Orthopaedic Spine Center
450 Broadway St. | MC6342
Redwood City, CA 94063
For Adult Patients: (650) 725-5905

Lumbar Spine Surgery: Microdecompression

Below are some of the procedures offered by Dr. Cheng to treat lumbar spine conditions. Click the links below to learn more about the selected treatment:

Microdecompression: is an operation to remove pressure on a nerve caused by spinal stenosis. This surgery involves a vertical incision one to two inches in length along the midline of the back. The doctor uses a microscope to see and protect the nerve roots, and safely remove the portions of tissue and bone which press on the nerve roots. Removing the tissues pressing on the nerve allows the nerve to begin to heal.

The reason to do this surgery is to relieve the leg pain or weakness caused by the pressure on the nerve roots. The success rate of relieving leg pain is very high, approximately 90%. The success rate of relieving chronic back pain present prior to surgery is much less predictable.

The length of the operation is typically short (60-90 minutes), but depends on the number of spinal levels operated upon, whether or not previous surgery has been performed and the severity of the pressure on the nerve roots. Blood loss is minimal so no blood donations are necessary before the operation. Hospitalization is brief and while some patients may go home the day of surgery, most patients go home the day after surgery.

Risks of Surgery

Surgery and anesthesia involve stresses to many organs and tissues in the body. Incisions and handling tissues during surgery can result in many problems. The benefits of surgery must be carefully weighed against these risks. Some more common or serious problems are listed here.

Recurrent Stenosis: The aging process continues, and arthritic changes may still occur. However, regrowth of bone spurs is likely to take a long time, so we do not anticipate the same area being pressed on. As arthritis progresses in the whole body, other areas of the spine may need surgery in the future, but having every area “cleaned out” now is not indicated. Surgery is only indicated on those areas which are currently causing symptoms of nerve root compression.

Spinal Nerve Root Injury: Permanent spinal nerve root injury is extremely rare. It is not unusual, however to experience minor temporary tingling, numbness, weakness or pain which resolves over several weeks. All precautions will be taken but rarely, more serious nerve root injuries may occur, effecting walking, balance, bowel or bladder functions.

Dural Tear: Leakage of spinal fluid can occur due to a tear in the tissue (called the dura) holding the spinal fluid and containing the nerve roots. On rare occasions additional surgery may be needed.

Infection: Infection is always a post-operative risk and occurs in approximately 0.5% of lumbar microdecompression patients. Infections may be superficial or deep into the bone. You are given antibiotics before and after the surgery to help prevent this complication. Please follow the instructions for wound care to help prevent infection.

Other complications: Other possible complications include blood clots, pneumonia and complications related to the general anesthesia.

Activities and Exercise / Rehabilitation

Adequate rehabilitation is crucial for a successful result. Many patients with spinal injuries have suffered from spinal pain for some time. This may result in considerable weakening of the spinal muscles due to lack of exercise, so you should return to the normal activities slowly.

The primary form of rehabilitation after microdecompression is an aggressive walking program. You should start immediately after discharge, walking more and more each day. In general, we recommend two to three episodes of exercise per day. The average patient should be walking 20-minutes twice a day by their first postoperative visit and 40- minutes twice a day by six- weeks after surgery. Walk more if you are so inclined!

Expectations

Patients routinely experience a dramatic reduction in their leg pain. If the nerve has been irritated for a long time before surgery, then a more gradual reduction of the leg pain is to be expected. As the nerve heals, you may experience tingling or a warm feeling. Numbness in the leg/foot experienced before surgery is often the symptom which takes the longest to resolve.

Back pain associated with the incision is largely improved within two to three weeks. Increased pain with prolonged sitting and driving is also expected.