Spinal decompression describes any technique that attempts to alleviate spinal compression, or pressure on the spinal cord or its spinal nerves. When neural tissue is compressed it is a pathological condition, and with enough or prolonged compression the tissue begins to die. These events produce symptoms that are indicative of the location and severity of the compression. Decompressing the neural tissue is the only way to alleviate the forces producing the symptoms before irreversible damage can occur.
Spinal Compression Causes
Spinal decompression is required to alleviate spinal compression, or pressure on the spinal cord. The compression can be caused either by slowly progressing factors or by trauma. Compression due to bony involvement can result from fractures or misalignment of the vertebrae, as well as spondylosis, an osteoarthritic condition. Other slower processes such as hematoma and tumors of the spinal column can also produce spinal compression. Degenerative disk disease can cause spinal disks to rupture or herniate and exert pressure on the spinal cord or on the spinal nerves.
Spinal Compression Symptoms
Spinal decompression is required when the symptoms of spinal cord or spinal nerve compression warrant intervention. These symptoms can be extremely varied, and depend on the level of the compression and its severity. Generally, back pain which radiates into the lower limbs is one of the primary symptoms. This can be accompanied by changes in sensory abilities such as tingling and diminished sensitivity to touch. Weakness, paralysis and hyperreflexia are also signs of spinal compression. More severe compression can result in bowel and genitourinary dysfunctions, such as bladder retention and erectile dysfunction.
Goal of Decompression
The Cleveland Clinic reports that the reason spinal decompression techniques are attempted is to relieve the pressure on the spinal cord or on the spinal nerve roots. The pressure can be relieved relatively quickly by surgical or nonsurgical techniques. Even though the pressure might be relieved instantly, the symptoms may not disappear as quickly, as completely or even at all. This is because compressing neural tissues can result in irreversible damage. Once neurons or nerve fibers die, they cannot be replaced.
Decompression Surgery
Spinal decompression using surgical techniques is modified according to the underlying cause of the compression. For example, fracture of a spinal vertebra may necessitate surgical removal of bony fragments pressing on the spinal cord. Dislocation of a vertebra may require repositioning and stabilizing the bone with steel hardware such as rods and screws. Sometimes simply sucking out the compressive force, as with a tumor or hematoma, can decompress the underlying neural tissue. The final result of all these procedures is alleviating the compression on the spinal cord or spinal nerves.
Nonsurgical Therapy
Other methods to alleviate compression on the spinal cord or spinal nerves aim to do so without surgery. These are mainly performed when compression is a result of disk herniation. One technique used for decades is spinal traction, which pulls apart the vertebrae and disks if they are the underlying cause of the compression. Spinal manipulation also can be used, and this includes the Cox Technique often used by chiropractors. Prolotherapy, steroid injection into the disk and various mechanical devices have also been used for spinal decompression, although their effectiveness, and that of most nonsurgical therapies, remains controversial.
