Spinal Decompression Treatment

 

      Spinal Decompression is a term that englobes both surgical and non surgical procedures which attempt to relieve the pressure caused on a pinched spinal column nerve or nerves and the pain symptoms that this pressure causes. The causes of a pinched nerve can be trauma or disease and usually they involve a bony part of the spinal column that has been damaged or broken. The most common surgical procedures are Microdisectomy, also called micro decompression, and Laminectomy, also known as open decompression. The non surgical procedure involves the use of mechanical traction devices controlled by computer and different physical therapies.

 

• Which problems does the surgery or treatment solve

      A pinched spinal column nerve usually happens when a bone or part of a bone from the spinal column goes out of place and pressures one of the nerves of the zone. The causes of this bone dislocation can be trauma, or disease. However, when bone that is part of the spinal column goes out of place it tends to be a spinal disc, and the phenomenon caused it is called a herniated disc. A herniated disc, also called prolapsed disc, happens when due to a big pressure a spinal column disc bulges out from between two vertebrae. The damaged then begins compressing the spinal canal, which is where the nerves of the spinal column are located. When the herniated disc is in the lumbar or thoracic region, this will cause sharp and continuing back pain, a weakening of the muscles in the leg, and some loss of sensation in the leg and foot. In addition, it may also be difficult to raise the leg when it is held in a straight position. If the herniated disc is in the cervical region it will cause neck pain, stiffness, and numbness and weakness in the arms or hands.

• How is the surgery or treatment performed

      There are two surgeries and one non surgical treatment that can be done in order to solve achieve Spinal Decompression. The two surgeries are Microdisectomy and Laminectomy.

• Microdisectomy: is done using a surgical microscope. An incision about two inches is made over the problem disc, in the low back. The skin and soft tissues are separated in order to expose the bones of the spinal column’s back. The lamina bones above and below the damaged disc are spread apart using a retractor. Then, a tiny incision is made in the ligamentum flavum, which is the spinal column protective cover, exposing the compressed nerve. Next, a special hook is placed under the nerve and used to lift it. After this, the damaged disc becomes visible. The outer ring of the disc is then sliced open, to allow removing the material from the inside of the disc. The area around the compressed nerve is inspected, and any disc fragments are removed. Finally, the nerves, muscles, and soft tissues are put back in place, and the skin is stitched together.

• Laminectomy: is a more traditional procedure and no surgical microscope is used. First of all, the patient is usually positioned lying on the side or stomach. The procedure begins by making a small straight incision over the damaged area. Next, a retractor is used to spread apart the muscles and fatty tissue overlying the spinal column. When the laminae have been reached, part of the bony arch is cut in order to expose the ligamentum flavum. Then, an opening is cut in the ligamentum flavum in order to reach the spinal canal and expose the compressed nerve. The retractor is then used to move the compressed nerve aside. Next, in order to relieve pressure on the nerve, as much of the damaged disk as necessary will be removed. The space occupied by the disk will be eventually filled by new connective tissue. Finally, the incision is closed in layers using different types of sutures for the muscles, soft tissues, and skin.

• The Spinal Decompression non surgical treatment uses a traction device controlled by a computer. The computer uses mathematical programs to calculate the pressure, and the places where it must be done in order to make the herniated disc return to its original position. This treatment is designed to be done in different sessions that can also include massages and physical therapy.

• Anesthesia: General anesthesia is used during the surgical procedures; this means that the patient will be asleep during the operations. During the non surgical procedure anesthesia is not needed.

• Lenght of the surgery or treatment: Microdisectomy takes less time than Laminectomy, the first taking from one to two hours and the second from one to three hours. The non surgical procedure instead consists on sessions that take and average time of 45 minutes during 5 days in periods of four to six weeks.

• How is the post-surgery or post-treatment process

      After both surgical procedures the patient must remains at the hospital from one to three days. During and after that time, pain medications will be given. After leaving the hospital the patient must avoid heavy lifting for at least 4 weeks. That time can be extended to 6 weeks.

The non surgical treatment requires the use of supportive devices between sessions and for at least 4 weeks after the last session.

• Possible complications

      Nerve damage is a main complication, common to all spinal column surgeries. This happens due to the proximity of the spinal canal. This usually occurs when a surgical instrument damages one of the nerves from the zone. Consequence of this is muscle weakness and loss of sensation to the areas supplied by the damaged nerve. However this complication is rare. No complications are known for the non surgical procedure.

• What does the treatment do

      All the treatments eliminate the pain symptoms and allow the spinal column to recover mobility.

• What does the treatment not do

      The surgical procedures do not prevent the treated disc from ruptures in the future. However, the non surgical procedure, may require continuous maintenance to prevent the symptoms from returning