Spinal Decompression is an operation carried out to make more space for nerves that go down your legs. The reasons for this surgery are due to the fact that during the ageing process your disc will collapse narrowing the spaces available for the nerves. The nerves are living tissue and require a good blood supply, supplying nutrients and oxygen. During the process of narrowing, the space available for these nerves and their blood supply becomes smaller. This is the process creating symptoms of pain on walking. This pain is often relieved by adopting a sitting or bending forward posture as this increases the available space for nerves thus allowing a better blood supply and decreasing the direct pressure on them. Spinal decompression is an operation to remove as much bone, disc and ligament as necessary to increase the available space for nerves and thus decrease the effects of compression.
These days it is unusual to carry out a laminectomy as most surgery can be performed without a great deal of bone removal. This means that the procedure is much less destructive reducing both potential blood loss and hospital stay.
Occasionally with patients whose spines are very stiff it is not possible to manoeuvre between the lamina and therefore some bone removal is required.
Spinal Decompressions are also occasionally combined with a stabilisation procedure such as a Wallis ligament implant. This is for two reasons
- To try and prevent further collapse as the spine ages leading to more nerve compression
- To stabilise the spine and relieve back pain as an accompanying symptom to nerve compression.
The risks and complications of such surgery are the anaesthetic itself. There is a risk of nerve injury during this surgery although this is usually rare. There is a risk of tearing the envelope around the nerves leading to leakage of cerebo spinal fluid. If this tear is big enough it is repaired at the time but there is a possibility that a headache will ensue which is treated by bed rest. There is a small risk of haematoma formation around the nerves which if it causes undue pressure, may require evacuation surgically. More usual risks would be those of infection or deep vein thrombosis which will be guarded against by the use of antibiotics and the use of TED stockings.
Surgery takes anywhere between one and two hours to perform and the hospitalisation period is about seven days. It will take about six weeks to get over the general wound ache following the operation. The rate of recover of nerves is unpredictable as previously noted, but there is evidence that nerves can recover for up to 18 months following surgery. It should also be noted that immediately after surgery nerve function can temporarily deteriorate due to local swelling.