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Spinal Decompression Surgery

Spinal decompression surgery is a surgical procedure performed to relieve pressure on the spinal cord or nerve roots. Spinal decompression surgery will usually involve at least one of the following procedures:

Laminectomy – where a section of bone is removed from the back of one or more of your vertebrae (spinal bones) to relieve pressure on a nerve.

Discectomy – where a section of a damaged disc is removed to relieve pressure on a nerve.

Spinal fusion – where two or more vertebrae are joined together to help stabilise the spine.

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Everything you need to know

Spinal decompression surgery is a surgical procedure performed to relieve pressure on the spinal cord or nerve roots.

It can be used to treat:

  • Spinal stenosis. This is the most common situation when a section of the spinal canal narrows so much that it puts pressure on the nerves inside. This is most often caused by age-related degenerative changes such as osteoarthritis
  • A slipped disc. This is where a damaged spinal disc presses down on an underlying nerve
  • Spinal injuries, such as a fracture
  • Metastatic spinal cord compression – where cancer in one part of the body, such as the lungs, spreads into the spine and presses on the spinal cord or nerves
  • The compression of the spinal cord or nerves can lead to various symptoms such as significant pain, numbness, weakness, or tingling in the affected areas, as well as difficulty in walking.

Decompression surgery is an effective option when conservative treatments (such as physical therapy, medication, and epidural injections) have not provided relief from symptoms. The specific approach will depend on your condition and the location of the spinal compression.

Before surgery

Firstly, you will have an appointment with one of our spinal consultants. If you don’t already have a confirmed diagnosis, they will take a history, conduct a physical exam, and refer you for an MRI scan of your spine. You may need to have some blood tests as well.

If decompression surgery is recommended, your doctor will walk you through the potential risks and details of the procedure.

If you decide to go ahead with surgery, we will help you prepare, but you should also try to eat healthily in the run up and stop smoking if you can.

We will conduct some pre-operative tests, which will include an MRSA test. We will give you some specific antibacterial soap and lotions to use in the run up to the procedure, which will help reduce your risk of contracting MRSA.

If you take any blood thinners—for example, Warfarin or aspirin, tell your doctor straight away, as you may need to stop taking these or modify your intake from a week before surgery. Your doctor will give you specific instructions if this is the case. You should also tell your doctor if you take nonsteroidal anti-inflammatory drugs, such as ibuprofen.

From midnight on the day of your surgery, do not eat or drink anything. This includes water, chewing gum and hard candies. Brush your teeth with toothpaste only on the morning of surgery. If you take any prescriptions medications, bring them to hospital with you. Your doctor will let you know if you can take these with a sip of water before your surgery or if you should wait until after.

On surgery day, it’s a good idea to wear loose, comfortable clothing and bring a small bag with things you might need during your stay. Items to remember include a toothbrush and toothpaste, your phone and a charger, a book, any prescription medications and a change of clothes.

Once you have arrived and are settled in your room, a nurse will help prepare you for surgery by monitoring vital signs and running through your medical history, medications and emergency contacts.

Once you have arrived and are settled in your room, your doctor will once again run you through the procedure and ask you to sign a consent form for surgery.

During surgery

Firstly, you’ll have an intravenous (IV) line fitted into a vein. This is usually on an arm or hand. Through this, your surgical team can quickly give you medications and fluids. The surgical team will also place monitors on you so you can stay safe throughout the surgery.

Like with any spinal surgery, a lumbar decompression surgery will start with giving you general anaesthetic. This means you will be asleep throughout the procedure. For this surgery, you will normally be lying face-down on a curved mattress, so the surgeon can easily access your spine. Sometimes the procedure can also be done under local aneasthetic with sedation, but you’ll first discuss those options with your consultant during your initial appointment.

The surgeon will then make a vertical incision over the affected area of the spine. The size and location of the incision will depend on the area being treated and the complexity of the operation.

The surgeon will gently move aside the muscles in order to access the spine. With a clear view of the spine, the surgeon will address the cause of the compression. If you are having a laminectomy, any bone or tissue putting pressure on your spinal cord will be removed and the nerve will be pulled back towards the centre of the spinal column.

If you are having a discectomy, your surgeon will expose the bulging disc and remove just enough to prevent pressure on the nerves.

If you are having fusion, the surgeon will connect two or more vertebrae with an additional section of bone and potentially some rods and screws. This will help prevent excessive movement between the vertebrae and lower the risk of further compression.

To finish, the surgeon will close the incision using stitches or staples. You will then be taken to our recovery area, where specialist staff will monitor your vital signs, including blood pressure, heart rate and oxygen levels, as you wake up from anaesthesia.

After surgery

Once we’re happy you’re doing well, we will take you to your private room where you can start your recovery. We’ll encourage you to start moving the day after your operation, so one of our physiotherapists will guide you through some exercises and an occupational therapist will take you through an assessment as well. Depending on your specific situation, your stay in hospital could range from one night to a few days.

For the first few weeks after your procedure, we will ask you to attend regular physical therapy. We have an excellent therapies department based on-site in our hospital. This will help you achieve an optimal recovery, so you can get back to enjoying life quickly. You may find that you feel generally sore and tired for a few weeks after surgery, and this can take up to six weeks to pass.

When you get home, it’s important to take things easy at first, and gradual increase your level of activity every day. Some help at home is usually needed for at least the first week after surgery.

Make sure you stick to the exercise programme recommended by your physiotherapist and try not to sit or stand in the same position for more than 15-20 minutes at a time, as this will make you feel stiff and sore.

Stitches

Deep stitches beneath the skin will dissolve and don’t need to be removed. Non-dissolvable stitches or staples will need to be removed five to 10 days after your operation. Before you leave hospital, you’ll be given an appointment to have them removed.

Your stitches will be covered by a simple adhesive dressing, like a large plaster. Be careful not to get this wet when you wash. After having your stitches removed, you won’t need a dressing and will be able to bath and shower as normal.

For a faster recovery, it’s important to follow the advice of your surgeon.

How to pay for your treatment

If you’re… paying for yourself

Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.

For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of consultant and appointment times.

If you’re… insured

St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.