Minimally Invasive Lumbar Decompression
When patients experience severe symptoms of spinal stenosis, Dr. Greenwald may suggest Minimally Invasive Lumbar Decompression as a possible treatment option. This surgical procedure is designed to alleviate the pressure on the spinal cord, and the nerves that radiate out of the spinal column. One of the biggest advantages of Minimally Invasive Lumbar Decompression is reduced trauma to the tissue at the operating site, and a faster recovery. Having helped many patients alleviate discomfort and debilitating pain caused by spinal nerve compression, Dr. Greenwald has extensive expertise in performing this procedure in a way that promotes decompression of the spinal cord while speeding up the healing process.
If you’d like to schedule a consultation with Dr. Greenwald about possible Minimally Invasive Lumbar Decompression, please call our office at (650) 968-4747, or email us through the Contact Form.
When is Minimally Invasive Lumbar Decompression Performed?
The need for Minimally Invasive Lumbar Decompression surgery arises when a patient experiences severe symptoms from lumbar stenosis, which causes either the spinal canal or the foramina to narrow and create pressure on the spinal cord or the nerves that radiate out of the spinal column.
The spinal canal is an opening in the vertebrae that accommodates and protects the spinal cord. The foramina are the openings on the sides of the vertebrae, which allow nerves from the spinal cord to reach the rest of the body.
In a healthy spine the spinal canal and the foramina are wide enough to easily accommodate the spinal cord and the nerves. However, when these openings narrow such as from cysts or herniated discs, they can create pressure that results in symptoms like tingling, numbness, and pain. In severe cases, the pain can become debilitating and the numbness can turn into weakness of one or both legs, and may even cause bladder dysfunction.
To address these symptoms, Minimally Invasive Lumbar Decompression can be performed to relieve pressure by removing the herniated disc, or other structures caused by arthritis, hypertrophy or ligament hypertrophy, and widen the size of the spinal canal and/or the foramina.
Why Lumbar Stenosis Occurs
There are many reasons why lumbar stenosis can occur, including natural aging, injury, or a herniated disc.
When lumbar stenosis develops as part of aging, this is typically induced by arthritis or the wear and tear of the intervertebral discs. For example, arthritis can gradually lead to the development of bone spurs on the vertebrae, which cause the spinal canal or the foramina to narrow and exert pressure on the spinal cord and the nerves.
Additionally, the pressure can be induced by swelling of the ligaments in the area, as well as the wear of intervertebral discs, which causes the disc(s) to bulge and press against the nerves.
Injury can also cause damage to the vertebrae or discs, leading to pressure.
How is Minimally Invasive Lumbar Decompression Performed?
Minimally Invasive Lumbar Decompression has two main goals; to alleviate pressure on the spinal cord and the surrounding nerves, and to achieve this result with the least amount of trauma to the area.
When the procedure begins, the patient will be placed under general anesthesia in the prone position.
Once the patient is sedated and comfortable, Dr. Greenwald will map out the incision points and then insert small needles to demarcate the points of incision(s). These needles are used in conjunction with x-ray imaging, to carefully identify the full incision path and insertion of surgical instruments.
After the needle has been set in place to determine the exact level, Dr. Greenwald will make an incision to accommodate a surgical tube or a minimally invasive retractor. This retractor is inserted into the incision and will act as a pathway for the surgical tools used during the Minimally Invasive Lumbar Decompression surgery. The retractor is only a few inches wide, and allows for much smaller incisions than during the common lumbar laminectomy.
After the surgical retractor has been secured in place, Dr. Greenwald will perform lumbar decompression through a variety of steps. This may involve removing the lamina (a bone on the vertebrae) to widen the spinal canal, using a burr drill and magnification loop (or microscope) to remove bone spurs, removing parts of surrounding ligaments, and removing fragments of a ruptured intervertebral disc (if fragments from a ruptured disk entered the spinal canal).
Dr. Greenwald goes to great lengths during this step of the procedure, to ensure that that spinal cord and the surrounding nerves are decompressed, and that there is ample room in the spinal canal and the foramina.
Once the procedure has been completed, Dr. Greenwald will remove the surgical tube and carefully suture the incision.
Is Minimally Invasive Lumbar Decompression Safe?
When performed by an experienced surgeon like Dr. Greenwald, Minimally Invasive Lumbar Decompression is a safe procedure that can significantly improve the patient’s quality of life by alleviating nerve compression symptoms.
To achieve this, Dr. Greenwald uses multiple techniques. For example, he will take the time to carefully analyze your imaging tests well ahead of surgery to look for all nuances that will need to be addressed during the procedure, and devise the best surgical course of action in your specific situation. He takes every patient’s case very seriously and may order additional imaging tests if needed.
During Minimally Invasive Lumbar Decompression, Dr. Greenwald will use imaging technology to ensure that the incision is made in the best location for performing the surgery in your case, and that the surgical retractor is placed perfectly, to allow for easy access to the affected area.
When it comes to removing obstructions that are pressing on the spinal cord or the surrounding nerves, Dr. Greenwald works meticulously to widen the spinal canal and/or the foramina to avoid a recurrence of the problem in the future, and to ensure there is no instability (the latter is achieved by maintaining the majority of the joint). This means visualizing the nerves and the surrounding structures to achieve the best possible results.
Minimally Invasive Lumbar Decompression Side Effects
Side effects from Minimally Invasive Lumbar Decompression are similar to side effects from larger incisions, including post-operative pain and the possibility of infection. However, because the incision is smaller, the risk of these side effects is typically reduced. For example, many patients are able to start walking the day of surgery, or the next day.
Recovery from Minimally Invasive Lumbar Decompression
Minimally Invasive Lumbar Decompression is typically performed on an outpatient basis and rarely requires and overnight hospital stay. Many patients feel some improvement in the core symptoms immediately after surgery, with additional improvement over the weeks that follow.
Pain will persist at the incision site, and will subside as the wound heals. However, Dr. Greenwald will prescribe pain medication, as needed, and many patients report that the discomfort from the incisions is mild when compared to the symptoms of a compressed spinal cord or surrounding nerves.
For faster recovery, it is recommended that the patient start walking the day of surgery, and gradually transition to a more active lifestyle that includes building strength in the muscles around the treatment site. However, Dr. Greenwald will discuss the best recovery instructions for your unique situation before Minimally Invasive Lumbar Decompression surgery.
Your Minimally Invasive Lumbar Decompression Consultation
If your doctor suggested that you will benefit from Minimally Invasive Lumbar Decompression, or if you would like a second opinion, please contact our office to schedule a consultation. Dr. Greenwald will take the time to review your results, will discuss the procedure with you in detail, and will answer any questions you may have. He has helped many patients throughout his career, and takes great pride in providing excellent surgical results while ensuring that each patient is treated with compassion and individualized attention.
To schedule your Minimally Invasive Lumbar Decompression consultation, please call our office at (650) 968-4747, or use the Contact Form to send us an email.