What is Surgical Spinal Decompression

Spinal decompression is a surgery to create more space for the spinal cord. It is done to relieve pressure on the spinal cord and nerves in the spine (spinal nerves) when that pressure causes symptoms, such as:

• Severe pain.
• Weakness.
• Numbness.
• Trouble emptying one’s bladder or bowel.
• Trouble controlling one’s bladder or bowel (incontinence).

There are several types of spinal decompression. They include:

• Laminectomy. This type is done to remove the bony arch at the back of the bones of the spine (vertebrae), which forms the spinal canal.
• Diskectomy. This type is done to remove a disk between vertebrae.
• Microdiskectomy. This type is done to remove part of a spinal disk.
• Foraminotomy. This type is done to widen the bony passage that spinal nerves pass through.
• Corpectomy or vertebrectomy. This type is done to remove a vertebra.

If the spinal decompression makes the spine unstable, spinal decompression may be done along with a procedure to make two or more vertebrae grow together (spinal fusion).

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Bleeding.
• Infection.
• Allergic reactions to medicines or dyes.
• Damage to other structures or organs, such as nerves or the spinal cord.
• A blood clot that forms in the leg and travels to the lung (pulmonary embolism).
• Failure to relieve your symptoms.
• Need for more surgery.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.

General instructions

• Starting one month or more before surgery, do not use any products that contain nicotine or tobacco. These include cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• You may have an imaging study of your spine, such as an MRI or CT scan, to help plan the procedure.
• You may have a test called a diskogram. In this test, a dye is injected into your back before X-rays are taken.
• Plan to have someone take you home from the hospital.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital. This is important.
• Ask your health care team what steps will be taken to prevent infection. These may include:
  • Removing hair at the surgery site, if needed.
  • Washing the skin with germ-killing soap.
  • Antibiotic medicine.

What happens during the procedure?

• An IV will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
• The surgeon will make an incision near your spine. If the affected part of the spine is in the neck, the incision may be made in the front or back of the neck. The length of the incision will depend on how many vertebrae and disks are affected and whether spinal fusion will be needed.
• Your surgeon may move muscles and nerves so the affected part of the spine can be seen easily.
• The surgeon will do the appropriate type of spinal decompression.
• If needed, a spinal fusion will be done.
• The muscles and nerves will be put back in their normal position.
• The incision will be closed with stitches (sutures) or staples.
• A small drain may be placed close to your incision to prevent fluid or blood from pooling in your incision. The drain will be removed within 1–2 days.
• A bandage (dressing) will be placed over the incision.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
• Your IV may be removed when you are able to drink fluids on your own.
• You will receive pain medicine as needed.
• You will be encouraged to get up and walk around as soon as you can.
• You may have to wear compression stockings. These stockings help to prevent blood clots and reduce swelling in your legs.

Summary

• Spinal decompression is a surgery to create more space for the spinal cord.
• The surgery may be done to relieve symptoms such as severe pain, weakness, numbness, or difficulty controlling one’s bowel or bladder (incontinence).
• Before the procedure, you will need to make plans to have a responsible adult care for you for at least 24 hours after you leave the hospital.

Surgical Spinal Decompression, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain in the surgical area for the first few days.
• Muscle tightening (spasms) across the back.
• Numbness in the legs or the back.
• Weakness in the legs.

Follow these instructions at home:

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider. You may need to have someone change your dressing for you.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. If you cannot see your incision, have someone check it for you. Check for:
  • More redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.
• Keep the dressing dry until your health care provider says it can be removed.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Rest as told by your health care provider.
• Avoid sitting for a long time without moving. Get up to take short walks every 1–2 hours. This is important to improve blood flow and breathing. Ask for help if you feel weak or unsteady.
• Do not bend or twist at the waist until your health care provider approves. To lower yourself to pick things up, bend your knees instead of tipping your upper body forward.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe. Avoid lifting anything above the level of your head.
• Sit, stand, walk, turn in bed, and reposition yourself as told by your health care provider. This will help to keep your spine in proper alignment.
• Avoid pushing and pulling motions.
• Do exercises as told by your health care provider or physical therapist.
• Avoid doing household chores that require a lot of effort, such as vacuuming.

Managing pain, stiffness, and swelling

• If directed, put ice on the injured area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.

Driving

• Do not drive or use heavy machinery while taking prescription pain medicine.
• Ask your health care provider when it is safe to drive.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay incision and bone healing. If you need help quitting, ask your health care provider.
• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
  • Take an over-the-counter or prescription medicine for constipation.
• If you have a back brace, wear it as told by your health care provider. Remove it only as told.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you:

• Have a fever.
• Notice that your incision feels warm to the touch.
• Have more redness, swelling, or pain at the site of your incision.
• Have pus or a bad smell coming from your incision.
• Have fluid or blood coming from your incision.
• Have pain that is not controlled by medicine.
• Have new numbness, tingling, or weakness in any part of your body.

Get help right away if you:

• Have increasing pain, numbness, or weakness.
• Lose control of when you urinate or have a bowel movement (have incontinence).
• Cannot move a part of your body (paralysis).
• Notice that your incision feels swollen and tender, and the surrounding area looks like a lump. The lump may be red or bluish in color.
• Develop pain in your lower leg or at the back of your knee.
• Have difficulty breathing.
• Have chest pain.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

• After the procedure, it is common to have some pain, weakness, and fatigue.
• Follow instructions from your health care provider about how to take care of your incision. Do not let it get wet until your health care provider approves.
• Rest as told by your health care provider. Follow instructions about activity and movements.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Make sure you know what symptoms should cause you to get help right away.