Spinal decompression is a medical term describing various therapeutic techniques and surgical procedures aimed at relieving pressure on the spinal cord or one or more compressed nerve roots passing through or exiting the spinal column. This pressure, often caused by herniated discs, spinal stenosis, degenerative disc disease, or other spinal conditions, can lead to pain, numbness, weakness, or impaired function in the affected areas of the body. Spinal decompression seeks to alleviate these symptoms by creating space around compressed nerves and restoring function and comfort to patients.
To understand the importance of spinal decompression, it helps to first grasp how the spine works. The human spine consists of 33 vertebrae stacked atop each other, cushioned by intervertebral discs. These discs act as shock absorbers and allow for movement and flexibility. The spinal canal, running through the center of the vertebrae, houses the delicate spinal cord and nerve roots that branch out to the rest of the body. Over time, or due to injury, disease, or congenital conditions, this intricate structure can become compromised:
• Herniated or Bulging Discs: The soft center of a spinal disc pushes through a crack in the tougher exterior casing, pressing on nearby nerves.
• Degenerative Disc Disease: Discs lose hydration and elasticity with age, narrowing the spaces in the spine and pinching nerves.
• Spinal Stenosis: Narrowing of the spinal canal, usually in the cervical (neck) or lumbar (lower back) regions, compresses the spinal cord or nerve roots.
• Spondylolisthesis: one vertebra slips forward over the one below it, irritating nerves.
• Bone Spurs: Overgrowths of bone from arthritis can encroach on nerve spaces.
• Trauma or Injury: Accidents or fractures can cause swelling or misalignment, leading to nerve compression.
When nerve tissue is compressed, patients may experience symptoms ranging from localized pain and tingling to muscle weakness or loss of bowel and bladder control in severe cases. Spinal decompression is targeted at restoring the space around these nerves to relieve symptoms and prevent further nerve damage.
There are two main categories of spinal decompression: non-surgical (conservative) and surgical.
Non-Surgical Spinal Decompression
Non-surgical spinal decompression is a type of motorized traction that gently stretches the spine, changing its force and position. This change relieves pressure off the spinal discs, which are gel-like cushions between the bones of your spine, by creating negative pressure in the disc. As a result, bulging or herniated discs may retract, taking pressure off nerves and other structures in your spine. This, in turn, helps promote movement of water, oxygen, and nutrient-rich fluids into the discs so they can heal.
Common non-surgical spinal decompression treatments include:
• Mechanical Traction Tables: Specialized tables that use computer-controlled force to gently stretch and relax the spine in cycles.
• Manual Traction: Performed by a trained healthcare professional, who uses their hands to apply a steady, gentle pull on the spine.
• Physical Therapy: Involves stretching, strengthening, and movement exercises to relieve pressure and support spinal health.
• Inversion Therapy: The patient is positioned upside down or at an angle to use gravity to relieve pressure on the spine.
Non-surgical decompression is generally considered for people with mild to moderate symptoms who have not responded to other conservative treatments like physical therapy, medication, or rest.
When non-surgical treatments fail to relieve symptoms or if neurological deficits (such as significant weakness or incontinence) are present, surgery may be recommended. Surgical spinal decompression aims to physically remove the structures causing nerve compression, restoring normal anatomical space.
Common surgical decompression procedures include:
• Laminectomy: Removal of the lamina, a part of the vertebral bone, to enlarge the spinal canal and relieve pressure.
• Discectomy: Removal of a herniated or damaged portion of a disc to eliminate nerve compression.
• Foraminotomy: Enlargement of the foramen, the passage where nerve roots exit the spinal column.
• Corpectomy: Removal of part of the vertebral body and adjacent discs, usually for severe compression.
• Microdiscectomy: A minimally invasive technique using special instruments and a microscope to remove small portions of disc material pressing on nerves.
Surgical decompression can be performed using open techniques or minimally invasive approaches, which use smaller incisions and specialized instruments, often resulting in less postoperative pain and faster recovery