(This is the section that explains the detail of the operation or procedure above and should be read in conjunction with the section called your back operation).

A lumbar decompression is performed for trapped nerves. The aim of the operation is to remove the compressive elements that are compressing the nerves of the spine. This may be bone, ligaments or even bits of discs. The usual situation is that the patient will present with progressive pain on standing and activity that gets better with rest.
They will also have progressive weakness and a feeling of their legs giving away under them. This is because the compression of the nerves lead to dysfunction in these nerves.

The aim of this procedure is to remove the compression with as minimal an approach as possible without causing the spine to become unstable. If the decompression needs to be severe, a fusion procedure might be required to stabilise the spine.

When undergoing this operation, you will be lying on your stomach on bolsters or pillows during your procedure. Your surgeon will make a small cut along your spinous processes. This cut can vary from two or three centimetres to a much larger cut depending of the number of vertebrae and spinal levels involved.
The length of the cut is actually immaterial to the success of the operation and a surgeon should never complicate the operation by trying to make the cut too short. The soft tissue and muscles that are attached to the vertebraes are then stripped off by a combination of electrosurgical cautery (a blade that cuts with an electrical current) and dissecting instruments. All the compressive bone, ligaments and disc fragments are then removed and the nerves probed to make sure that they are lying loose in the spine and in the canals that they follow to exit the spinal canal.
If there are sufficient structures left to allow it, your surgeon might place a spacer between the spinous processes to keep the spinal canal open allow the nerves to breathe. Thereafter the wound is stitched up.

Ward care

You would be expected to get out of bed quite early and usually on the first day following surgery. You may usually walk around as much as you want depending on the stability of your spine. Your surgeon will advise you about this. You should be careful of sitting for too long or on a seat that is very low. This is to prevent you from placing too much strain on your lower back. Most surgeons recommend a duration of 30 minutes or less of sitting at a time.

Discharge

You would normally be discharged between two days and a week after your operation. Staff at the hospital will take care of your follow-up consultation, analgesia to take home, sick certificate and wound care provisions in the post-operative period.

Rehabilitation

It is incredibly important to get a lot of rest and exercise following your surgery. Do not try to rush back to work. It is important to walk for exercise and also exercise in conjunction with the guidelines from your physiotherapist. You may perform activities only as prescribed by your health care provider. You should refrain from exercises that involve impact for at least three months. This would include jogging, mountain biking and equestrian pursuits.

Follow up

You will usually be seen after six weeks but will be seen earlier if there are any complications. In cases of spinal fusion you would usually undergo an X-ray of your back a few months after the operation to evaluate the bone growth between the two vertebrae. It is important that this bony growth takes place; otherwise the operation might have to be repeated. It is important to realise that you will have to protect your back the rest of your life with good back habits. See the section on exercises to see what you can do to keep your back healthy.