Lumbar spinal stenosis is one of the most common reasons for lumbar decompression surgery. Lumbar spinal stenosis is a condition in which the spinal canal and/or vertebral foramen becomes narrowed. If the narrowing is substantial, it can cause nerve compression and result in painful symptoms. Lumbar decompression surgery removes any structures that are compressing the nerves in the lumbar (lower back) section of the spinal canal or vertebral foramen (the opening through which the spinal cord passes).
During surgery, a small section of the bone over the compressed nerve root is removed to alleviate pressure and allow the nerve root to heal. Sometimes, fragments of material from discs (shock-absorbing cushions between vertebrae) are lodged under the nerve root and also are removed during lumbar decompression surgery.
In some cases, lumbar decompression surgery must be combined with lumbar fusion surgery. If too much of the bony structures that are pressing on the nerve needs to be removed, it can affect the stability of the spine. Spinal fusion corrects the instability by permanently joining (fusing) the vertebrae together to prevent them from moving. If the lumbar decompression surgery is minimally invasive, the structure of the spine will stay intact and there will be no need for spinal fusion.
Most lumbar decompression surgeries are performed with the goal of leaving the spinal structure intact. Once the compressive structures have been removed, your spine surgeon will evaluate the stability of your spine and determine if cervical fusion surgery also is needed.
- Microdiscectomy – Also called microdecompression, this minimally invasive surgery is performed through a small incision in the back. The spine surgeon removes a small section of the bone over the nerve root and may also remove any disc material from under the nerve root. A microdiscectomy aims to relieve neural compression and allow the nerve to heal.
- Lumbar laminectomy – In this procedure, a small section of the lamina (bone covering the back of the spinal cord) is removed to relieve compression on the nerve. The remaining spinal bones are then connected with titanium metal rods and screws to stabilize the spine.