Treatment For Nerve Decompression

Nerve Decompression

Our spine is made up of a stacking of individual bones known as vertebrae and intervertebral disks cushioning between them. Such an arrangement forms a spinal cavity through which our spinal cord runs and protects against any potential damage.

The nerves that form the spinal cord pass through the openings between the vertebrae to other parts of our body. Sometimes, the nerves may get compressed due to pressure from surrounding structures such as bones, ligaments, or soft tissues. This condition is known as nerve compression. This can happen anywhere along your spine, from your neck down to your lower back.

What are the conditions that may cause nerve compression?

The conditions that may cause nerve compression in spine may include:

Bone spurs
Bulging or herniated discs
Spinal stenosis or narrowing
Degenerative conditions like arthritis
Improper bone alignment
Spine injury
Spine tumors
Spinal infections

What is nerve decompression?

Surgery called "nerve decompression" is used to treat symptoms brought on by compressed nerves. The goal of the procedure is to either remove the structure that is creating pressure or to open up the narrowed space for the nerves.

When do we need to undergo nerve decompression?

A compressed nerve can cause pain, numbness, tingling, and muscle weakness. It may also lead to bowel or bladder incontinence and paralysis in severe cases. The symptoms may develop suddenly or gradually, depending on the cause of compression.

You may be a candidate for spinal nerve decompression if your symptoms persist even after trying conservative methods such as physical therapy and painkillers for an extended period of time. Other conditions, such as Cauda equine syndrome (compression of nerve roots at the lower end of the spinal cord known as Cauda equine), may require immediate surgical intervention to release the compression.

What are the different procedures to perform nerve decompression?

The common procedures of nerve decompression include:

Diskectomy: Removing a portion of a disk.
Laminotomy or Laminectomy: Removing a section of lamina (bony arches of the vertebral arch) or entire lamina.
Foraminotomy or forminectomy: Enlargement of the openings from which the nerves exit the spinal cord by removing sections of bone or tissues.
Osteophyte (bone spur) removal: Removal of bony growths referred to as bone spurs.
Corpectomy: Removal of damaged portions of the vertebrae and the intervertebral disks.

In some cases, spinal fusion may also be required. Spinal fusion is a surgical procedure that involves fusing the vertebrae with the help of screws or bone implants.

How to prepare for the surgery?

It is always important to discuss with your doctor to make yourself prepared for the surgery.

Medications: Discuss the medicines you take, as you may need to stop certain medications, such as aspirin, two weeks before surgery. Other medicines, such as painkillers, are to be discontinued as per the doctor's advice.
Smoking: It is also recommended to stop smoking, as it slows down bone healing.
Ask for assistance: You may have to arrange someone to drive you home and to help you at home for few days.

What happens before the surgery?

The night before the surgery, you will have to follow the instructions carefully regarding when to stop eating or drinking to avoid anesthesia complications.

On the day of the surgery,

On the day of surgery, you need to arrive at the hospital at your scheduled time.
Remove all the accessories and jewelry; as well as contact lenses, eyeglasses, and dentures.
You need to change your dress and wear a hospital gown.

What happens during the surgery?

The duration of the surgery depends on the extent and severity of the nerve compression.

Before the surgery, you will be given anesthesia to make you sleep while performing the surgery.
Antibiotics may also be administered to you to stop infections.
The surgery is performed while you are lying on your stomach
Depending on the extent of the condition, the surgeon makes an incision in your back at or near the spine.
Now, the muscles are moved in such a way that your spine is exposed. The surgeon will then locate and remove the tissue that is causing pressure on your spinal nerves. Procedures such as spinal fusion may be performed as required before closing the incision.
The incision is then closed with the help of stitches or staples.

What happens after the surgery?

Post-surgery You will be shifted to the recovery area in the hospital. You may be given medication to overcome pain. With the use of regular medication, you may notice improvements in the symptoms gradually. Nurses or a physical therapist may help you move and take a few steps after your surgery. The surgery is usually minimally invasive, allowing the patients to be discharged within a day or two. However, some patients may require a longer hospital stay, depending on the complexity of the surgery.

What is the post-surgical care to be followed?

You may be discharged from the hospital once your doctor confirms that your pain is under control and fit for discharge. You may need to continue pain medication as recommended and follow the instructions regarding wound care. It is important to avoid strenuous activity, such as heavy lifting, bending, or twisting, for about three months post-surgery. You may return to work as per your doctor's advice. It is always beneficial to get involved in a rehabilitation program with the help of a physical therapist for better recovery.

What is the outlook of the surgery?

The recovery from surgery is usually fast. It helps eliminate pressure on the nerves and may provide immediate or gradual relief from pain. It can also prevent the worsening of associated symptoms like numbness and weakness.

What are the risks involved in the surgery?

Nerve decompression surgery includes the risks involved in any other surgery, like bleeding, infection, blood clots, or an allergic reaction to anesthesia.

Other risks associated with nerve decompression include: