Decompression surgery is a term to describe spinal procedures that reduce pressure on the spinal cord or nerve roots. While the specific approach taken will vary among procedures, the goal of decompression surgery is all the same: to create more space in the spinal canal, alleviate pressure on the nerves, and provide relief from symptoms like pain or numbness.

Conditions that can lead to compression of the spine include:

• Herniated disc: When a disc herniates, it can press against nearby nerves. Decompression surgery can help relieve this pressure by removing or repositioning the herniated portion of the disc.
• Spinal stenosis: Spinal stenosis is the narrowing of the spinal canal, which can compress the spinal cord and nerves. Decompression surgery can create more space within the spinal canal to alleviate this pressure.
• Degenerative disc disease: As discs in the spine wear down, they can contribute to spinal instability and compression of the nerves. Decompression surgery may be used to address this issue and stabilize the spine.
• Sciatica: Sciatica is often caused by compression of the sciatic nerve in the lower back. Decompression surgery can relieve this compression, reducing pain and other symptoms.
• Spinal cord tumors: Tumors within or near the spinal cord can cause compression and damage. Surgical decompression can be part of the treatment plan to remove or reduce the tumor’s pressure on the spinal cord.
• Myelopathy: This condition involves compression of the spinal cord and can cause symptoms like weakness and coordination difficulties. Decompression surgery can address this compression.

Several procedures can aid in spinal decompression. Dr. Gottlieb may choose one of the following to achieve this goal:

• Corpectomy involves removing a vertebral body or intervertebral disc
• Discectomy or microdiscectomy is done to remove a disc or a portion of a disc
• Laminectomy is done to remove the lamina or a portion of the lamina 
• Foraminotomy involves removing spinal bones to expand the opening for nerve roots
• Spinal fusion will join bones in the spine together for stability

Lumbar decompression surgery is targeted to treat lower back pain. This type of decompression is performed on the lumbar spine. Lumbar disc decompression can be accomplished by removing structures in the lower region of the spine, like vertebrae or discs, to create additional space within the spinal canal. 

Several procedures fall under the category of lumbar decompression back surgery, including laminectomy, discectomy, and foraminotomy, among others. Your surgeon may suggest multiple lumbar spine decompression treatments during one surgery to optimize your surgical outcome.

Instrumented spinal fusion involves custom-made tools affixed to your spine to facilitate the fusion of vertebrae. Lumbar decompression and instrumented fusion surgery complement each other as the fused spinal bones relieve pressure on the nerves in your lower back. This approach is used in certain cases to address specific spinal conditions like spondylolisthesis or severe spinal stenosis and achieve better overall outcomes.

There are several reasons why Dr. Gottlieb may use instrumented fusion, including:

• Stabilization and treatment of instability: Lumbar decompression is primarily performed to alleviate symptoms caused by nerve compression, but it doesn’t address instability in the spine. Instrumented fusion is used to stabilize the affected area by joining two or more vertebrae together. This helps prevent excessive movement and maintains spinal alignment.
• Preventing recurring symptoms: Decompression surgery doesn’t necessarily guarantee that your symptoms won’t return. Fusion surgery can stabilize the spine and minimize the chance of recurrence at the decompressed segment.
• Addressing deformities: In situations where spinal deformities like scoliosis are present, fusion surgery may be necessary to correct the curvature and provide stability to the spine.
• Enhancing long-term outcomes: Combining decompression with fusion can lead to improved long-term outcomes, particularly when there’s a significant structural issue.

Depending on the type of decompression surgery being performed, the steps to the procedure may vary. Here’s a general overview of the steps to decompression surgery:

1. Anesthesia: No matter the procedure, spine surgery begins with the administration of anesthesia to ensure your comfort. The type of anesthesia used may depend on the specific procedure and preference. 
2. Incision: Your surgeon will make a small incision over the affected area of the spine. The location and size of the incision will vary based on the surgical approach and the targeted vertebrae. For example, if lumbar decompression surgery is being performed, the incision will be made in the lower back.
3. Nerve decompression: With better access to the spinal canal, the surgeon can identify and address the source of nerve compression. This may involve removing herniated discs, bone spurs, or other structures that are pressing on the nerves.
4. Spinal fusion (if necessary): In some cases, particularly when there’s spinal instability, your surgeon may perform a spinal fusion alongside decompression to stabilize the spine and prevent excessive movement.
5. Closure: Once the decompression is complete, your surgeon carefully closes the incision with sutures or staples. 
6. Recovery: Following the procedure, you will be monitored in a recovery area as the anesthesia wears off. Depending on the type of surgery and your overall health, you may be able to return home the same day. You should follow all post-operative instructions provided by your surgeon to support a quick recovery.

If you’re experiencing symptoms of nerve compression, such as pain, numbness, or weakness, it’s important to consult with a spine specialist like Dr. Jamie Gottlieb to determine the most appropriate treatment approach. Decompression surgery can alleviate this pressure and its associated symptoms.