Spinal Decompression


 

Pinched nerves in the spine can lead to extreme pain. Spinal decompression refers to several surgical procedures designed to alleviate this pain by “freeing” the nerves from any structures compressing them. Spinal decompression is used to reduce pain, restore nerve function and improve a person’s quality of life.

Why would I need a Spinal Decompression?

Degeneration of the spine is a normal sign of aging but certain factors such as obesity and prior spinal injury can accelerate this wear and tear. Our intervertebral discs lose the ability to cushion our body and there is thickening of the joints and ligaments of the spine. Occasionally, this degeneration can become severe resulting in neck or back pain or we can develop compression of the nerve roots or spinal cord resulting in arm or leg pain and neurologic dysfunction.

Symptoms of spinal cord compression can include:

  • Neck or back pain
  • Extremity pain
  • Tingling and/or numbness
  • Weakness
  • Bowel or bladder incontinence
  • Imbalance and difficulty with walking
  • Electrical sensation down the back or into the limb with movements

Symptoms of nerve root compression can include: 

  • Neck or back pain
  • Arm pain (cervical)
  • Leg pain (lumbar)
  • Arm or leg weakness
  • Pain with sitting or standing
  • Bowel or bladder incontinence

How Does Spinal Decompression Surgery Work?

There are many different ways to decompress the spine. The exact method used will depend upon the cause of the compression, the location in the spine, and the type and severity of your symptoms

The most common types of spinal decompression include:

  • Microdiscectomy: Spinal discs are essentially elastic rings with soft material inside that serves to cushion the vertebral bodies. The disc may bulge outward with degeneration. Not infrequently the elastic ring can tear, allowing the soft tissue inside the disc to extrude through the defect or herniate outside of the elastic ring. The herniated disc material can compress the nerves or spinal cord passing by. Surgery can be performed to trim or remove the herniated disc freeing the nerves and allowing them to heal.
  • Laminectomy: A laminectomy is performed to address spinal stenosis. Stenosis is the narrowing of the spinal canal typically due to thickened ligaments and joints. Some people are born with smaller than average spinal canals pre-disposing them to this condition later in life. If surgery is recommended, often a portion of the spine known as the lamina is removed. The ligaments and facet joints that are leaning on nerves or spinal cord are then trimmed or removed to relieve the compression.
  • Laminoplasty: This is a variation of laminectomy where a portion of the lamina is elevated to create more space within the spinal canal. It is most frequently performed in the cervical spine. This procedure avoids fusion that is sometimes necessary for multiple level decompression.
  • Foraminotomy: The nerves of the spine exit through small holes between the bones we call foramen. Occasionally, thickened ligaments, joints, or bulging discs may narrow this opening resulting in compression of the passing nerve. A foraminotomy is a procedure to enlarge this hole and relieve the nerve from any compression.

Additionally, with advanced disease, progressive instability or scoliosis can develop further compressing the spinal elements. Occasionally, in order to adequately decompress the nerves and/or relieve your central pain, your surgeon will have to remove a portion of the spine which compromises it's stability. This can result in the need for both a decompression and fusion (for more details please see our ACDF and Lumbar Spinal Fusion informational pages).

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Neurosurgical Specialists of West County
621 S. New Ballas Road, Tower A, Suite 297
Saint Louis, MO 63141
Phone: 314-227-0908
Fax: (314) 251-7897
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