What is a Lumbar Decompression and Pedicle Screw Fusion?

Spinal Decompression is performed to relieve pressure on the fibrous sheath which contains the spinal nerves and stabilises the spine from slipping forward.

X-rays will be taken during surgery to determine the correct levels of surgery. A cut is made down the middle of the back, over the decompression site. To decompress the spine, the muscles are stripped from the bones at the back of the spine. The bones on the back of the spine (spinous process and laminae) maybe removed from the spine to relieve pressure.

Following the decompression, supporting screws are inserted into the pedicles of the vertebrae which require support. Sometimes, a computer navigation system is used for screw placement. X-rays are taken to ensure the screws are in the correct place. The screws are then joined together with several rods and nuts.

A separate cut may be made over the hip to harvest some hip bone. Harvested bone is sometimes mixed with a bone substitute. It is then packed along the sides of the rods to fuse the spine. A small plastic tube (drain) may be inserted to allow any residual fluid to be drained away. This will be removed within 24 to 48 hours. The cut is closed with stitches or staples.

This procedure will require a general anesthetic.

Spinal Decompression

What are the risks of this specific procedure?

There are risks and complications with the spinal decompression procedure. They include but are not limited to the following. Infection, requiring antibiotics and further treatment. Minor pain, bruising and/or infection from IV cannula site. This may require treatment with antibiotics. Pain from the bone graft site of the hip. This usually settles in time.

Rare occurrences of this procedure include heart attack due to the strain on the heart. Stroke or stroke like complications may occur causing neurological deficits such as weakness in the face, arms, and legs. This could be temporary or permanent. Nerve root injury causing a weakness in foot movement which may affect mobility. This may be temporary or permanent. Bladder or bowel problems due to nerve root injury. This may be temporary or permanent.

Ongoing persistent back and leg pain, with possible leg numbness due to nerve damage from compressed nerve roots. This may require further surgery.