Treatment
A small, precise procedure that takes pressure off a pinched nerve — and leaves the rest of your spine untouched.
Microdecompression is a minimally invasive operation to relieve pressure on a spinal nerve. Through a very small opening, Dr. Melamed removes only what is crowding the nerve — a fragment of herniated disc, a thickened ligament, or a bit of overgrown bone — and nothing more.
The goal is targeted, not sweeping. By addressing the exact source of compression and leaving the surrounding muscle, bone, and joints intact, the procedure relieves leg or arm pain while preserving the spine's natural stability and motion.
Microdecompression is a minimally invasive procedure used to relieve pressure on damaged nerves in the spine. A lot of the time, this damage is caused by spine conditions like bone spurs, spinal degeneration, or herniated discs.
Medically reviewed byDr. Hooman Melamed, MD, FAAOS
Microdecompression is a good fit when imaging shows a clear, focal point of nerve compression — most often from a herniated disc, foraminal narrowing, or a bone spur — and when conservative care has not settled the pain. It is not the right choice for problems driven by instability, which need a different plan.
People with sciatica (pain down the leg), radiculopathy (pain caused by irritated spinal nerves), or spinal stenosis (narrowed spinal canal) may especially benefit from this procedure.
Dr. Hooman Melamed offers a variety of microdecompression treatments for back pain. Dr. Hooman Melamed is a board-certified orthopedic spine surgeon who has been recognized for multiple awards in the field of medicine.
The Spine Pro team uses minimally invasive microdecompression techniques and advanced diagnostic imaging to pinpoint the exact source of nerve compression for a precise and accurate procedure.
Types of microdecompression surgeries include:
Dr. Melamed diagnoses and treats a variety of spine-related conditions. Some of these include:
Using a biportal endoscopic approach, Dr. Melamed makes two incisions under a centimeter: one for a high-definition camera and one for fine instruments. Muscle is gently spread rather than cut. Under magnified, well-lit vision, only the tissue pressing on the nerve is removed, and the nerve is confirmed to be free before closing.
Because the working field is so precise and the disruption so small, most microdecompressions are done as an outpatient procedure — you go home the same day.
Dr. Melamed’s microdecompression procedure is designed with the patient in mind.
First, your surgeon will perform an evaluation using techniques such as MRI scans, blood tests, and X-rays.
Prior to the procedure, you must report any allergies, as well as any medications, vitamins, or supplements you are taking. Blood thinners, anti-inflammatory drugs, and aspirin should be stopped 1-2 weeks before surgery.
You should also avoid alcohol and tobacco for 1 week before surgery, and for 2 weeks afterward.
The night before your procedure, you’ll need to fast for at least 8 hours. You may be placed on a special diet and be given laxatives. Showering with an antibacterial soap the night before can help lower your risk of infection.
You will need to have someone drive you home the day of your procedure, so make sure to arrange this beforehand. Signing an informed consent form before the procedure is a requirement.
Microdecompression surgery generally takes about 30-60 minutes to complete. However, expect to be in the recovery room for about 2 hours because of the anesthesia you will be given.
For the procedure, you will first be put under anesthesia.
After seeing where the affected area is, the surgeon will carefully remove the small piece of bone or disc that’s pressing against the spinal nerve. This will relieve pressure on the spine.
To relieve any pain during recovery, most patients take over-the-counter pain medications and may find that cold and heat therapy reduces inflammation. You may also be prescribed antibiotics to reduce the chance of infection.
Refrain from smoking and lifting (during the first 6 weeks) to give your body a chance to heal.
Your diet will begin with liquids after surgery, and you can slowly progress to normal, solid foods, as tolerated.
Light activities like walking are encouraged when healing to prevent blood clots, and physical therapy is part of the recovery process. A gradual return to work and daily life routines usually happens over 2-3 weeks, but you should refrain from driving until your doctor says it’s okay.
With muscle preserved rather than detached, recovery is dramatically faster than open surgery. Most patients are up and walking the same day, back to light activity within days, and steadily returning to normal life over the following weeks. Dr. Melamed's approach is designed to minimize narcotics throughout.
There are many benefits to choosing microdecompression surgery. The precise and minimally invasive (small incision) technique makes it an attractive alternative to traditional surgery.
Since advanced magnification tools are used, the surgeon only removes the damaged portion of the bone or disc. This means that the surrounding area of the spine is preserved.
Since microdecompression surgery targets the root cause of the pain and removes only the damaged portion, the surgeon is able to know exactly where the pain occurs. By ensuring that the correct area is removed, it’s likely that patients will notice pain reduction in the arms or legs quickly.
A small incision is used in microdecompression surgery, which means there is usually less blood loss, muscle damage, and scarring, and reduced postoperative pain.
Questions, Answered
It shares the same goal — freeing a compressed nerve — but the scale is very different. A traditional open laminectomy removes more bone and detaches muscle. A microdecompression removes only the tissue pressing on the nerve through sub-centimeter incisions, preserving stability.
Almost never. Because microdecompression preserves the joints and bone that keep your spine stable, it does not create the instability that would call for a fusion.
Many patients with desk jobs return within a week or two; more physical work takes a bit longer. Your exact timeline depends on your job and your case, which Dr. Melamed reviews with you.
Second opinions welcome
Send your imaging for a personal review with Dr. Melamed. Many patients learn a smaller, muscle-sparing option is on the table.