What is Lumbar Decompression?
When we think of decompression it usually involves a glass of wine or a hot bath after a long day at the office. This isn’t exactly what we’re talking about with lumbar decompression, but it can give the person suffering from lower back pain the same kind of relief.
There are 5 vertebrae, or bones, that make up the lumbar spine. These are located at the very bottom of the spine, just above the tailbone. In between each of the bones is a disc. The disc is fibrous on the outside edges, or rings, and has a jelly-like material in the middle. Running alongside the bones and discs are the nerves that innervate the legs. If one of these discs bulges out, putting pressure on the nerve, it results in pain.
The lumbar spine is a hotbed for injury for various reasons. If a person is lacking flexibility in their legs and they bend forward, the stress is placed on the lower back to reach the floor. If done repeatedly, it can result in injury to the lumbar spine. Remember your mother harping, “Stand up straight!”? Even though she may not have been a doctor, her advice wasn’t off the mark. Poor posture can result in increased pressure over the discs in the lower back. Lifting heavy objects or twisting the wrong way can also aggravate the lower back. Lumbar decompression is sometimes the solution for lower back pain.
There are both surgical and non-surgical methods of decompressing the lumbar spine
. Typically, a more conservative approach is used first, rather than jumping under the knife.
This type of decompression can be either mechanical or inversion traction. Both involve equipment that can look like medieval torture contraptions, but the end result is typically much more pleasant. The basic premise of inversion and mechanical traction is to allow the vertebrae to separate, taking pressure off the discs and nerves.
Mechanical traction involves use of a machine that the patient lies down on. They can either be on their stomach or on their back, depending on the angle the spine needs to be in to decompress the appropriate spinal level. The machine is then set to the desired force of pull, or traction, for a period of time. Sometimes it is continuous traction over a period of time lasting 15 to 20 minutes. Other times intermittent traction is used where it pulls and releases over shorter time intervals.
Inversion traction is like channeling your inner “batman”. There are a few different types of inversion traction, but they all involve tipping yourself upside down. One type involves boots that are clipped into a holder that allow you to hang completely upside down, or inverted. The other type involves a table that you lie on while your ankles are held in place by a bar. You are then tipped backward to a desired angle, controlled by a tether strap underneath the unit.
If conservative treatment has not been successful in alleviating the pain, then surgery may be the next step. Surgical decompression is a method of alleviating the pressure on the nerve by cutting away or removing the structure pressing on it.
There are two main types of surgical decompression: microdiscectomy and laminectomy. Microdiscectomy is a procedure that is minimally invasive with little scarring. It involves going in and removing a small portion of the jelly-like substance, or nucleus pulposus, which has herniated out of the fibrous rings of the disc. A laminectomy is a slightly more involved procedure that consists of removing a piece of the arch of the vertebrae that is pressing on the nerve. A more thorough explanation of each procedure can be found here.
Whichever method is used, lumbar decompression can mean the difference between counting the hours between pain pills and actually enjoying the day.