Lumbar decompression surgery: What to know

Share on Pinterest

Certain conditions can place pressure on the nerves in the spine. This may result in:

• pain
• numbness
• weakness
• difficulty moving

Lumbar decompression surgery aims to increase the space in the spinal canal so the spinal cord and nerve roots are not compressed. It involves precisely removing or trimming parts of the spine, such as disks, bones, or ligaments.

There are several types of decompression surgery, each targeting different structures within the spine:

• Laminectomy: This procedure involves removing the lamina, a part of the bone that makes up the vertebrae. It opens the spinal canal and reduces pressure on the spinal nerves.
• Diskectomy: This technique targets herniated disks. The surgeon removes the portion of the disk that is pressing on the spinal nerve.
• Foraminotomy: This procedure enlarges the vertebral foramen, which is the opening through which the spinal nerves exit the spine. It aims to relieve nerve compression.

Surgeons may perform these procedures using traditional open surgery or with minimally invasive techniques, such as keyhole surgery.

The choice of method depends on the specific condition a person has, the severity of the nerve compression, and the person’s overall health.

Conditions that may benefit from lumbar decompression surgery include:

• Herniated disk: This is when the soft center of a spinal disk pushes through a tear in its outer layer, pressing on spinal nerves. This is also called a slipped disk.
• Spinal stenosis: Spinal stenosis refers to the narrowing of spinal spaces, leading to pressure on the spinal cord and nerves.
• Spondylolisthesis: In this condition, one bone in the spine slips over another. Spondylolisthesis can misalign the spine and possibly compress nerves.

The primary goal of lumbar decompression surgery is to reduce symptoms and improve quality of life. It may not cure the condition causing the pain.

Doctors typically recommend surgery to people who have nerve compression that has not responded to nonsurgical treatments, such as physical therapy, medication, or injections.

The person may have symptoms that significantly reduce their quality of life, affect their mental health, or interfere with daily activities.

However, it is not suitable for everyone. People with the following may not be able to undergo this surgery:

• previous surgeries in the same location
• local or systemic infections
• higher than grade II spondylolisthesis
• bleeding or blood clotting disorders

The results of lumbar decompression can vary case by case. Many factors influence the outcome, including the condition a person has, how severe it is, and the specific procedure.

Laminectomy has success rates of around 90%, with patient satisfaction of over 75%, according to a 2023 research article. Another research article states the success rate of diskectomy is between 60% and 90%.

A 2020 review of 2,699 lumbar decompression surgeries found that it is more generally effective for reducing leg pain due to pinched nerve roots and, to a lesser extent, back pain.

People can get more information on whether lumbar decompression is likely to help their unique situation by speaking with their doctor.

Preparation for lumbar decompression surgery involves a thorough medical evaluation. This may include imaging tests, such as MRI or CT scans, to identify the location and cause of nerve compression.

The procedure itself will vary depending on the type and methods a surgeon uses, but generally, it will follow these steps:

1. The person receives general anesthesia, ensuring they are asleep during the procedure.
2. The surgeon makes an incision over the affected area of the lower back to access the spine.
3. They carefully move muscles and tissues aside to visualize the vertebrae and identify the area causing nerve compression.
4. Depending on the cause of compression, they may remove parts of the spinal bones or herniated disks or widen the nerve exit holes.
5. In some cases, the procedure might include spinal fusion or insertion of metal hardware to stabilize the spine, especially if the surgeon removes a significant amount of bone or disk material.
6. Following the procedure, the surgeon repositions the muscles and tissues and closes the incision with sutures or staples.

People can typically expect to stay in the hospital for 1 to 4 days after lumbar decompression surgery. A day after the surgery, medical professionals may encourage a person to begin walking and moving around.

To begin with, people may experience some pain and have less mobility than usual. They may need help around the home during the first week. People can gradually increase their level of physical activity, but they should avoid heavy lifting or twisting movements.

If there are nondissolvable stitches, a person will need to return to the clinic or hospital to have these removed. This may occur between 5 and 10 days after the surgery.

Full recovery, including the return to daily activities, can take anywhere from 4 weeks to several months, depending on the person’s job. Those with physically demanding jobs may need to wait longer before they can safely return to work.

Physical therapy can help reduce stiffness, increase movement, and speed recovery.

The potential risks of these surgeries include:

• bleeding
• infection
• adverse reactions to anesthesia
• nerve damage
• nerve injury, which could cause paralysis
• blood clots
• spine instability
• dural tear, which is a tear in the protective lining around the spinal cord and nerves
• leakage of cerebrospinal fluid

As with all surgeries, there is a risk of death due to some of these complications, but this is rare.

Below are some answers to frequently asked questions about lumbar decompression surgery.

How long does lumbar decompression surgery take?

The surgery lasts at least 1 hour but could take much longer depending on the complexity of the case and the specific techniques used.

Do the benefits of spinal decompression last?

This depends on the specific procedure and reasons for it. However, in most cases, people experience a long-term improvement. For example, the recurrence rate following a diskectomy is between 3% and 15% within 10 years.

The symptoms may come back if there are complications following surgery or if the condition gets worse.

How much does lumbar decompression surgery cost?

The cost of lumbar decompression surgery can vary significantly based on geographic location, the specific procedure, and insurance coverage.

With Medicare, a laminectomy, facetectomy, and foraminotomy cost $898 in an ambulatory surgical center and $1,583 in a hospital as an outpatient. For a minimal diskectomy, the cost is $1,987 and $1,883, respectively.

Lumbar decompression surgery may help people with nerve compression who have not gotten relief from other treatments, such as medications or physical therapy.

The surgery opens up space around compressed nerves, reducing pressure. There are several types of procedures, each focusing on different parts of the spine. Generally, they have positive results, although there are some risks. A small number of people can also have symptom recurrence.

As with any surgical procedure, it is important to weigh the benefits against potential risks and costs with a healthcare professional.