Spinal Decompression Treatments

Surgical Decompression: Relieving Nerve Root Compression

Individuals experiencing persistent pain, weakness, numbness, and tingling in the back could be suffering from nerve root encroachment. Could surgery ease nerve compression and improve symptoms for persistent and severe cases?

Surgical Decompression

The pain, weakness, numbness, and tingling associated with nerve root encroachment are usually first treated with non-surgical therapies that include:

  • Anti-inflammatory medications
  • Physical therapy

This can be enough to address the irritation of the spinal nerve root. But when cases become severe, surgical decompression may be recommended and necessary. It can be done in a couple of different ways.

Causes and Symptoms

Vertebrae are bones in the spine. Small openings called foramina allow a spinal nerve root to pass through on each side of the vertebra. When nerve root encroachment is present, the spinal nerve root gets compressed, pinched, and trapped, which can cause peripheral symptoms such as numbness, tingling, pain, or weakness to develop. Nerve root encroachment is typically caused by normal aging degenerative wear and tear changes in the vertebrae. (Choi Y. K. 2019) These degenerative changes can include:

  • Facet joint hypertrophy
  • Ligament and bone hypertrophy
  • Disc disorders
  • Formation of bone spurs or osteophytes.

If these degenerative changes progress, they can encroach and compress a nerve root, leading to peripheral symptoms. (Choi Y. K. 2019)

When Surgery Is Recommended

When symptoms occur, initial treatment will involve:

  • Physical therapy
  • Chiropractic realignment
  • Massage therapies
  • Rest
  • Lifestyle adjustments
  • Nonsteroidal anti-inflammatories – NSAIDs
  • Corticosteroid injections into the spine

If conservative therapies don’t fully heal or improve symptoms or there are neurological problems like difficulty with balance or walking, then surgery may be recommended. Severe pain that limits normal function is an indication for surgery, and rapidly progressive weakness of the arms and/or legs or signs of cauda equina syndrome are indications for emergency surgery.

Surgery Options

Different types of spinal surgery may be performed. A neurosurgeon will decide the best procedure for each patient based on their case, age, medical conditions, and other factors. Specific spinal surgical decompression depends on what is causing the nerve compression. In most cases, it involves removing bone or tissue to relieve nerve pressure or provide support to stabilize the joint. The most common types of surgical decompression include: (Mayo Clinic Health System, 2022)

  • Laminectomy
  • Discectomy
  • Laminotomy
  • Foraminotomy
  • Fusion

Spinal surgical goals are to: (American Association of Neurological Surgeons, 2024)

  • Decompress pressure on the nerve roots.
  • Relieve pressure on the nerve roots.
  • Maintain the stability and alignment of the spine.
  • Improve the stability and alignment of the spine.

Anterior Surgery

The anterior approach to surgery means that the spine is accessed through the anterior/front of the spine. In this surgery, one or more discs and bone spurs may be removed through an incision in the front of the neck. (American Association of Neurological Surgeons, 2024) For example, an anterior cervical discectomy may alleviate pressure on one or more nerve roots in the neck. With an anterior lumbar interbody fusion, a surgeon removes a degenerative disc in the lower spinal area by going through a patient’s lower abdomen. (American Association of Neurological Surgeons, 2024) After the disc is removed, a structural device, usually made of bone, fills the space where it once was. This device encourages bone healing and helps the vertebrae’s bodies fuse.

Posterior Surgery

Posterior surgery means the spine is accessed through the posterior/back of the spine. An example is removing a thickened ligament, bone spur, or disc material in the neck. To do this, a small incision in the back of the neck may be made to remove part of the back of the vertebrae called the lamina. This is called a posterior cervical laminectomy. (American Association of Neurological Surgeons, 2024) A posterior lumbar interbody fusion removes a degenerative disc by going through the back. (American Association of Neurological Surgeons, 2024) Like the anterior approach, a structural device often contains bone to fill the space where the disc once was to fuse the bones.

Potential Risks

As with any surgery, it’s important that the individual and their healthcare provider carefully discuss the benefits and risks. Spinal surgical decompression includes: (Proietti L. et al., 2013)

  • Bleeding
  • Blood clots
  • Surgical site infection
  • Urinary tract infection
  • Lung infection
  • Intestinal blockage

There are also specific risks to the area of the spine being operated on and how it is surgically approached. For example, a cervical anterior procedure may injure the esophagus, trachea, or carotid artery. Likewise, damage to the C5 nerve root/C5 palsy can occur from cervical spinal decompressive surgery. This complication causes weakness, numbness, and pain in the shoulders. (Thompson S. E. et al., 2017) The spinal cord may also be injured during surgery and result in paralysis, although this is rare. (American Association of Neurological Surgeons, 2024)

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


The Non-Surgical Solution


References

Choi Y. K. (2019). Lumbar foraminal neuropathy: an update on non-surgical management. The Korean journal of pain, 32(3), 147–159. doi.org/10.3344/kjp.2019.32.3.147

Mayo Clinic Health System. (2022). Decompress and stabilize: understanding types of back surgery. Speaking of Health. www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/understanding-types-of-back-surgery

Related Post

American Association of Neurological Surgeons. (2024). Cervical spine. www.aans.org/patients/conditions-treatments/cervical-spine/

American Association of Neurological Surgeons. (2024). Lumbar spinal stenosis. www.aans.org/patients/conditions-treatments/lumbar-spinal-stenosis/

Proietti, L., Scaramuzzo, L., Schiro’, G. R., Sessa, S., & Logroscino, C. A. (2013). Complications in lumbar spine surgery: A retrospective analysis. Indian journal of orthopaedics, 47(4), 340–345. doi.org/10.4103/0019-5413.114909

Thompson, S. E., Smith, Z. A., Hsu, W. K., Nassr, A., Mroz, T. E., Fish, D. E., Wang, J. C., Fehlings, M. G., Tannoury, C. A., Tannoury, T., Tortolani, P. J., Traynelis, V. C., Gokaslan, Z., Hilibrand, A. S., Isaacs, R. E., Mummaneni, P. V., Chou, D., Qureshi, S. A., Cho, S. K., Baird, E. O., … Riew, K. D. (2017). C5 Palsy After Cervical Spine Surgery: A Multicenter Retrospective Review of 59 Cases. Global spine journal, 7(1 Suppl), 64S–70S. doi.org/10.1177/2192568216688189

Professional Scope of Practice *

The information herein on "Surgical Decompression: Relieving Nerve Root Compression" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.

Blog Information & Scope Discussions

Our information scope is limited to Chiropractic, musculoskeletal, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.

We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.

Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.*

Our office has reasonably attempted to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez, DC, or contact us at 915-850-0900.

We are here to help you and your family.

Blessings

Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed as a Doctor of Chiropractic (DC) in Texas & New Mexico*
Texas DC License # TX5807, New Mexico DC License # NM-DC2182

Licensed as a Registered Nurse (RN*) in Florida
Florida License RN License # RN9617241 (Control No. 3558029)
Compact Status: Multi-State License: Authorized to Practice in 40 States*

Dr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
My Digital Business Card

Dr Alex Jimenez

Welcome-Bienvenido's to our blog. We focus on treating severe spinal disabilities and injuries. We also treat Sciatica, Neck and Back Pain, Whiplash, Headaches, Knee Injuries, Sports Injuries, Dizziness, Poor Sleep, Arthritis. We use advanced proven therapies focused on optimal mobility, health, fitness, and structural conditioning. We use Individualized Diet Plans, Specialized Chiropractic Techniques, Mobility-Agility Training, Adapted Cross-Fit Protocols, and the "PUSH System" to treat patients suffering from various injuries and health problems. If you would like to learn more about a Doctor of Chiropractic who uses advanced progressive techniques to facilitate complete physical health, please connect with me. We focus on simplicity to help restore mobility and recovery. I'd love to see you. Connect!

Published by

Recent Posts

Relieve Pregnancy Discomfort with a Massage Gun

Stress on the lower back during pregnancy often leads to back (upper, middle, lower), sciatica,… Read More

Melatonin: Your Natural Sleep Solution

Can melatonin help many individuals dealing with sleep issues and help them stay asleep longer… Read More

Kettlebell Training at Any Age: Improving Strength and Balance

For older individuals looking for a workout that can help improve overall fitness, can kettlebell… Read More

The Importance of Choosing the Right Pillow for Neck Pain

Can choosing the right pillow help many individuals with neck pain get a full night's… Read More

Choosing the Right Back Pain Mattress: What Experts Say

What is the recommended way to choose a mattress for individuals with back pain?  … Read More

How to Reduce Piriformis Syndrome with Non-Surgical Methods

Can non-surgical treatments help individuals with piriformis syndrome reduce referred sciatica pain and help restore… Read More