serious?
Lumbar decompression surgery is an invasive procedure. So, as with any surgical procedure, it comes with certain risks.
With that said, lumbar decompression is widely performed and considered safe. Advancements in medical technology have even made minimally-invasive lumbar decompression surgery possible. This allows for greater safety and a lower risk of complications.
If you have symptoms of a pinched nerve, don’t hesitate to talk to your doctor about the complete scope of treatment options available to you.