Home / Conditions / Decompression surgery
Making room for a squeezed nerve or spinal cord by removing what is pressing on it — thickened bone, ligament or disc. It is the most common spinal operation, and for the right problem it works well.
Nerves leave the spine through narrow spaces. Wear over the years can close those spaces: the small joints enlarge, a ligament inside the canal thickens, discs flatten and bulge, and bone spurs form. A nerve or the spinal cord ends up with too little room — see spinal stenosis, slipped disc and cervical myelopathy.
Decompression surgery takes away whatever is doing the pressing, so the nerve has space again. It does not repair the nerve or reverse the wear; it removes the cause of the pressure and lets the nerve recover.
It treats pressure, not pain in general. Where leg or arm symptoms come from a squeezed nerve, relieving the pressure treats the cause. Back or neck pain with no nerve compression is a different problem, and decompression is not the answer to it.
The types of decompression surgery spine surgeons perform are named after what is removed. Often two are done together at the same level.
| Laminectomy or laminotomy | Foraminotomy | Discectomy | |
|---|---|---|---|
| What is removed | Part of the bony roof at the back, and the thickened ligament under it | Bone and spur around the tunnel where one nerve leaves | The part of the disc that has pushed out |
| Usual reason | Spinal stenosis — leg pain and heaviness on walking | One nerve pinched at its exit, with pain down one arm or leg | A slipped disc pressing on a nerve root |
| What improves most | Walking distance | Pain along that one nerve | Leg or arm pain, often quickly |
Fusion is a separate question. Most decompressions do not need it. It is added when the level is unstable or a vertebra has slipped — see spondylolisthesis — or when the decompression itself would leave the level unstable. In the neck, decompression from the front is usually combined with fusion or a disc replacement: see ACDF surgery.
Call us on +65 8849 0677. We will see you the same day and arrange imaging if it is needed.
For the first symptom, go to an emergency department if we are closed. Decompression done early in cauda equina syndrome protects function that may not return later.
Call +65 8849 0677Most decompressions are now done through a small incision, using a microscope or a tube that parts the muscle rather than cutting it. Endoscopic techniques work through a smaller opening still. Less muscle damage generally means less pain and a faster recovery.
An MRI, and X-rays if alignment or stability is in question. Blood tests and an anaesthetic review. Blood thinners paused on advice, and smoking stopped if fusion may be needed.
Under general anaesthetic, usually one to three hours depending on how many levels are treated. The nerve is freed, and the surgeon checks it moves freely before closing.
Up and walking within a day. Hospital stay from same-day discharge to about three days. Leg or arm pain often eases straight away; the wound and back muscles ache for a while longer.
Walking daily from the start, with physiotherapy as advised. Desk work in two to four weeks, heavier work six to twelve. Driving once you can brake sharply without hesitating, and are off strong painkillers.
For leg pain from stenosis or a slipped disc, decompression relieves symptoms in the large majority of well-selected patients, and walking distance usually improves. Back pain itself improves less predictably. Numbness and weakness recover more slowly than pain, and long-standing weakness may not come back fully.
Decompression is done here by both spine surgeons, from different training.
Dr Mathew Tung performs spinal decompression, foraminotomy, and decompression with fusion, using endoscopic and minimally invasive “keyhole” microsurgery including Matrix Tube Spine Surgery.
His stated approach is conservative treatment first, preserving movement, and preferring reversible options over fusion wherever they are suitable.
Dr Lim Heng Hing treats spinal stenosis and slipped discs using endoscopic and robotic techniques, with robotic assistance for screw placement where fusion is part of the plan.
He also handles deformity correction, which matters when narrowing comes with a curve or a slipped vertebra.
Either is a sound first appointment. Having both in one clinic means the recommendation is not shaped by whichever one you happened to book. More on the difference: neuro spine and orthopaedic spine surgery.
Usually not. Fusion is added when the level is unstable, a vertebra has slipped, or the decompression would leave the level unstable. In the neck, decompression from the front is normally combined with fusion or a disc replacement.
Between same-day discharge and about three days, depending on how many levels were treated and how you are moving.
Leg or arm pain from a squeezed nerve usually improves a great deal, often quickly. Back pain is less predictable, and numbness or weakness recovers more slowly than pain.
Driving once you are off strong painkillers and could brake hard without hesitating. Desk work in two to four weeks; physical work six to twelve weeks.
It can. A disc can herniate again, and wear continues at the same and neighbouring levels. Most people do not need a second operation, but it happens often enough to be worth knowing.
No. Bring your MRI images and report, any X-rays, and a note of the treatment you have already had.
Spinal stenosis · Slipped disc · Spondylolisthesis · Cervical myelopathy · Sciatica · ACDF surgery
Bring your MRI. The first question is usually whether surgery is needed at all, and if so, how small it can be.
