A physician who treats you for spinal stenosis, a herniated disk or other severe back problems will probably advise you to try conservative pain management for a time. The conservative plan can include medications or physical therapy. If these treatments fail to resolve your pain, your doctor may advise you to seek the opinion of a neurosurgeon, as surgery may be necessary to eliminate or greatly reduce your back pain. If you are reluctant to undergo surgery because you are unaware of the typical results, it is time to educate yourself on this type of minimally invasive spine surgery.
What Type of Patients Benefit From Minimally Invasive Lumbar Decompression?
Any patient who suffers from concrete acute or sub-acute spine pathology that is deemed surgical should learn about this type of surgery. In general, the best candidates for this type of surgery lead busy, active lifestyles, and they don’t have time to wait six to eight weeks to recover from the more invasive open surgeries. Elderly patients can also benefit if their overall health makes it risky to have the more traditional, open surgery. However, this type of minimally invasive spine surgery may not be the best alternative for patients with scar tissue from past surgeries or those who are extremely obese or have spinal deformities.
What Happens During Minimally Invasive Lumbar Decompression?
The doctor advises on which medications to take the morning of the operation and which ones to cease a few days beforehand. The patient is admitted to the hospital and prepped for surgery. Once the patient has been put to sleep and is lying on the operating table, the surgery begins. A small incision of less than an inch made in the patient’s back, and a retractor is used to gently pull the muscle away from the spinal column. The surgeon uses specially designed instruments and a microscope to remove bone spurs or overgrown ligament that is causing the pain. Sometimes lasers or endoscopes may be used, however this does not fundamentally change the surgical goals. Each patient is different, and the technique for the minimally invasive lumbar decompression depends on what your surgeon feels is best for you and your type of problem.
Use of Pain Medications
Patients who have this type of surgery typically are able to discontinue their use of pain medications within 14 days after the surgery. This helps reduce any side effects from the medications, such as fatigue, constipation, an upset stomach or vomiting. The patients feel more like themselves without the narcotics, so this helps speed the recovery from a psychological standpoint. Cutting down or ceasing the use of the narcotics also reduces the risk of developing a dependency.
Less Blood Loss During Surgery
Since the incision is quite small and the length of surgery time is often reduced, blood loss is less during a minimally invasive lumbar decompression than in those of the invasive variety. Very significant blood loss can lead to transfusions which are undesirable for a variety of reasons, but even if a transfusion is not required, more blood loss at surgery generally leads to a longer recovery time.
Length of Hospital Stay
Patients typically go home on the day following the surgery and are usually up and walking immediately afterwards. This light physical activity helps lessen recovery time and encourages the body to heal at a faster pace.
Less Postoperative Pain
A smaller incision means less postoperative pain for the patient; therefore, there is less worry about accidentally reopening the wound due to activity. Smaller incisions tend to heal more rapidly because movement puts less stress on the wound. There is also much less muscle injury with a minimally invasive approach which produces less pain and faster recovery.
Less Risk of Infection
Since the surgery is minimally invasive, patients are at less risk of obtaining an infection. When an infection occurs, the recovery time is longer, so patients miss more time from work and other normal activities due to wound care or other complications. If an infection is not controlled quickly with antibiotics, the problem can escalate quickly and may even evolve into a life-threatening illness.
Post-op Care
Your surgeon will likely want you to return to the medical office two weeks after your minimally invasive lumbar decompression. At this time, the doctor will talk with you about your pain level and any other concerns you have. At this time, the doctor may recommend physical therapy for a few weeks to aid in your recovery process. Your return to work, sports and other normal activities depends on your overall health, the condition of your wound site and how you are progressing in your recovery. Often, patients with sedentary or desk jobs can return to work immediately..
Minimally invasive lumbar decompression surgeries have been around for years. Patients who undergo this type of surgery usually come to find that the fear they had of enduring a long and painful recovery time was unfounded. Although surgery should be a last resort, sometimes it is the best option to restore your quality of life. Talk with a board-certified neurosurgeon to determine if this type of surgery is the right choice for you.
