Spinal Decompression

Operation
Also known as lumbar spinal decompression or partial laminectomy

Indication
Spinal Stenosis, neurogenic claudication, lateral recess stenosis, central canal stenosis, foraminal stenosis, facet joint cyst.

Pre-assessment
Yes

Special preparation for surgery
stop all blood thinning medications including aspirin, warfarin, clopidogrel.
Stop HRT and oral contraceptives. Stop some herbal medicines.
You will be advised when to stop these medications.

Admission to hospital
on day of surgery

General anaesthetic
Yes

Operation position
Prone (lying on the front)

Details of operation
A midline incision is made over the vertebra to be decompressed. The spine is approached by dissecting muscles and ligaments from the posterior bony arch. Using a high speed burr, osteotomes, spinal nibblers and rongeurs bony and ligamentous material is removed to expose the dura ( fine sac containing nerves and spinal fluid) More ligament and bone is carefully removed to allow expansion of the nerve canal and better flow of blood to the nerves.

Length of surgery
1 – 1.5 hours for a single level, 2 -3 hours for multiple levels

Urinary catheter required
For longer operations

Post-operative drain required
Occasionally

Post-operative antibiotics
Yes

Post-operative iv fluids ( drip)
Yes for fluids and occasionally for patient controlled analgesia

DVT prophylaxis
Yes, aspirin, TED Stockings, calf or foot pumps

Mobilization after surgery
Within 24 hours

Length of stay in hospital
2-5 days

Post hospital recovery
2 weeks resting at home followed by 2 – 4 weeks of increasing daily activities and then further 2 weeks of returning to normal activities.

Sutures removed
Usually dissolvable suture

Dressing
Plastic glue dressing

Review appointment
4 – 6 weeks post operation

Physiotherapy
Optional

Return to driving
2 -4 weeks

Return to work
4 – 6 weeks