Lumbar decompression: how it works, what it’s for, recovery time

Written in association with: Mr Sinan Barazi
Published: | Updated: 02/04/2020
Edited by: Nicholas Howley

Lumbar decompression is a surgical operation to create more space for your nerves and spinal cord. There are many different ways a lumbar decompression can be carried out depending on your condition. This article by leading neurosurgeon Mr Sinan Barazi looks at how the procedure works, who it’s for, and what to expect after the operation.

Why do I need lumbar decompression surgery?

Lumbar decompression surgery aims to free up space for your spinal cord and relieve pressure on your nerves. Pressure on the nerves can cause serious symptoms such as:

  • pain (sciatica)
  • difficulty walking
  • weakness in the legs

These symptoms can arise due to a slipped disc or an age-related condition such as spinal stenosis.

Read more: Slipped disc

Read more: Spinal stenosis

These conditions are initially treated with conservative techniques such as medication and physiotherapy. However, if this has not been successful in treating the symptoms described above, your doctor may recommend lumbar decompression surgery.

In rare cases, a compressed spine can interfere with your bladder or bowel function, and emergency spinal surgery is required.

How does lumbar decompression surgery work?

Lumbar decompression surgeon involves getting access to your spine and removing some bone and tissue to take some pressure away from the affected area. It is performed under general anaesthetic.

To access the spine, the surgeon will make a small incision and locate the correct level of the spine guided by an X-ray. This might involve moving some muscles out of the way but these will be stitched together again afterwards.

We have a number of ways to reduce the pressure on the nerves and spinal cord. Your doctor might use the following terms:

Laminotomy

This is a procedure to remove part of the lamina. The lamina is an inside arch of the vertebral bone, and two laminae make up the back wall of the vertebra. A laminotomy usually removes part of just one lamina, and can be performed using open-access or minimally-invasive techniques.

Laminectomy

This removes the entire lamina, in cases of severe decompression

Discectomy

This is an operation to remove the bulging part of a herniated disc, and can also be performed with open-access or minimally-invasive techniques (also known as a microdiscectomy). To access the herniated disc the surgeon will also remove a small part of ligament in the spine and a tiny bit of bone, freeing the nerve root.

Read more: microdiscectomy

Foraminotomy

This is a procedure that increases the space where a nerve root exits the spinal canal. Every vertebra in your spine has two openings called neuroforamen, and when these spaces become to small these nerves can become pinched. A foraminotomy involves removing whatever is causing the compression – whether it is a herniated disc or a bone spur.

What to expect after the operation

After the operation you’ll stay in hospital overnight so that if any complications arise they can be dealt with quickly. Before you leave the hospital you’ll be given advice on exercise to build up your back muscles again and stay mobilised.

You should have another consultation after about 6-8 weeks to assess your overall progress.

If you are struggling with back pain or weakness in your legs, book a consultation with Mr Sinan Barazi.

By Mr Sinan Barazi
Neurosurgery

Mr Sinan Barazi is a leading London-based​ pituitary, skull base, trigeminal neuralgia/facial pain and spinal neurosurgeon. He was born in Copenhagen and subsequently moved to the United Kingdom where he attended Winchester College.

He qualified from King’s College Hospital School of Medicine in 1996, after which he completed his French military service in the 14th Parachute Regiment in Toulouse. He completed his surgical training in London at the Atkinson Morley Hospital, King’s College Hospital, and St George’s Hospital.

After finishing his specialist training, he worked in Bologna, Italy, as a fellow in endoscopic pituitary surgery under Giorgio Frank and Ernesto Pasquini, and finally in Manchester as a skull base fellow under Professor Andrew King and Scott Rutherford. He was appointed consultant skull base neurosurgeon at King’s College Hospital NHS Foundation Trust in 2011.

He is a core member of the Skull Base, Pituitary and Complex Facial Pain multi-disciplinary teams and he has established the Complex Facial Pain service with Dr Giorgio Lambru across the King’s College Hospital and St Thomas’ Hospital sites. He has published extensively in major neurosurgical journals and has presented at national and international meetings on a range of topics including pituitary, skull base and facial pain surgery. 

Mr Barazi is a member of several professional organisations including the British Skull Base Society (BSBS) (where he has just completed three years as a council member), the Society of British Neurological Surgeons (SBNS) and the Royal College of Surgeons. He is the lead for the Royal College of Surgeons accredited Senior Fellowship in Skull Base, Pituitary and Facial Pain service at King’s College Hospital.

He was appointed joint chair of the Medical Advisory Board of the Trigeminal Neuralgia Association of the United Kingdon in 2023 alongside Dr Giorgio Lambru. His private practice is at the Harley Street Clinic, Cromwell Hospital, Chiswick Medical Centre, and the Guthrie Clinic at King's College Hospital. He is fluent in English, French, Danish, German and Swedish.

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