Lumbar decompression and fixation is a surgical treatment for severe spinal stenosis, herniated discs, spondylolisthesis, or spinal instability that causes nerve compression and chronic pain. The surgery relieves pressure on nerves (decompression) and stabilizes the spine (fixation/fusion).
Common Symptoms Leading to Surgery
Patients may require this procedure if they have:
- Chronic lower back pain (radiating to legs – sciatica).
- Numbness/weakness in legs or feet.
- Difficulty walking (neurogenic claudication).
- Loss of bladder/bowel control (cauda equina syndrome – medical emergency!).
- Failed conservative treatments (physical therapy, epidural injections, medications).
Lumbar Decompression & Fixation Types
1. Procedures for Decompression
- Laminectomy: To relieve nerve pressure, a portion of the vertebra (the lamina) is removed.
- Discectomy: When a herniated disc presses against nerves, it is removed.
- Extending the foramen, or nerve outlet space, is known as foraminotomy.
2. Techniques for Fixation and Fusion
- Pedicle screw-rod fixation: The spine is stabilized using metal screws and rods.
- Interbody fusion: To encourage fusion, a spacer or cage (containing bone graft) is positioned in between vertebrae.
- Common fusion techniques include PLIF/TLIF (Posterior/Transforaminal Lumbar Interbody Fusion).
