Overview
What is spinal decompression?
Spinal decompression describes different types of treatment that can offer back pain relief by taking pressure off the neural elements of your spine.
Why do people have spinal decompression therapy?
Your spine (backbone) provides support for your body. It consists of bones called vertebrae, with ligaments and spinal disks that keep it flexible. Your spinal column provides a nerve pathway that runs down the middle of these bones, ligaments and disks.
Spine injuries or degeneration (wear and tear) to your spine can cause pain. You might feel pain from compression in your spine that puts pressure on your spinal cord or nerves. Spinal decompression seeks to relieve the pressure to ease the pain.
What conditions can spinal decompression treat?
Some common reasons you might seek spinal decompression treatment include:
- Bulging disks, when a cushion between vertebrae bulges out.
- Degenerative disks, when the cushion between vertebrae starts wearing out.
- Herniated disks, when part of a disk pushes on a nerve.
- Pinched nerves, when a nerve gets pinched (compressed), causing numbness, pain or tingling.
- Sciatica, damage to your sciatic nerve.
- Spinal stenosis, narrowing of spaces in your spine due to bone spurs or bulging or herniated disks.
Procedure Details
What types of spinal decompression therapies are there?
Some types of back pain don’t need a healthcare provider to treat them. Acute (sudden) back pain usually gets better on its own. Pain relievers or muscle relaxants offer relief while you heal. Using hot and cold packs can help, too.
For chronic back pain or long-lasting pain, there are other treatment options. Most people start with non-invasive therapies. If home care doesn’t work, your healthcare provider may recommend surgical treatment.
What are alternative treatments for spinal decompression?
Complementary or alternative medicine can relieve pain without surgery. Options you might consider:
- Acupuncture: A healthcare provider puts small acupuncture needles through your skin at different points on your body to relieve pain.
- Chiropractic care: Spinal adjustments using chiropractic care realign your bones to ease your pain.
- Physical therapy: You work with a therapist to learn stretches, better ways to lift things and exercises to relieve pain.
- Traction: Your healthcare provider uses pulleys and weights and a traction table to stretch your spine. Your healthcare provider may also use an inversion table. Inversion therapy is a type of traction that uses gravity. You lie on a table that tilts to angle your body, relieving pressure on your spine.
- Nerve stimulation: Transcutaneous electrical nerve stimulation (TENS) uses small electrical charges from a device. The charges help muscles relax and nerves stop hurting.
What are spinal decompression surgeries?
Healthcare providers may recommend surgery if other therapies don’t help. While some spinal decompression surgeries use minimally invasive techniques, not all do. Ask your healthcare provider if a minimally invasive surgery will work for you.
Your surgical options for spinal compression may include:
- Corpectomy: A surgeon removes a vertebra or disk. To stabilize your spine, your surgeon may do a spinal fusion, which fuses two bones together.
- Diskectomy: Your surgeon removes part of a disk to take pressure off your nerve.
- Foraminotomy or foraminectomy: Your surgeon expands the openings for your nerve roots by removing bone or other tissue. Opening the spaces for your nerves to exit your spinal cord relieves pain.
- Laminotomy or laminectomy: Your surgeon removes a piece or all of the bony arches on your spinal canal. Removing these pieces of bone opens your spinal canal and relieves pressure.
- Osteophyte removal: Osteophytes, or bone spurs, are outgrowths of bone that happen as people age. Your surgeon can remove them to relieve pressure.
After your surgery, you may stay in the hospital for up to five days. A full recovery can take months, depending on the type of surgery you had. Physical therapy can help you regain strength, movement and nerve sensation.
How do you choose a spinal decompression procedure?
Deciding which procedure would work best for you depends on many factors. Your healthcare provider will make a recommendation based on your overall health history and injury severity.
In general, healthcare providers prefer a “stepped” approach. They start with less invasive and more cost-effective procedures to see how the injury responds. If those don’t work, the next level of care may include surgery.
What tests determine the severity of the injury?
Your healthcare provider may conduct several tests to better understand your injury. These tests may include:
- Bone scans: A bone scan is an imaging test that detects fractures, cancer or infections in your bones. Your healthcare provider orders a bone scan to find the source of your back pain.
- Diskography: Your healthcare provider injects contrast (a dye that shows up on X-rays and other scans) into your back. Then a computed tomography (CT) scan takes pictures. Diskography can show any damage to your disk.
- Electrical tests: Your healthcare provider orders electromyography to check electrical activity in your nerves and muscles. An evoked potential study tests how fast electrical signals go through your nerve to your brain. Nerve conduction studies (NCS) measure how well your nerves work.
- Diagnostic imaging: Your healthcare provider uses diagnostic imaging to take “pictures” inside of your body. These images can indicate the cause of your pain. Specific imaging may include CT scans, magnetic resonance imaging (MRI) and X-rays.
Risks / Benefits
What are the risks of spinal decompression?
Medications can cause allergic reactions, and alternative therapies may not work. Surgical options can cause infection, bleeding, blood clots or nerve or tissue damage. Discuss your options and concerns with your healthcare provider.
What are the benefits of spinal decompression?
The right treatment can fix problems that are causing back pain. Using a stepped approach allows your healthcare provider to find an option best suited for your case, with the least risk possible. Treatment can get you back to work, school or play.
Recovery and Outlook
What kind of success does spinal decompression have?
Surgical cases can have a high success rate at relieving pain. Surgery may not fix all degenerative issues. You may experience symptoms again.
In clinical trials for spinal stenosis, people who had surgery showed more improvement than those who received nonsurgical treatments.
Talk to your healthcare provider about your individual needs and outlook.
Spinal decompression is the relief of pressure on the spinal cord or on one or more compressed nerve roots passing through or exiting the spinal column.[1] Decompression of the spinal neural elements is a key component in treating spinal radiculopathy, myelopathy and claudication.
Surgical methods[edit]
Decompression of nerve roots[edit]
When a single spinal nerve root is compressed, the resulting clinical outcome is termed radiculopathy, and is usually labeled according to the specific nerve root compressed (hence compression of the nerve root exiting the spinal column below the left-sided pedicle of the L5 vertebra will be diagnosed as “left L5 radiculopathy”).
Microdiscectomy (or microdecompression) is a minimally invasive surgical procedure in which a portion of a herniated nucleus pulposus is removed by way of a surgical instrument.[2] The purpose of this procedure is to relieve the pressure and reduce the local inflammatory reaction around a nerve root, caused by the herniated nucleus pulposus.
Decompression of the spinal cord or cauda equina[edit]
Laminectomy is an open or minimally invasive surgical procedure in which a portion of the posterior arch of the vertebrae and/or spinal ligaments is removed from the spine to alleviate the pressure on the spinal canal contents. This procedure is usually performed when decompression of more than one nerve root is needed. In the lumbar spine it is commonly used to treat spinal claudication caused by spinal stenosis, and is considered the most effective treatment for this condition based on current evidence.[3] In the cervical and thoracic spine it is used to treat myelopathy caused by compression of the spinal cord itself.
CITATIONS:
- Spinal Stenosis~treatment at eMedicine
- ^ “Back and Leg Pain – Definition List | Resources | HJD Spine Center”. Med.nyu.edu. Archived from the original on 25 August 2010. Retrieved 18 December 2010.
- ^ Weinstein, James N.; Tosteson, Tor D.; Lurie, Jon D.; Tosteson, Anna N.A.; Blood, Emily; Hanscom, Brett; Herkowitz, Harry; Cammisa, Frank; Albert, Todd; Boden, Scott D.; Hilibrand, Alan; Goldberg, Harley; Berven, Sigurd; An, Howard (2008). “Surgical versus Nonsurgical Therapy for Lumbar Spinal Stenosis”. The New England Journal of Medicine. 358 (8): 794–810. doi:10.1056/NEJMoa0707136. PMC 2576513. PMID 18287602.
- ^ Daniel, DM (18 May 2007). “Non-surgical spinal decompression therapy: does the scientific literature support efficacy claims made in the advertising media?”. Chiropractic & Osteopathy. 15: 7. doi:10.1186/1746-1340-15-7. PMC 1887522. PMID 17511872.
- ^ Singh, V; Malik, M; Kaur, J; Kulandaivelan, S; Punia, S (March 2021). “A systematic review and meta-analysis on the efficacy of physiotherapy intervention in management of lumbar prolapsed intervertebral disc”. International Journal of Health Sciences. 15 (2): 49–57. PMC 7934127. PMID 33708044