Spinal Cord Decompression

When something is pressing on your spinal cord, you may notice clumsy hands, trouble with balance or a slow loss of strength that’s easy to brush off at first. Spinal cord decompression can often correct the problem by giving the cord room again and protecting the function you have.

What Is Spinal Cord Decompression?

Spinal cord decompression is surgery to relieve pressure on the spinal cord. The cord runs through a bony canal in the neck and mid back. When that canal narrows, from arthritis, bulging discs, bone spurs, thickened ligaments, injury or a tumor, the cord can be squeezed. This is called spinal cord compression, and over time it can cause myelopathy, a loss of spinal cord function.

“Decompression” describes the goal, not a single operation. Depending on where the pressure is coming from, Dr. Grunch may remove it from the front or the back of the spine:

• From the front of the neck: anterior cervical discectomy and fusion (ACDF) removes discs and bone spurs, and a corpectomy removes part of a vertebra when pressure sits behind the bone.
• From the back of the neck: a cervical laminectomy removes the bony roof of the canal, and laminoplasty hinges it open to make more room while keeping motion.
• With stabilization: when the spine is unstable or removing bone would weaken it, decompression is combined with a posterior cervical fusion or thoracic fusion.

Who Needs Spinal Cord Decompression?

• Signs of cervical myelopathy: numb or clumsy hands, dropping things, trouble with buttons or handwriting
• Balance problems, a wide or unsteady walk, or frequent falls
• Weakness or numbness in the arms or legs
• Changes in bladder or bowel control
• Spinal cord compression on MRI from stenosis, a herniated disc, OPLL or cervical spondylosis
• Pressure on the cord from a tumor, infection or injury

Spinal cord compression is different from a pinched nerve. Because the spinal cord heals poorly once it is damaged, surgery is often recommended to stop symptoms from getting worse, even when pain is mild.

Treatments to Try First

• Close monitoring: for mild compression without symptoms, with regular exams and MRIs
• Physical therapy: for strength, balance and posture
• Medications: for neck pain or nerve pain
• Activity changes: avoiding high-risk activities that could injure the neck

Nonsurgical care can ease pain but cannot take pressure off the spinal cord. When myelopathy symptoms are present or progressing, surgery can often correct the problem and protect your function.

How Spinal Cord Decompression Is Done

1. Planning: MRI, CT and X-rays show exactly where the cord is being squeezed and whether the spine is stable.
2. Anesthesia and monitoring: You’ll be fully asleep. Spinal cord monitoring is used throughout surgery.
3. Reaching the spine: Through the front of the neck or the back of the neck or mid back, depending on where the pressure is.
4. Removing the pressure: The discs, bone spurs, thickened ligament or bone pressing on the cord are carefully removed.
5. Stabilizing, if needed: A spacer, plate, or screws and rods are placed when the spine needs support.
6. Closing: The incision is closed in layers.

Learn how spinal stenosis affects the neck:

Watch how a cervical laminectomy relieves pressure on the spinal cord:

Benefits and Risks

Benefits

• Stops or slows further loss of spinal cord function
• Often improves hand function, balance and walking
• Relief of arm and neck pain from pinched nerves
• Protection against a more serious injury from a minor fall

Risks

• Infection or bleeding
• Spinal cord or nerve injury, which is uncommon
• Temporary weakness lifting the arm (C5 palsy), which usually improves
• Trouble swallowing or a hoarse voice after surgery through the front of the neck
• A spinal fluid leak
• Neck pain or stiffness, and the need for a fusion or more surgery in the future
• Risks related to anesthesia, including blood clots

Surgery is designed to protect the function you have. Symptoms that have been present for a long time may improve only partly.

Why Choose Dr. Betsy Grunch for Your Spinal Cord Decompression

• Duke-trained: Dr. Grunch completed her neurosurgical residency and a spine research fellowship at Duke University School of Medicine, one of the top neurosurgery programs in the country, where she received the Spine Young Investigator Award.
• Front or back, matched to you: She performs ACDF, corpectomy, laminectomy, laminoplasty and posterior fusion and chooses the approach that best relieves the pressure in your spine.
• Motion-sparing options: When it’s safe, she offers laminoplasty and disc replacement to keep motion in your neck.
• Experience you can count on: She has been in practice since 2013 and performs 400 to 600 surgeries a year, more than 5,000 procedures over her career.
• Second opinions and revisions: She regularly sees patients who had spine surgery elsewhere and want a second opinion or need a revision.
• A teacher at heart: As “Ladyspinedoc,” she is known for explaining spine conditions clearly. You’ll leave your visit understanding your imaging and every option in front of you.

What to Expect

Before surgery

You’ll meet with Dr. Grunch or one of her physician assistants to review your imaging, your exam and your goals, and to decide together whether spinal cord decompression is right for you. Our team will coordinate any pre-operative testing, review your medications (including blood thinners you may need to pause) and walk you through the day of surgery so nothing is a surprise. If your surgery includes a fusion, stopping smoking and nicotine before surgery is strongly recommended. Our office can help.

Procedure day

Surgery usually takes two to four hours, depending on the approach and the number of levels. Most patients stay in the hospital for one to three nights. You’ll be up and walking the day after surgery, and physical therapy will help you get moving safely before you go home.

Recovery timeline

• First two weeks: Walk several times a day. Neck soreness and some trouble swallowing (after front-of-the-neck surgery) are common and improve.
• Four to six weeks: Your follow-up visit. Many people with desk jobs return to work in four to six weeks.
• Six to twelve weeks: Physical therapy helps with strength, balance and hand function.
• Three to twelve months: Spinal cord function can keep improving for many months.

Every patient heals differently. Your recovery will depend on how long the cord was compressed, the type of surgery and your overall health.

Caring for yourself at home

• Collar: Wear a neck collar only if Dr. Grunch’s team prescribes one.
• Walking: Walk several times a day, increasing a little each day. Use support if your balance is unsteady.
• Restrictions for about six weeks: No lifting more than 10 pounds and no overhead reaching or sudden neck movements.
• Your incision: If it is closed with skin glue, you may shower the day after surgery; if it has stitches or staples, wait three days. Don’t scrub or soak it, and don’t use ointments or creams.
• Swallowing: After surgery through the front of the neck, eat soft foods and take small bites until swallowing feels normal.
• Medications: Take pain medication with food and avoid alcohol while taking it. If you had a fusion, avoid anti-inflammatory medications such as ibuprofen and naproxen until Dr. Grunch’s team tells you it’s safe.
• Driving: No driving while taking narcotic pain medication or wearing a collar.

If you go home in a cervical collar, watch how to wear it correctly:

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Video: How to Correctly Wear the Aspen Vista Cervical Collar, from Dr. Grunch on her Ladyspinedoc channel (YouTube)

Call the office at 470-293-9800 if you have a fever over 101°F, redness, warmth or drainage from the incision, or calf pain or swelling. Call 911 for trouble breathing, swelling in the neck with trouble swallowing, new weakness, or new trouble controlling your bladder or bowels.

Download your patient instructions

Your instructions depend on the type of surgery you have. Find the sheet for your procedure on our Patient Resources page, or ask our team.

Frequently Asked Questions

Is spinal cord compression an emergency?

Sudden weakness, trouble walking or loss of bladder or bowel control needs emergency care. Slowly progressing symptoms still need prompt evaluation, because spinal cord damage can become permanent.

Will my symptoms go away after surgery?

The main goal is to stop symptoms from getting worse. Many people also notice improvement in hand function, balance and walking, though symptoms present for a long time may not fully recover.

Will I need a fusion?

Not always. Laminoplasty and some laminectomies don’t require a fusion. A fusion is added when the spine is unstable or when removing bone would weaken it.

Is surgery done from the front or the back?

It depends on where the pressure is coming from, how many levels are involved and the shape of your neck. Dr. Grunch will explain which approach she recommends and why.

How soon should I have surgery?

For progressing myelopathy, sooner is usually better, because the spinal cord has a limited ability to heal. Dr. Grunch will help you weigh the timing.

Call 911 or go to the nearest emergency room for new weakness or numbness in the arms or legs, trouble walking, or new trouble controlling your bladder or bowels.

Take the First Step Toward Relief

If spinal cord compression is affecting your hands, your balance or your walking, you have options. Whether you need a treatment plan, a second opinion or a clear explanation of your imaging, Dr. Grunch and the Southern Neurosurgery team are here to help.

Call 470-293-9800 to schedule an appointment or contact us online.

Have a question first? Ask our virtual assistant anything, 24/7.

We see patients across metro Atlanta and North Georgia at our offices in Gainesville, Sandy Springs and South Atlanta (Riverdale). Find the office nearest you.

Related pages: Spinal cord compression · Myelopathy · Cervical myelopathy · Cervical laminectomy · Laminoplasty · ACDF

This page is for educational purposes only and is not medical advice. It does not replace individualized care from a licensed physician. Please talk with your own doctor about your symptoms. If you have bladder or bowel changes, groin numbness or rapidly worsening weakness, call 911 or go to the nearest emergency room.