Spinal Decompression Surgery | Physiotherapists in Toronto

If you have been having persistent low back pain, numbness in your hands and feet or possibly even weakness in your arms/legs and haven’t been able to find relief with physical therapy or conservative treatment, spinal decompression surgery may have been suggested as your best option for long term pain relief.

What is spinal decompression Surgery?

Spinal decompression surgery is a surgical intervention in which an incision is placed in your neck or back region to remove foreign substances (bulging discs, bone spurs, thickened ligaments, disc herniations, or arthritic bones) that are causing your nerves to be impinged (pinched). By removing the causative factors, this will allow your nerves to have more room and help decrease the pain and symptoms that you are experiencing.

Types of spinal decompression surgery:

Laminectomy

The posterior part of your vertebrae which helps encapsulate the spinal canal is known as the lamina. Sometimes due to arthritic changes or very traumatic events, this bony part of your vertebrae can cause increased pressure on your nerves and in turn can cause you pain, numbness and even weakness into your hands/feet.

This surgical decompression procedure is usually only used when other types of non-invasive therapies don’t work. By removing the lamina, this will allow your nerves to decrease the pressure that they were under (decompression) and help decrease the radiating pain in your hands or feet and/or decrease some of the muscle weakness you were experiencing. Your doctor/surgeon will consider you a candidate for a laminectomy if you have had poor results from conservative therapy, if there is extensive muscle weakness, and if you are unable to control your bowel and bladder movements.

If the laminectomy is done in the neck it is known as a cervical laminectomy, and if it is done in the lower back it is known as a lumbar laminectomy. Furthermore, a laminectomy may need to be performed if you have a disc herniation, as your surgeon will have to remove part of the lamina to help clear the disc material affecting your nerves. As with any other medical decision you make it is very important to make sure you discuss the benefits and risks involved with this procedure.

Laminotomy

This is another type of spinal decompression therapy in which the lamina is the main site of surgery. The difference between a laminotomy and a laminectomy is that in this surgical procedure only a part of the lamina is removed. As only a part of the lamina is removed, laminotomies usually have quicker recovery times, fewer complications and affect fewer ligaments and nerves within the region. The reasons for conducting this surgery are the same as the laminectomy, however, as opposed to the impingement affecting the whole spinal canal it is usually located closer to one side. Once again it is always important to understand the pros and the cons of any surgical procedure, so it is advised you speak with your doctor/surgeon.

Discectomy

If you have been diagnosed with a bulging or herniated disc and have not been able to find relief through conventional therapy, you may be referred for a discectomy. In this procedure, your surgeon will remove all, or part, of your disc to help decompress the area. The extent of the herniation and/or pinching on the nerves will determine whether the whole disc or part of it is removed during a discectomy. Speak with your doctor about this surgery and consider all options before proceeding.

Corpectomy

Often performed along with Discectomy, Corpectomy is the removal the vertebral body. This is a more complete way to remove pressure on the spinal cord and nerves. Since this procedure is intensive and requires removal of quite a bit of bone and disc, the surgeon will need to replace the empty space with bone grafts from your hip/femur, or with an manufactured implant (cage) to maintain the spine.

Foraminotomy

Foramen is an anatomical way to describe an opening, hole or passage. So your neural foramen are the holes in which your spinal nerves exit to go to the rest of your body. Sometimes these foramina have arthritic changes which cause the nerves going out of them to be pinched. These pinched nerves will then potentially cause pain, numbness, weakness, and tingling. If the extent of these symptoms is quite severe, the pain is not getting better with physical therapy, or there is muscular weakness your doctor may prescribe a foraminotomy. A foraminotomy will help increase the size of these spinal openings and decrease the amount of pressure on the pinched nerves. By doing this it will allow you to help get relief from your symptoms. As always, always consult your doctor about the benefits and risks of a foraminotomy before making a decision.

Risks of spinal decompression surgery:

As with any surgical interventions there are risks with spinal decompression therapy, some of these will be listed below. Always go over the risks with your doctor to make sure you are fully informed before any procedure.

Bleeding
Infection
Blood clots
Nerve damage
Paralysis

Am I candidate for spinal decompression surgery?

It is always important to speak to your doctor and/or specialist to see if you are a candidate for spinal decompression surgery. However, if you fall under the below-mentioned categories your doctor will most likely recommend spinal decompression surgery:

Extensive radiating pain in your hands or feet
Extensive muscles weakness
Chronic pain/radicular symptoms that do not improve with physical therapy/medication
If you have a loss of bowel/bladder control
If the symptoms are having significant impacts on your activities of daily living.

What is the success rate of spinal decompression surgery?

This question is a very broad question many people ask. The success rate of any surgery including spinal decompression surgery will be based on your medical history, your fitness levels, and your surgeon. This is a question that you should discuss with your surgeon to get greater clarity.

What is the recovery time for spinal decompression?

Once again recovery will be based on your physical fitness level and the extent of your surgery. In general, once you have completed your surgery you will remain in the hospital between 1-4 days. Once you are discharged you it will take you about 4-6 weeks to get back to the level of movement and functionality that is expected. It is important to make sure that you undergo physical rehabilitation to help you speed up your recovery as well as improve your overall results.

Are there alternatives to surgery?

Your specialist may have recommended surgical intervention but you might feel concerned of intensive procedures. Many people opt to go the conservative route and try physiotherapy or chiropractic treatment. One of the most popular alternatives are to try spinal decompression therapy, which involves a traction table operated by a computerized system for your condition. Be sure to read more here on spinal decompression therapy and its effectiveness.

Conclusion

Spinal decompression surgery may be very effective in relieving your pain symptoms, but it is important to try conservative and non-invasive therapy before electing to undergo this procedure as long as it is not a medical emergency. It is important to understand all of the potential benefits and weigh them with the potential risk factors in making your decision. Consult your doctor and make sure that this surgery is right for you and make sure you make a fully informed decision.