A pinched nerve is a painful condition that occurs when a nerve in your back become compressed by some nearby structure. Oftentimes this impingement is caused by compression from bone or disc material in the spine.
See, the nerves in your spine operate similar to the hose in your backyard. When you want to water your garden, you twist the spigot handle, water runs through the hose and empties out at the end of the hose. If there’s a kink in the hose, water become impeded, and the flow is limited or halted altogether. It’s the same for the nerves in your back. The brain attempts to send a signal to your feet, but the compressed nerve makes it difficult for the signal to get through. This doesn’t mean you’re not going to be able to walk if you’re dealing with a pinched nerve, only that you may find it difficult to move without radiating pain.
Pinched nerves can sometimes be treated non-operatively with rest, physical therapy or chiropractic adjustments, but sometimes conservative options don’t fully address the compression, or it only provides temporary relief. For some pinched nerves, surgery is the best bet.
There are three common types of minimally invasive spinal decompression procedures. Here are the three most common surgical options for pinched nerves in your back.
Laminotomy/Foraminotomy – This procedure involves shaving off a part of the lamina (the flattened or arched part of your vertebral arch, which forms the root of the spinal canal) to create a larger opening in the spinal canal for the nerve to pass through. During this operation, a patient will lay on their stomach, and the surgeon will make a single incision on your back to access your spine. The surgeon then moves the muscles in the spine so they can address the lamina. The lamina and any other structures like a problemed disc or bones spurs are removed as necessary to free up the spinal canal.
Laminectomy – This involves a complete removal of the lamina. A laminectomy is preformed in the same manner as a laminotomy, although the surgeon may opt to go with a slightly larger incision in order to better access the lamina. Most times this procedure is preformed on an outpatient basis, and the patient can leave the surgical center or hospital on the same day.
Discectomy – This operation involves removing part of the disc that is compressing the nerve. Again, this procedure is preformed with the patient lying on their stomach. A small incision is made in the spine, the muscles are gently separated and a tubular retractor may be inserted to create a “tunnel” through which the surgeon may operate. A portion of the lamina is removed, and the pain-causing disc is addressed. The tubular retractor is then removed and the incision is closed, leaving behind only a minimal scar. Your surgeon may also opt to perform a microdiscectomy, which uses microsurgical techniques to remove a very small portion of the damaged disc that is pinching the nerve.
With all operations, patients can expect to be prescribed some mild pain relieving medications. The wound should be monitored at home for drainage, discharge, numbness or an elevation in temperature.
Complications from the above procedures are rare, but they can occur. Some potential risks include:
For more information about the operation, or to discuss your treatment options, contact a skilled back surgeon today.