Lumbar decompression surgery is a type of spinal surgery. It is used to treat some types of back and leg pain, which have failed to respond to other treatments.

The spine

The spine is made up of 24 individual bones, called vertebrae, which are stacked on top of each other. In between each vertebra are protective, circular pads of tissue called discs. The discs help cushion the vertebrae during activities such as walking and running.

Through the centre of the spine runs a bundle of nerve fibres known as the spinal cord. These help relay signals from the brain to the rest of the body.

The spinal cord is located inside a hollow cavity, known as the spinal column, which helps protect the nerves from damage.

Why do I need spinal surgery?

Decompression surgery is most commonly used to treat a condition called spinal stenosis. This is when a section of the spinal column becomes narrowed and places pressure on the nerves inside, leading to persistent pain and numbness and weakness in the lower back, buttocks and legs.

Decompression surgery can also be used to:

• treat a slipped disc – where one of the discs becomes damaged and in some cases presses down on an underlying nerve
• treat a spinal injury
• relieve pressure on the spinal cord that is caused by an abnormal growth of tissue (tumour) – spinal tumours can be both cancerous and non-cancerous 
• relieve pressure on the spinal cord caused by cancer spreading into the spine – this is known as metastatic spinal cord compression

Read more about why lumbar decompression surgery is necessary.

What happens during spinal surgery?

There are three main techniques used during spinal surgery:

• laminectomy – where a section of vertebrae (the lamina) is removed to relieve pressure on the affected nerve
• discectomy – where a section of a damaged disc is removed or destroyed to relieve pressure on a nerve
• spinal fusion – where two or more vertebrae are jointed together with a section of bone to strengthen the spine

In many cases, a combination of these techniques may be used.

For example, the surgeon may perform:

• a laminectomy to gain better access to a damaged disc
• then a discectomy to remove a section of the disc
• and then finally spinal fusion to reduce the chance of the spine becoming damaged again in the future

Read more about what happens during lumbar decompression surgery.

Recovering from lumbar decompression surgery

Depending on the complexity of the surgery, you may be well enough to leave hospital 1–10 days later.

You will need to avoid strenuous activities for around six weeks. Most people can return to work after this time.
 
Read more about recovering from lumbar decompression surgery.

Results

There is good evidence that decompression surgery can be an effective treatment for people with severe pain caused by compressed nerves. Four out of five people treated with surgery will experience a significant improvement in pain.

Complications

An infection at the site of the incision is the most common complication of lumbar decompression surgery and will need to be treated with antibiotics. Post-operative infection occurs in around 1 in 25 cases.

More serious complications are rare and include:

• damage to the spinal cord resulting in some degree of paralysis (inability to move one or more parts of the body) – this is thought to occur in around 1 in 300 cases
• death due to an unforeseen complication, such as a blood clot – this is thought to occur in around 1 in 350 cases where surgery is used to treat spinal stenosis and 1 in 700 cases where surgery is used to treat a slipped disk

Read more about the complications of lumbar decompression surgery.