The pain, weakness, numbness, and tingling associated with nerve root encroachment is usually first treated with non-surgical therapies, such as anti-inflammatory medication and physical therapy. This may be enough to address the irritation of the spinal nerve root. Persistent and severe cases, however, may require surgery to ease nerve compression and improve symptoms.
Decompressive surgery may be done in a couple of different ways. Regardless, the procedure is a serious one and does not come with a guarantee for complete pain relief.
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Causes and Symptoms of Nerve Encroachment
Vertebrae arebonesin your spine that are stacked one upon the other. On each side of the vertebra, there are small openings (called foramina), which allow a type of nervous tissue called aspinal nerve rootto pass through.
When you have nerve root encroachment, this spinal nerve root gets compressed, which can cause peripheral symptoms to develop, such as numbness, tingling, pain, or weakness.
If these degenerative changes progress, they can “encroach” and compress a nerve root, which may lead to the development of peripheral symptoms (e.g. pain, numbness, and/or weakness).
When Surgery Is Indicated
When symptoms do occur, initial treatment will involve nonsteroidal anti-inflammatories (NSAIDs), physical therapy, chiropractic care, massage therapy, weight loss, rest, and/or aninjection of corticosteroids into the spine.
If these conservative therapies are not helpful or there are neurological problems present—like difficulty with balance or walking— surgery may be considered. Severe pain that limits everyday functioning is an additional indication for surgery.
Rapidly progressive weakness of the arms and/or legs or signs ofcauda equina syndrome(e.g., loss of bladder/bowel control) are indications for urgent surgery.
Spine Surgery Options
There are different types of spinal surgery that may be performed. A neurosurgeon will decide what the best procedure for each patient is based on their unique problem, as well as their age, other medical conditions, and other factors.
Specificspinal decompression surgerydepends on what is causing the nerve compression. In most cases it involves removing bone or tissue to relieve pressure on the nerve or help stabilize the joint. The most common types of decompression surgery are as follows:
According to the American Academy of Neurosurgeons, the goals of spine surgery are to:Decompress or relieve pressure on the nerve rootsMaintain or improve the stability and alignment of the spine
According to the American Academy of Neurosurgeons, the goals of spine surgery are to:
Anterior Surgical Approach
The anterior approach to surgery means that the spine is accessed through the anterior part (front) of the spine.
For example, in order to alleviate pressure on one or more nerve roots in the cervical (upper) spine, ananterior cervical discectomymay be performed. In this surgery, one or more discs and bone spurs are removed through an incision in the front of the neck.
Posterior Surgical Approach
The posterior approach to surgery means that the spine is accessed through the posterior part (back) of the spine.
For example, in order to remove a thickened ligament, bone spur, or disc material in the neck, part of the back of the vertebrae (called the lamina) may be removed through a small incision in the back of the neck. This is called aposterior cervical laminectomy.
Risks
As with any surgery, it’s important that you and your healthcare provider carefully weigh the potential benefits of these procedures against the risks.
Some of the risks that may occur from spine surgery include:
There are also risks specific to the area of the spine being operated on and how it is surgically approached (anterior vs. posterior). For example, with a cervical anterior approach, there is a risk that the esophagus (the tube that connects your mouth to your stomach), trachea (windpipe), or carotid artery may be injured.
Likewise, damage to the C5 nerve root (called C5 palsy) may occur from cervical spinal decompressive surgery. This complication causes weakness, numbness, and pain in the shoulders.
Very rarely, the spinal cord may be injured during surgery and result in paralysis.
A Word From Verywell
If you or a loved one is considering a decompressive surgery, it is important to have informed conversations with your neurosurgeon. As you may or may not get relief from such a procedure, the pros and cons in your specific case must be carefully weighed.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Choi YK.Lumbar foraminal neuropathy: an update on non-surgical management.Korean J Pain. 2019 Jul; 32(3): 147–159. doi:10.3344/kjp.2019.32.3.147Mayo Clinic Health System.Decompress and stabilize: understanding types of back surgery.American Association of Neurological Surgeons.Cervical spine.American Association of Neurological Surgeons.Lumbar spinal stenosis.Proietti L, Scaramuzzo L, Schiro GR, Sessa S, Logroscino CA.Complications in lumbar spine surgery: a retrospective analysis.Indian J Orthop. 2013; 47(4):340–345. doi:10.4103/0019-5413.114909Thompson SE et al.C5 Palsy After Cervical Spine Surgery: A Multicenter Retrospective Review of 59 Cases.Global Spine J. 2017 Apr;7(1 Suppl):64S-70S. doi: 10.1177/2192568216688189
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Choi YK.Lumbar foraminal neuropathy: an update on non-surgical management.Korean J Pain. 2019 Jul; 32(3): 147–159. doi:10.3344/kjp.2019.32.3.147Mayo Clinic Health System.Decompress and stabilize: understanding types of back surgery.American Association of Neurological Surgeons.Cervical spine.American Association of Neurological Surgeons.Lumbar spinal stenosis.Proietti L, Scaramuzzo L, Schiro GR, Sessa S, Logroscino CA.Complications in lumbar spine surgery: a retrospective analysis.Indian J Orthop. 2013; 47(4):340–345. doi:10.4103/0019-5413.114909Thompson SE et al.C5 Palsy After Cervical Spine Surgery: A Multicenter Retrospective Review of 59 Cases.Global Spine J. 2017 Apr;7(1 Suppl):64S-70S. doi: 10.1177/2192568216688189
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Choi YK.Lumbar foraminal neuropathy: an update on non-surgical management.Korean J Pain. 2019 Jul; 32(3): 147–159. doi:10.3344/kjp.2019.32.3.147Mayo Clinic Health System.Decompress and stabilize: understanding types of back surgery.American Association of Neurological Surgeons.Cervical spine.American Association of Neurological Surgeons.Lumbar spinal stenosis.Proietti L, Scaramuzzo L, Schiro GR, Sessa S, Logroscino CA.Complications in lumbar spine surgery: a retrospective analysis.Indian J Orthop. 2013; 47(4):340–345. doi:10.4103/0019-5413.114909Thompson SE et al.C5 Palsy After Cervical Spine Surgery: A Multicenter Retrospective Review of 59 Cases.Global Spine J. 2017 Apr;7(1 Suppl):64S-70S. doi: 10.1177/2192568216688189
Choi YK.Lumbar foraminal neuropathy: an update on non-surgical management.Korean J Pain. 2019 Jul; 32(3): 147–159. doi:10.3344/kjp.2019.32.3.147
Mayo Clinic Health System.Decompress and stabilize: understanding types of back surgery.
American Association of Neurological Surgeons.Cervical spine.
American Association of Neurological Surgeons.Lumbar spinal stenosis.
Proietti L, Scaramuzzo L, Schiro GR, Sessa S, Logroscino CA.Complications in lumbar spine surgery: a retrospective analysis.Indian J Orthop. 2013; 47(4):340–345. doi:10.4103/0019-5413.114909
Thompson SE et al.C5 Palsy After Cervical Spine Surgery: A Multicenter Retrospective Review of 59 Cases.Global Spine J. 2017 Apr;7(1 Suppl):64S-70S. doi: 10.1177/2192568216688189
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