Preparation for spine surgery begins with a patient history, a physical exam, and imaging to confirm the spinal disease, to determine the affected level, and to decide on the type of surgery. Lumbar microdecompression is a minimally invasive decompressive procedure used to treat spine disease symptoms in the lumbar region.

A lumbar microdecompression is performed with the patient lying on their stomach with the lower back pointed upward. An intraoperative x-ray machine is used throughout the procedure to ensure that the correct vertebra/vertebrae is being operated on. After locating the proper vertebra, the skin is marked, cleaned, and draped for sterility. A small, less than one inch, incision is made on the lower back, either midline, or just off midline to the affected side of the body. The muscles of the back are dissected with as little disruption as possible, until the laminae of the spine is reached, which is the backside of the spine. Retractors are placed, which keep the incision open for the duration of the procedure, allowing the surgeon to see and operate without surgically opening the back. A small amount of the laminae is removed until the appropriate nerve root is exposed. Specialized biting instruments are then used to remove any element, such as disc fragment or bone spurs, that is placing pressure on the nerve root.

Once the nerve roots are decompressed, the procedure is complete and closing process may begin. The retractors are removed from the incision and bleeding is controlled. Each layer of tissue is closed with sutures and the final layer of skin is usually closed with a special medical grade glue, which typically leaves less scaring after healing. The final layer may be fully closed with sutures depending on the surgeon’s preference and on the patient’s skin.

After the procedure is completed, the patient recovers at the surgery center and is typically able to go home within a couple of hours of the procedure. Prior to discharge home, a patient needs to have pain under control, urinating normally, walking, and tolerating food and beverage. A friend or family member should be available to drive the patient home and should also be available to monitor the patient for at least 24 hours after the procedure.