Some sources of spinal compression produce symptoms that develop gradually over time, as is often the case with osteoarthritis—a progressive condition that wears down joints and tissues. At other times, nerve irritation happens fairly quickly, which is often the case with trauma that affects spinal discs or bones, although other issues with your spine can produce similar results. If medication, physical therapy, and other conservative treatments fail to ease your discomfort, you may benefit from one of the six common types of spinal decompression surgery discussed below.
Sometimes bone spurs and other abnormal growths make the spinal canal a bit too narrow for the spine’s nerves. One option for creating more room for the nerves is called a laminectomy. It involves removing the entire lamina, which is a bony arch that offers added protection for the spinal canal while also providing its characteristic shape.
In some situations, it’s only necessary to remove part of the lamina. This procedure is known as a laminotomy. One of the advantages of partial versus full lamina removal is a reduced risk of affecting spinal stability. Both a laminectomy and a laminotomy require the removal of part of a group of ligaments adjacent to the spinal cord and spinal nerves (ligamentum flavum).
If spinal nerve compression is relegated to the seven bones of your cervical spine (the neck), you may benefit from a spinal decompression procedure known as a laminoplasty. More room within this part of the upper spinal canal is created by cutting cervical vertebrae so they resemble doors, meaning they swing open. Tiny bone wedges are then inserted into the newly created open spaces. The wedges then prevent the “bone doors” from closing all the way.
When spinal discs become worn or damaged, they can become unstable as well, which sometimes results in added pressure on spinal nerves. A discectomy is the full removal of a damaged spinal disc that’s affecting nearby nerves. If only part of the damaged disc is removed, the procedure is known as a microdiscectomy.
An opening between vertebrae is known as a foramen. Another way to create more space for nerves is to remove part of the bone material that’s on the edge of this opening, a procedure called a foraminotomy. Santa Monica patients may also have a portion of a spinal disc removed if part of that disc is also pressing on the affected nerve root.
If only part of a disc is removed, there’s usually no need to do anything further. However, removing an entire spinal disc can make the spine itself unstable. To keep the spine stable, decompression surgery may be combined with spinal fusion surgery. This process involves:
• Fusing together adjacent vertebrae to prevent excess movement
• Using bone graft material to stimulate new bone growth
• Inserting special hardware to keep the spine stable as new bone forms
Generally, good candidates for any of these approaches to spinal decompression are individuals who aren’t responding well to conservative treatments after several months, those with significant or debilitating pain, and patients with symptoms that are becoming increasingly worse. You may also benefit from decompression surgery if your overall quality of life is affected or if image tests show you have a narrow spinal canal (spinal stenosis) that’s aggravating symptoms.
Patients requiring spinal decompression surgery can reach out to The Spine Institute for a second opinion, to ask questions about a specific surgical procedure, or to request an in-person consultation with a Santa Monica spine surgeon with years of experience performing all types of spinal decompression procedures. Call (310) 828-7757 today to schedule an appointment.