Our Summary

This study was conducted to understand how certain surgical procedures on the lower back (lumbar spine) affect its flexibility or range of motion (ROM). The researchers used 14 cadaveric human lumbar segments and tested their ROM in six different directions before and after three common types of surgeries: unilateral laminotomy, midline decompression, and nucleotomy.

Results showed that the ROM increased after each type of surgery. The unilateral laminotomy increased the ROM by about 6-12%, the midline decompression by 15-21%, and the nucleotomy by up to 153%. However, when the researchers used a type of hardware (called a pedicle screw fixation) to stabilize the spine, the ROM decreased significantly by about 80% in bending moments.

In conclusion, the researchers found that the type and extent of surgical decompression can significantly affect the lumbar spine’s ROM. However, using hardware to stabilize the spine can counteract this increase in ROM. This research may help surgeons predict how different procedures will affect a patient’s post-surgery flexibility.

FAQs

  1. What was the purpose of the study conducted on the lumbar spine?
  2. How does each type of surgery affect the range of motion (ROM) of the lumbar spine?
  3. How does the use of a pedicle screw fixation affect the range of motion after surgery?

Doctor’s Tip

A doctor may advise a patient undergoing spinal decompression to follow post-operative care instructions carefully, including avoiding heavy lifting or strenuous activity, maintaining good posture, and attending physical therapy sessions to help improve flexibility and strengthen the muscles surrounding the spine. It is important for patients to communicate any concerns or difficulties with their doctor to ensure a successful recovery.

Suitable For

Patients who are recommended spinal decompression typically have conditions such as herniated discs, degenerative disc disease, spinal stenosis, sciatica, or other types of nerve compression in the lumbar spine. These patients often experience symptoms such as back pain, leg pain, numbness, tingling, weakness, or difficulty walking that have not responded to conservative treatments such as medication, physical therapy, or injections. Spinal decompression may be recommended to alleviate pressure on the nerves and provide relief from these symptoms.

Timeline

Before spinal decompression:

  1. Patient experiences chronic back pain, sciatica, numbness or tingling in the legs, weakness in the legs, or other symptoms related to spinal compression.
  2. Patient consults with a healthcare provider who recommends spinal decompression as a treatment option.
  3. Patient undergoes diagnostic tests such as MRI or X-rays to determine the extent of the spinal compression.
  4. Patient discusses the risks and benefits of spinal decompression with their healthcare provider and decides to proceed with the surgery.

After spinal decompression:

  1. Patient undergoes spinal decompression surgery, which can be performed using various techniques such as laminotomy, midline decompression, or nucleotomy.
  2. Patient experiences an increase in range of motion (ROM) in the lumbar spine following the surgery, depending on the type and extent of decompression performed.
  3. If hardware such as pedicle screw fixation is used to stabilize the spine, the increase in ROM may be counteracted.
  4. Patient undergoes physical therapy and rehabilitation to improve strength and flexibility in the spine and surrounding muscles.
  5. Patient experiences relief from symptoms such as back pain, leg pain, and numbness as the spinal compression is alleviated.
  6. Patient follows up with their healthcare provider for post-operative care and monitoring to ensure proper healing and recovery.

What to Ask Your Doctor

  1. How will spinal decompression surgery affect my range of motion in my lower back?
  2. Will I need any hardware, such as pedicle screws, to stabilize my spine after the surgery?
  3. What are the potential risks and complications associated with spinal decompression surgery?
  4. What is the expected recovery time and rehabilitation process after spinal decompression surgery?
  5. Are there any alternative treatments or therapies that may be effective for my condition?
  6. How successful is spinal decompression surgery in relieving pain and improving mobility?
  7. Will I need physical therapy or other forms of rehabilitation after the surgery?
  8. What is the long-term outlook for my condition after spinal decompression surgery?
  9. Are there any lifestyle changes or precautions I should take after the surgery to prevent further issues with my spine?
  10. How frequently will I need follow-up appointments to monitor my progress after spinal decompression surgery?

Reference

Authors: Burkhard MD, Calek AK, Fasser MR, Cornaz F, Widmer J, Spirig JM, Wanivenhaus F, Farshad M. Journal: Eur Spine J. 2023 Jun;32(6):1876-1886. doi: 10.1007/s00586-023-07694-5. Epub 2023 Apr 24. PMID: 37093262