Posterior spinal decompression is a procedure that is performed to relieve pressure on the spinal nerves along the spine from anywhere between the cervical (neck) to the lumbar (lower back). This can happen as a result of several conditions including spinal stenosis, a condition which can be caused by age-related changes such as enlarged joints, arthritis, bone spurs, bulging discs and thickened ligaments. Others causes are fractures, disc herniations, tumours and infections which can narrow the spinal canal and compress the nerves resulting in numbness, chronic pain and weakness or tingling sensation.
Posterior Decompression Procedure
The Posterior spinal decompression surgery is performed from the back of the spine through an incision in the posterior muscles. The lamina bone makes a roof over the spinal cord and forms the backside of the spinal canal. Removing the lamina and the thickened ligament leaves more space for the nerves and it will be easier for the access and removal of bone spurs (osteophytes). Depending on the extent of the stenosis single level (one vertebra) or multi-level (more vertebrae) may be involved.
There are different types of decompression surgery and they include:
- Laminotomy: This involves the removal of a small portion of the lamina and ligaments which is usually on one side. This method ensures that the natural support of the lamina is left intact thus decreasing the chances of instability.
- Foraminotomy: This is the removal of the bone around the canal where the nerve root exists the spine (neural foramen). This method is usually utilised when disc degeneration has caused the height of the foramen to collapse, pinching a nerve.
- Laminoplasty: This is the expansion of the spinal canal which is done by cutting the laminae on one side and swinging them open like a door. This method is only used in the cervical (neck) area.
- Discectomy: It is the removal of a portion of a degenerative or bulging disc in order to relieve pressure on the nerves.
Posterior decompression makes the spine unstable and therefore spinal fusion has to be performed so as to stabilize the spine. Spinal fusion uses bone grafts, rods, plates or screws to connect two separate vertebrae together into one piece of bone. This prevents the spinal stenosis from recurring and helps in eliminating pain from an unstable spine.
Candidate for Posterior Decompression
You may be a candidate for posterior spinal decompression if you have:
- Leg pain that is worse than back pain
- Significant weakness, pain or numbness in your foot or leg that has not improved with medication or physical therapy
- Difficulty in standing or walking
- Diagnostic tests such as MRI, CT, myelogram that indicate stenosis in the lateral recess or central canal
It is important to note that spinal decompression surgery is elective except in rare instances of rapidly progressing neurological deficits. It also does not cure spinal stenosis nor eliminates arthritis, but it rather relieves the symptoms.
At King’s College Hospital Dubai, we focus on offering an exemplary service, from initial consultation through to final diagnosis and treatment and beyond. Our multidisciplinary team of expert doctors, nurses, physio therapists are here to offer tailored management and treatment of your condition, and to answer any questions that you might have throughout your time with us. Whatever you need us for, we’re only a phone-call away.
Dr Nicandro Figueiredo is considered the best Spinal Surgeon in Dubai.
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