What is a lumbar decompression?
This aims to relieve the pressure on nerves caused by spinal stenosis or degenerative spondylolisthesis in order to help the leg pain (sciatica or aching heaviness) that you are experiencing. If it involves a single level of the spine, this may be performed using minimally invasive techniques.
What does it involve?
You come to hospital on the day of the operation. The procedure is performed using a general anaesthetic. A small incision is made in the middle of your lower back but this may be slightly longer if you are having two or more levels decompressed. The bone causing the nerve compression is removed from the laminae and facet joints to take the pressure off the nerves. The wound is normally closed with dissolvable stitches under the skin.
What are the alternatives?
Continue with conservative measures: these include taking pain killers and staying as active as possible. Performing physiotherapy exercises to reduce muscle spasm and keep your core muscles functioning is important. Some people find their symptoms can resolve after an initial flare up whilst others find they can manage their pain by adapting their daily activities.
Nerve root injection: this puts some steroid around the painful nerve and aims to reduce the inflammation in this area. It often helps sciatic pain but may not help the heaviness that some people experience with spinal stenosis. It does not take away the underlying compression on the nerves so may only have a temporary effect.
You will start to mobilise out of bed fairly soon after the operation. Some people can go home the same day whilst others may need to stay one night. When you go home, your back will be sore but this will quickly settle over the course of 2-3 weeks. Changing your position regularly will help reduce muscle stiffness in your back.
You will have a dressing covering your scar for at least 2 weeks and this will be checked by a healthcare professional to ensure it is healing well. Please do not remove this by yourself.
It is important to stay active and aim to take 2 or 3 short walks a day, gradually building up the distance you are walking. It may be beneficial to start physiotherapy exercises and gentle core stability work at 4-6 weeks following the operation.
Medications: Continue taking your normal medications after the operation and, when the pain starts to improve, you can reduce them gradually one at a time. There are some medications that should not be stopped abruptly so please check with your doctor about this.
Leg symptoms: Some people find their leg pain and heaviness disappears immediately, whilst others may find it takes a few weeks for any nerve inflammation to settle down. The pain may disappear but some people do experience numbness down the leg, which often reduces in size over subsequent months. If you have leg weakness due to nerve compression prior to the operation, this may slowly improve over the next 18 months; however, it may not return to normal.
Post-operative problems: if you experience any unexpected symptoms, please seek medical advice. Seek immediate advice if you cannot pass urine, develop numbness around your buttocks, or weakness in your legs; or if you feel unwell and the wound is red or oozing,
Returning to work: for office-based jobs, you may be able to return at around 4 weeks after the operation. For more manual jobs, you may require light duties initially. Consider returning to work part-time for the first 1-2 weeks to ensure you are comfortable.