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What is it?
Lumbar decompression is a surgical procedure that is performed to alleviate pain caused by pinched nerves.
What is its goal?
The aim of the operation is to remove the compressive elements that are compressing the nerves of the spine. This compression may be caused by bone, ligaments or even parts of intervertebral discs.
How is it done?
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.
First, the back is approached through a several inch incision in the midline of the lower back. After the incision is made, a retractor is used to pull aside fat and muscle until the lamina (bone) is exposed. After the spine is approached, the lamina is removed (laminectomy) with a fine drill and/or bone cutters, allowing visualization of the nerve roots. The facet joints, which are directly over the nerve roots, may be undercut (trimmed) to give the nerve roots more room. Any bone spurs or impinging intervertebral disc material can also be removed through this approach as well.
The operation is completed when each layer of the incision is closed with absorbable or non-absorbable suture material (stitches) or surgical staples. If the outer incision is closed with staples or non-absorbable sutures, they will have to be removed after the incision has healed.
What are the risks?
There are always risks with any surgery. Potential complications may include:
- Pain, numbness due to nerve manipulation
- Weakness, paralysis due to nerve root damage
- Bowel/bladder incontinence or impotence
- Cerebrospinal fluid leak
- Recurrence or continuation of pain.
- Bleeding/injury to major blood vessels
- General anesthetic complications
What is the success rate?
The success rate of a lumbar laminectomy to alleviate pain from spinal stenosis is generally favorable. Patients tend to have significant improvement in their function (ability to perform normal daily activities) and a markedly reduced level of pain and discomfort associated with spinal stenosis. The procedure is particularly effective for the leg pain but is not nearly effective for relief of any associated lower back pain.
How long will I stay in the hospital?
After the surgery, patients are in the hospital for one to three days. Each individual patient's mobilization (return to normal activity) is largely dependent on his/her pre-operative condition and age. Patients are encouraged to walk directly following a laminectomy; however, it is recommended that patients avoid excessive bending, lifting or twisting for several weeks after the surgery in order to avoid breaking the sutures before the wound heals completely. Typically you will be able to go home once your vital signs are stable, you can walk on your own, you can eat without having nausea, and you have resumed normal bladder activity.
What can I expect after I am discharged?
You will be given additional instructions on the day you are discharged which will include:
- Walk daily, gradually increasing time and distance. Avoid sitting or lying down for long periods as this will lead to pain and stiffness.
- Do not get overtired; balance periods of activity with rest periods.
- No driving while taking narcotic pain medication.
- You may go up and downstairs.
- Do not carry heavy items, such as groceries or laundry. Do not lift anything heavier than a gallon of milk until told otherwise by your doctor.
- You should not need special equipment for home