Lumbar decompression surgery

Lumbar decompression surgery releases compressed nerves in the lower spine with the aim of reducing pain or numbness in the legs.

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Lumbar decompression treatment and surgery at private hospitals across London
Care that's rated as ‘very good’ or ‘excellent’ by 97% of our orthopaedic patients

What is the lumbar spine?

The lumbar spine is the lower back region of your spinal column (also referred to as the backbone) and it comprises five bones (vertebrae) known as L1 to L5. There are five spongy cushions called intervertebral discs between these vertebrae, providing shock absorption and helping keep the spine stable.

There are five pairs of nerves in the lumbar region. A pair branches off from the right and left sides of the L1 to L5 vertebrae. The nerves run from this area of your lower back and merge with others to control the pain and movement signals of the lower body. Therefore, any damage to this area can result in significant lower back or leg pain.

What is the role of the lumbar spine?

The lumbar spine has several functions:

Supports your upper body: The five vertebrae of the lumbar spine provide support for your chest, neck and head.

Protection of nerves: The vertebrae in your spine protect the nerves at the end of your spinal cord called the cauda equina.

Moves your body: The muscles and vertebrae in the lumbar region allow your torso to twist, bend and rotate.

Controls leg movement: The nerves at the end of the spinal cord and the cauda equina control sensations and power in the legs.

Can lumbar spine injuries be treated conservatively?

Lumbar decompression surgery will only be recommended after other treatments have been considered. Depending on your condition, your consultant may initially suggest non-surgical options such as:

Lifestyle changes: These can include gentle exercise, avoiding aggravating activities, and rest.

Ice or heat: Applying ice to the affected area can reduce swelling. Heat can then help promote healing within the damaged tissue.

Painkillers: Your doctor will establish how much pain you're in and account for any other medical conditions you have before applying appropriate pain relief.

Physiotherapy: Exercises designed to strengthen the muscles that support the back can be tailored to your circumstances. The aim is to reduce pain and muscle stiffness and improve mobility.

Steroid injections: These are used to reduce inflammation and manage pain. A common option is a caudal epidural, applied to the base of the spine.

What is lumbar decompression surgery?

Lumbar decompression is a procedure used to treat compressed nerves in the lower spine. It will only be recommended by your consultant when other treatments haven't helped. In some cases, spinal fusion may be done at the same time. This fuses two or more vertebrae to add stability to the spine.

There are many types of spinal decompression procedures, the most common including:

Laminotomy and laminectomy

This is when a section or the entire lamina – the bony arch of the back part of the spinal bone or the posterior aspect of a vertebra – is removed to widen the spinal canal and relieve pressure on the affected nerve. A laminotomy is when only part of the lamina is removed. A laminectomy is when the entire lamina – or multiple laminae – are removed.

To do this, your surgeon makes a cut over the affected area to access the spine. Small instruments are used to remove the smallest amount of lamina necessary. If required, bone spurs may also be removed during the procedure.

Discectomy

During this procedure, a section of the slipped disc is removed to relieve pressure on a nerve. The surgeon reaches the damaged disc from the back of the spine by making an incision over the affected area.

The back muscles are moved to one side to expose the vertebra and an X-ray is taken to confirm accuracy.

The surgeon creates an opening in the lamina and gently pulls back the protective sac of the spinal nerve root. A surgical microscope is sometimes used to find the affected disc and only the ruptured portion is removed. If there are any bone spurs or a synovial cyst (fluid filled sac), these are removed too.

Foraminotomy or foraminectomy

Both foraminotomy and foraminectomy are procedures that enlarge the openings in the spinal column where nerve roots exit the spinal cord by removing excess bone or a bulging disc. This releases any compressed nerves in that area.

Your surgeon will make an incision on your back and expose the affected vertebra. The intervertebral foramen is then widened and any blockages are removed.

The process is the same for a foraminectomy but a larger amount of bone is removed.

Corpectomy

During a corpectomy, your surgeon removes the large front portion of the vertebra. They may also remove the damaged disc. This relieves the pressure on your spinal cord and nerves. It's followed by replacement of the vertebra with a spacer such as a cage, then fusion of the vertebrae above and below the removed portion to provide stability.

A corpectomy is a much bigger procedure than a discectomy, and a larger and more vertical incision will often be used to allow your surgeon better access to the vertebra.

Minimally invasive lumbar decompression surgery

It's possible to have minimally invasive lumbar decompression surgery. Your surgeon makes one or more small incisions in your skin and a small metal tube or endoscope is placed through the cut. Carrying out your operation through additional smaller incisions causes much less damage to muscles and soft tissues.

In many cases involving the lumbar spine, surgeons will opt to access the spine from the side of the body.

When is lumbar spine decompression surgery needed?

As so much movement depends on the five vertebrae at the base of the spine, many conditions can affect this area. Decompression back surgery is used to treat:

Spinal stenosis: This is where a section of the spinal column narrows and puts pressure on the nerves inside. This is often caused by the ageing process, wear and tear, or a genetic predisposition. Symptoms can include numbness in the leg or foot, along with problems with walking and back or leg pain.

Slipped disc: This occurs when one of the intervertebral discs becomes damaged and presses down on an underlying nerve, causing pain. Not all slipped discs cause symptoms, but you may experience leg pain or numbness, tingling or weakness in the affected area.

Sciatica: Slipped discs in the lower back are one of the main causes of sciatica. This is a condition that affects the sciatic nerve, which runs down the back of the leg from the rear of the pelvis to your foot. The main symptom of sciatica is pain that radiates down the leg and into the foot. As well as the typical radiating pain, a slipped disc can also lead to pain in the lower back.

Spinal injuries: These can arise from fractures, trauma or the swelling of tissue. Fractures may be caused by infection, cancer, osteoporosis or physical trauma. If the fracture causes the bone to press on a nerve it can result in issues with walking, weakness or numbness in the arms or legs, radiating pain down the legs, and bowel problems.

Metastatic spinal cord compression: This happens when a cancerous tumour spreads into the spine and presses on the spinal cord or nerves. This is a rare condition, but lumbar decompression surgery might alleviate pain caused by the pressure on the nerves.

What diagnostic tests are carried out?

If your consultant is considering a spinal decompression operation, they might conduct several tests to better understand your injury. These may include imaging tests such as an X-ray and an MRI scan. This will confirm the level of damage to the lumbar spine.

A specialist musculoskeletal radiologist will report on the results, providing your consultant with the full picture before discussing treatment options with you.

How do I prepare for lumbar decompression surgery?

Your consultant will explain how spinal decompression surgery works. In the days before your operation, it's worth taking the time to plan for your return home post-surgery. You’ll need to arrange for someone to pick you up from the hospital, as you won't be able to drive. It's worth seeing if someone can assist you with your day-to-day activities too.

As you'll be given a general anaesthetic, your consultant will tell you how long to avoid eating and drinking before your procedure.

What's the recovery from lumbar spine decompression surgery like?

The average stay post-treatment is one to two nights in hospital. The day after your operation, a physiotherapist or a nurse will help get you moving. The amount of movement is then increased daily.

Before leaving hospital, you'll be advised to continue to slowly build up activity levels, but activities that are more strenuous than walking will need to be avoided for about six weeks. You may be able to return to work after about four to six weeks, but you may need more time off if your job involves lifting heavy objects or driving for long periods.

Full recovery times vary. This will depend on whether you had one or more procedures during your operation and how well your body responds. There is good evidence that when appropriate, lumbar decompression surgery is effective for pain relief and improved function.

Consultant Robert Lee in consultation.jpg

When should I see a spinal consultant?

If you're experiencing pain or numbness in your back and legs, book an appointment with one of our specialist spinal consultants.

You can browse the profiles of our expert orthopaedic surgeons with vast experience of performing spinal decompression surgery.

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Lumbar decompression surgery FAQs

What type of spinal decompression procedure will I have?

The type of procedure you receive depends on several factors, including your condition and what the surgeon finds when the operation is underway. It may be that they treat you for a slipped disc. However, they might find when operating that an additional procedure, such as a laminectomy, is required.

Will I be in pain after lumbar decompression surgery?

You’ll have some initial pain around the area where the operation was carried out, but you’ll be given pain relief to manage it. The pain you had before surgery usually improves immediately.

Some people have difficulty urinating after the operation. This is usually temporary and affects a very small number of people. However, there are rare cases where complications such as nerve damage may cause the legs or bladder to stop working effectively. Your consultant and nurse will be on hand immediately if you have problems.

Pain and the feeling of fatigue after your operation can take up to six weeks to disappear.

How soon after my spinal decompression operation can I drive?

This depends on how severe your injury is, what treatment you have, and how your body heals. Most people feel ready to drive after two to six weeks.

It can take six months or more to fully recover after this type of procedure, but you can help with the process by doing any exercises or stretches you’re advised to do by your physiotherapist.

What are the risks of lumbar decompression surgery?

As with any type of surgery, there are risks to consider. With lumbar decompression surgery, these include:

Bleeding
Infection
A reaction to the anaesthesia
Nerve damage
Paralysis
Blood clots and deep vein thrombosis
Spinal fluid leaking

Your specific condition may mean there are other risks to be aware of too. Your consultant will discuss any concerns with you before the procedure.

How much does private lumbar decompression surgery cost?

The cost of lumbar decompression surgery depends on the tests and treatment you require. Payment can be made through your medical insurance provider or by yourself. If you're a self funding patient, please ask your consultant for information on self-pay pricings.

Please get in touch for more information about pricing and the estimated cost of spinal decompression surgery.

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How do I book a lumbar decompression treatment appointment?

To book an appointment to discuss the pain you're experiencing with a spinal consultant:

1. Call us or book an appointment online

2. Have your GP referral letter to hand as this can help speed up the booking process (not required for self-pay patients).

3. If you've chosen to call us we will confirm the appointment with you directly, or, if you have any special requests, we'll get back to you within 24 hours.

Why choose HCA UK for spinal decompression surgery?

Tailored treatment: Our spinal team comprises expert spinal orthopaedic and neurosurgical consultants. Their experience enables them to tailor your treatment to your specific injury.

Be seen quickly: We'll confirm your appointment with a spinal consultant within 24 hours. We can also perform imaging tests on the same day as your consultant appointment, if required.

Spinal injury treatment specialists: They're experts in the diagnosis, treatment and management of spinal injuries.

Technologically advanced imaging: We have the latest imaging technology at our disposal, so we can accurately diagnose your condition and recommend the most effective course of treatment.

Trusted: In our 2023 patient satisfaction survey, 99% would recommend HCA UK to their family and friends for orthopaedic care.

Leading private hospitals: We have a higher proportion of 'Outstanding' ratings from the Care Quality Commission (CQC) than any other private healthcare group in the UK.

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We have the experience and knowledge to diagnose the cause of your pain, provide leading treatment and support the management of your spinal condition. Call us today or complete our online booking form.

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