Minimally Invasive Lumbar Decompression for Lumbar Stenosis

What is Minimally Invasive Lumbar Decompression and Why is it Done?

Minimally invasive lumbar decompression is a surgery to relieve pressure on the spinal cord or nerves in the lower back (lumbar spine) caused by lumbar spinal stenosis. Spinal stenosis occurs when the spinal canal narrows due to facet joint arthritis and hypertrophy, thickening of ligaments, and disc protrusions, causing pressure on nerves. This can cause lower back pain, leg pain, numbness, tingling, or weakness, especially when standing or walking. The surgery removes small amounts of bone and ligaments to widen the spinal canal, therefore taking away pressure on nerves and improving symptoms.

How is the Surgery Performed?

• Anesthesia: You’ll be under general anesthesia, so you’ll be asleep and feel no pain during the procedure. 
• Incision: The surgeon makes one small incisions (about 1 inch or less) accordingly to the level of narrowing (under the guidance of X-ray) in your lower back. Two or more incisions may be required in case of multi-level lumbar stenosis.
• Accessing the Spine: Using a microscope or endoscope (a tiny camera) and specialized tools, the surgeon carefully navigates through the small incision, moving muscles aside without cutting them.
• Decompression: Small portions of bone, ligaments, or tissue pressing on the nerves are removed to create more space in the spinal canal. This may involve a procedure called a laminotomy (removing part of the vertebra’s bone) or foraminotomy (widening the nerve exit pathways).
• Closing: The incisions are closed with stitches, leaving minimal scarring that often fades over time.

The procedure typically takes 1-2 hours, and many patients go home the next day after the surgery.

Benefits of Minimally Invasive Lumbar Decompression

• Less Invasive: Smaller incisions and minimal muscle disruption lead to less pain and scarring compared to traditional open surgery.
• Faster Recovery: Most patients resume light activities within 1-2 weeks, with full recovery in 1-2 months.
• Effective Relief: The surgery often (92% of cases) reduces leg and back pain, improving mobility and quality of life.
• Lower Risk: The minimally invasive approach reduces the risk of complications compared to larger surgeries.

Possible Risks and Complications

While complications are uncommon, all surgeries carry some risks, including:

• Nerve Irritation: Rarely, nerves may be affected, causing temporary numbness, tingling, or weakness in the legs.
• Dural Tear: The protective covering around the spinal cord may tear, but this can often be repaired during surgery.
• Recurrence of Stenosis: Narrowing may return over time, typically in neighboring levels, requiring further treatment.
• Persistent Symptoms: Rare patients may still experience pain or limited relief after surgery.
• General Surgery Risks: These include infection, bleeding, blood clots, or reactions to anesthesia.

You can lower these risks by carefully following your surgeon’s instructions before and after surgery. Discuss all potential risks with your surgeon to understand what’s involved.

Who is a Candidate for Minimally Invasive Lumbar Decompression?

You may be a candidate if you have lumbar spinal stenosis causing significant symptoms, such as leg pain, numbness, or weakness, that interfere with walking or daily activities. Your surgeon will assess your condition using an exam, imaging (like an MRI or CT scan), and a discussion of your symptoms to determine if this procedure is right for you.

Talk to Your Surgeon

Minimally invasive lumbar decompression is a safe and effective option for many patients with lumbar stenosis. It can help relieve pain and improve your ability to move comfortably. If you’re considering this surgery, talk to a Neurosurgeon/Spine Surgeon about your symptoms, treatment options, and any questions to make an informed decision.