Spinal decompression is the release of pressure on the spinal cord or nerve roots. Decompression is performed surgically to repair disc injuries in the lower back and neck area associated with herniated and bulging discs, pinched nerves, sciatica, degenerative disc disease, radiating arm pain and other spine-related disorders. A form of non-surgical spinal decompression therapy promoted as an alternative to back surgery is another option, but it has been met with skepticism by members of both the medical and chiropractic communities.
Background
The spine is a long column of stacked individual bones (vertebrae) that runs from the base of the skull down the center of the back to the pelvis. Cushioned between the vertebrae are gel-filled discs that support the spine and facilitate movement. The spinal cord runs down from the brain stem through the spine with nerve roots that branch out of the spine through the vertebrae.
Significance
Disc problems that cause spine compression can put pressure on the spinal cord and pinch the nerves, causing pain and often immobility. The goals of both surgical and non-surgical spinal decompression are to alleviate the pressure and pain, free the nerve and straighten the spine.
Surgical Procedures
There are various types of spinal decompression surgery and sometimes a combination of procedures must be used to decompress the spine. Diskectomy is the removal of part of a disk. Laminotomy (or laminectomy) is the removal of all or part of the lamina, which are the bony arches of the spinal canal. This surgery relieves pressure by opening up the canal. A foraminotomy, or foraminectomy, is the removal of bone and tissue blocking the opening in the spinal cord where nerve roots exit. Other types of surgery remove bone spurs on the spine or remove the vertebra or disks themselves.
Non-Surgical Procedure
Non-surgical spinal decompression therapy is a noninvasive form of spine rehabilitation that is similar to traction therapy. This therapy, which requires daily treatment over the course of about a month, plus ongoing maintenance treatments in some cases, uses pressure and positioning to get the injured disc to slip back into its normal position. Therapy is performed on a special decompression table, and other chiropractic treatments, such as heat therapy and electric stimulation, are often simultaneously used.
Outcome
The published success rates for spinal decompression surgery and non-surgical decompression are similar. Up to 90 percent of laminectomies and discectomies are successful according to Wisconsin spine surgeon Peter F. Ullrich, Jr., MD, while decompression therapy boasts an 86 percent success rate.
Many factors affect the outcome of surgical and non-surgical treatments for back pain, however, and not everyone with spinal compression problems is a good candidate for any particular procedure. Many individual factors, including source of pain, degree of pain, psychological condition and personal expectations, help both doctor and patient determine appropriate treatment.
Considerations
Although published studies and statistics indicate a high success rate for non-surgical spinal decompression, a review of all available studies published in a 2007 issue of the journal "Chiropractic & Osteopathy" disputes those results. This review revealed that only limited clinical research has been performed and no well designed studies have ever been completed that would indicate spinal decompression is an effective long-term treatment for most people with chronic spine conditions and back pain.
