“Spinal decompression” can mean two very different things: an operation, or a non-surgical traction treatment. Dr. Charla Fischer, a board‑certified orthopedic spine surgeon in New York City, performs surgical decompression. Here is how the two compare, so you know which one someone is talking about.
What Does “Decompression” Mean?
Both aim to take pressure off the spinal nerves. Surgical decompression does it by removing the bone, disc or soft tissue that is pressing on a nerve or the spinal cord. Non-surgical decompression therapy tries to do it by stretching the spine.
Non-Surgical Spinal Decompression Therapy
In decompression therapy, a provider uses a traction table, with pulleys and weights, to stretch the spine. Some versions use an inversion table that relies on gravity. It is offered for conditions such as bulging or herniated discs, degenerative disc disease, pinched nerves, sciatica and spinal stenosis.
It is non-invasive, but it doesn’t remove what is compressing the nerve. In clinical trials for spinal stenosis, people who had surgery showed more improvement than those who received non-surgical treatments.
Surgical Spinal Decompression
Decompression surgery removes whatever is pressing on the nerve or spinal cord. It is considered when non-surgical care, such as physical therapy, injections or pain management, hasn’t given enough relief. Dr. Fischer performs several types:
- Lumbar laminectomy: removes part or all of the lamina and overgrown tissue to relieve stenosis.
- Minimally invasive microdiscectomy: removes the part of a herniated disc pressing on a nerve.
- Posterior cervical foraminotomy: widens the opening where a nerve leaves the spine in the neck.
- Posterior cervical laminoplasty: opens up the spinal canal in the neck while preserving motion.
Some decompressions are paired with a fusion when the spine needs to be stabilized.
Surgery vs. Therapy at a Glance
| Decompression surgery | Decompression therapy | |
|---|---|---|
| What it is | An operation that removes what is compressing the nerve | Traction that stretches the spine |
| Who performs it | A spine surgeon | A healthcare provider, using a traction or inversion table |
| Removes the cause? | Yes | No |
| Recovery | Often same-day surgery; most return to work in 2–4 weeks | No surgical recovery |
Recovery and Results After Decompression Surgery
Many decompression surgeries are done on a same-day basis, and patients walk right away. Most people return to work within two to four weeks, and microdiscectomy may allow an earlier return. In reported outcome data, about 60% of decompression and microdiscectomy patients reported improvement in back pain at or after six months, and 67% to 70% reported improvement in leg pain.
Risks
Decompression surgery carries the risks of any operation, including infection, bleeding, blood clots, and nerve or tissue damage. Dr. Fischer reviews the risks and the alternatives, including continued non-surgical care, with each patient.
How to Get Help
If back or leg pain from a pinched nerve or spinal stenosis hasn’t improved with non-surgical care, a spine surgeon can tell you whether surgical decompression makes sense. Dr. Fischer sees patients at NYU Langone Center for Musculoskeletal Care, 333 East 38th Street, 6th Floor (646-501-7200), and NYU Langone Madison Orthopedic Surgery Associates, 145 East 32nd Street, 4th Floor (212-427-3986). Contact Dr. Fischer to schedule a consultation.
Sources: Cleveland Clinic, Spinal Decompression Therapy (updated Jan 2022); Hospital for Special Surgery, Spinal Decompression Surgery (updated Apr 2023); Cleveland Clinic, Laminectomy (warning signs after surgery); Dr. Fischer’s laminectomy, microdiscectomy, foraminotomy and laminoplasty pages.
Frequently Asked Questions
Is spinal decompression therapy the same as decompression surgery?
No. Decompression therapy uses a traction table or inversion table to stretch the spine. Decompression surgery removes the bone, disc or soft tissue that is pressing on a nerve or the spinal cord.
What conditions is decompression therapy used for?
It is offered for conditions such as bulging or herniated discs, degenerative disc disease, pinched nerves, sciatica and spinal stenosis. It doesn’t remove what is compressing the nerve.
When is decompression surgery recommended?
Surgery is considered when non-surgical care, such as physical therapy, injections or pain management, hasn’t provided enough relief.
How long is recovery after decompression surgery?
Many decompression surgeries are done on a same-day basis and patients walk right away. Most people return to work within two to four weeks, and microdiscectomy may allow an earlier return.
What types of decompression surgery are there?
Common types include laminectomy, microdiscectomy, foraminotomy and laminoplasty. Some decompressions are combined with a fusion when the spine needs to be stabilized.