This minimally invasive procedure is used to remove overgrown vertebral bone and soft tissue to relieve the compression of nerve roots in the lumbar spine. It is performed through a small incision on the back.
After anesthesia has been administered and the
patient is positioned face down, the surgeon uses a
portable x-ray machine to identify the diseased
vertebral level or levels. Then, the surgeon makes
the smallest possible incision in the skin directly
above the target level.
Accessing the Vertebra
A series of dilators of increasing size are carefully
guided down through muscles and soft tissue. The
surgeon slides a tubular retractor over the dilators
and removes the dilators, creating a working
channel that leaves muscle tissue intact. This
working channel allows the surgeon to access the
target vertebra and painful nerve root in a way that
minimizes incisional pain and scarring of the
The surgeon may use a microscope or endoscope
to direct surgical instruments through the working
channel. Excess bone or ligament tissue is carefully
removed from the space around the nerve root,
relieving pressure and pain.
Completing the Decompression
The surgeon may then shift the working channel,
repositioning the retractor so that it is directed at
the other side of the vertebra. This allows the
surgeon to access the opposite side of the vertebra
without creating a new incision in the skin. The
surgeon inspects and relieves any compression,
ensuring that the nerve roots on both sides of the
vertebra are completely free of obstruction.
End of Procedure and Aftercare
The instruments and the working channel are
removed, and the incision is closed and bandaged.
Most patients are discharged from the hospital the
same day and can return to their usual activity level
within a few weeks of surgery. The patient may take
pain medication to relieve incisional pain, but
usually this is needed for less than 1-2 weeks.