Concierge spinal surgery · UK
Private lumbar decompression surgery in the UK, by a consultant spinal surgeon.
Creating room for compressed nerves in a narrowed lumbar canal. It is the operation for neurogenic claudication - leg pain and heaviness on walking that eases when you sit - and it works far better for legs than for backs.
Why patients choose us
- 01
A spinal surgeon who will tell you not to operate
Decompression works well for leg symptoms and poorly for back pain. The surgeons we introduce are clear about that distinction rather than blurring it.
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Symptoms and imaging matched properly
Degenerative change on MRI is near-universal over 60. What matters is whether the narrowing explains your specific symptoms - and that takes a proper examination.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private lumbar decompression costs in the UK.
Indicative ranges across our partner spinal units. Send the MRI report and a description of your symptoms and we quote firm figures for the operation actually proposed.
In short
A single-level decompression: £8,000–£13,000, often a day case.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Spinal surgeon consultation | £250–£450 | 45 min | Same visit |
| Lumbar MRI | £400–£800 | 30 min | 24–48 hours |
| Epidural or nerve root injection | £1,000–£2,000 | 30 min | Day case |
| Single-level lumbar decompression | £8,000–£13,000 | 60–90 min | 0–2 nights |
| Multi-level lumbar decompression | £11,000–£18,000 | 2–3 hours | 2–3 nights |
| Decompression with fusion | £18,000–£30,000 | 3–5 hours | 3–5 nights |
Prices vary by centre, by the number of levels, by whether fusion is added, and by whether the approach is open or minimally invasive. Adding fusion roughly doubles the cost and significantly lengthens recovery, so it is worth asking specifically why it is being proposed. Lumbar decompression is performed to a high standard on the NHS, though waits can be long. We come back with a firm quote within one working day.
The problem
Decompression treats legs. It does not treat backs.
The single most useful thing to understand before lumbar surgery is that decompression reliably improves leg pain, numbness and walking distance, and does much less for back pain. People who go in expecting their back to be fixed are the ones who come out disappointed.
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Leg pain when you walk, relief when you sit?
That is neurogenic claudication, and it is the symptom decompression treats best. Walking distance often improves dramatically.
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Mostly back pain?
Decompression is a poor operation for back pain alone. Physiotherapy, exercise and pain management usually serve better, and we will say so.
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Being offered a fusion as well?
Fusion is warranted where there is genuine instability or spondylolisthesis. Where there is not, it adds cost, risk and recovery time without adding benefit.
The journey
From enquiry to recovery - what happens, in order.
One spinal surgeon from imaging review through to the six-week check - with an honest conversation about expectations before anything is booked.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
Admission and theatre
Phase 3 · After
Concierge, back on
- 01
Before
You send us the imaging
A short, confidential form and your lumbar MRI report, plus what your symptoms actually are - leg or back, walking distance, and what relieves them.
- 02
Before
We come back with a recommendation
Within one working day: whether conservative treatment still has room to run, whether an injection would help first, and which spinal surgeon fits.
- 03
Before
We arrange the consultation
Usually within one to two weeks. Examination, imaging review and an honest discussion of what surgery will and will not change.
- 04
On the day
Admission and anaesthetic
Admission, consent and a full discussion with the surgeon and anaesthetist. Most decompressions are done prone under general anaesthetic.
- 05
On the day
The operation itself
60 to 120 minutes for one or two levels. Bone and thickened ligament removed to enlarge the canal, with the nerve roots checked for free movement before closing.
- 06
On the day
Walking the same day
You are up and walking within hours. Most patients stay one or two nights, and single-level decompressions are frequently day cases.
- 07
After
Recovery and physiotherapy
Leg symptoms often improve immediately, back soreness settles over four to six weeks, and physiotherapy starts at around six.
Typical end-to-end: 2–4 weeks from enquiry to surgery. Full recovery: 6–12 weeks.
When it helps
When lumbar decompression is the right operation.
The symptoms it treats well, the ones it does not, and the presentation that means emergency surgery within hours.
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Neurogenic claudication
Leg pain, heaviness or numbness that comes on with walking and eases on sitting or leaning forward. The classic indication, and the one with the best results.
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Lateral recess stenosis
Narrowing where the nerve root turns to leave the canal, producing radicular pain in a single dermatome. A targeted laminotomy or foraminotomy treats it.
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Foraminal stenosis
Compression at the exit hole itself, often worse on standing and extending. It needs a foraminotomy rather than a central decompression.
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Degenerative spondylolisthesis with stenosis
One vertebra slipped forward on another, narrowing the canal. Decompression is required; whether fusion should be added is a genuine and case-specific judgement.
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Progressive neurological deficit
Increasing weakness, foot drop or numbness rather than pain alone. That shifts surgery from elective to urgent.
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Failed conservative treatment
Where physiotherapy, analgesia and injection have not restored acceptable walking distance over months, surgery becomes a reasonable next step.
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When it is not the answer
Back pain without leg symptoms, symptoms that do not match the imaging, and vascular claudication all point away from decompression.
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Red flag: cauda equina syndrome
Numbness in the saddle area, difficulty passing or controlling urine, loss of bowel control, or rapidly worsening weakness in both legs - A&E immediately, this needs surgery within hours.
Surgical options
Not every decompression removes the same amount of bone.
What each technique involves - and which pattern of narrowing it suits.
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Laminotomy
Removing part of the lamina on one or both sides, preserving the midline structures. Enough for many cases and it maintains more of the spine's natural stability.
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Laminectomy
Complete removal of the lamina and spinous process at a level, giving the widest exposure. Used for severe central stenosis and multi-level disease.
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Foraminotomy
Widening the exit hole where a nerve root leaves the spine. Targets radicular pain from foraminal narrowing rather than central canal stenosis.
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Unilateral approach, bilateral decompression
Working through one side under the microscope to decompress both sides. It preserves the muscles and ligaments on the opposite side and speeds recovery.
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Tubular minimally invasive decompression
Through a small tubular retractor with a microscope or endoscope. Less muscle disruption, less blood loss and faster mobilisation in suitable cases.
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Decompression with fusion
Added where there is genuine instability, significant spondylolisthesis or where decompression would itself destabilise the segment. It roughly doubles cost and recovery time.
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Interspinous spacer devices
An implant placed between the spinous processes to hold the segment slightly flexed. Less invasive but with higher reoperation rates, and used selectively.
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Non-surgical management
Physiotherapy, exercise, weight management, analgesia and epidural injection. First-line for most people, and sufficient for many.
Our vetted UK network
A small panel of spinal surgeons, we picked them.
Consultant spinal surgeons - neurosurgical and orthopaedic - across UK spinal units. Not listed publicly, and introductions are made privately once we understand your imaging and symptoms.
Selection criteria
How we choose every spinal surgeon in our network.
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Consultant spinal surgeons with a dedicated degenerative lumbar practice and audited outcomes
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Microscopic and tubular minimally invasive techniques available, not just open surgery
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A clear position on when fusion is and is not warranted, explained to you before you consent
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Spinal physiotherapy and pain management available as genuine alternatives, not afterthoughts
Safety and recovery
What to expect afterwards - honestly.
Decompression relieves leg symptoms in roughly 80 per cent of well-selected patients. The complications worth planning around are dural tear, back pain that persists, and the possibility of needing further surgery years later.
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Dural tear and CSF leak
The commonest technical complication, affecting around 5 per cent and more in revision surgery. Repaired at the time, it usually means a period of bed rest and nothing more.
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Back pain may not improve
Decompression targets nerve compression, not degenerative back pain. Expecting the back pain to resolve is the single commonest source of disappointment after this operation.
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Infection
Wound infection affects around 1 to 3 per cent, and deep infection fewer. It presents with increasing pain, redness or discharge in the first weeks.
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Nerve injury
New weakness or numbness is uncommon, at well under 1 per cent for straightforward decompression, but it is a recognised risk of working around nerve roots.
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Recurrent stenosis and adjacent segment disease
Degenerative change continues. Roughly one in ten needs further surgery within ten years, either at the same level or at the one next to it.
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Instability after extensive decompression
Removing too much bone or a facet joint can destabilise the segment. This is precisely the balance a decompression is designed around, and why fusion is sometimes added.
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DVT and PE
Prophylaxis and early mobilisation are standard. Walking the same day is not just about comfort - it is the most effective clot prevention available.
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Recovery is not instant
Leg symptoms often improve immediately, but back soreness, stiffness and fatigue take four to six weeks. Nerves that have been compressed for years may take months to settle fully.
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Red flags after surgery
New or worsening leg weakness, difficulty passing urine, saddle numbness, fever, or clear fluid leaking from the wound - A&E or the spinal unit the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whether the decompression was open, microscopic or tubular, the note your surgeon writes keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and levels
The diagnosis, which levels were symptomatic, the MRI findings, and how they correlated with your examination.
- 02 Technique
Approach and extent
Open, microscopic or tubular; laminotomy, laminectomy or foraminotomy; which levels and sides were decompressed; whether fusion or instrumentation was added.
- 03 Findings
Intraoperative findings
The degree of stenosis actually found, thickness of the ligamentum flavum, any disc fragment removed, whether a dural tear occurred, and nerve root mobility at the end.
- 04 Impression
Recovery, restrictions and review
Read this first: when to walk, drive and return to work, what lifting restrictions apply, when physiotherapy starts, and which symptoms mean calling.
Recognised by major UK insurers
Cover for spinal surgery is usually funded when medically indicated and supported by imaging, but insurers commonly require evidence that conservative treatment has been tried first, and several exclude spinal fusion or require pre-authorisation for it. Chronic back pain management and long courses of physiotherapy are often capped. We check your policy wording before booking.
Frequently asked
Everything we get asked about lumbar decompression.
Quick answers on success rates, back pain, fusion, recovery time and whether to wait.
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How successful is lumbar decompression?
Around 80 per cent of well-selected patients get good or excellent relief of leg symptoms and a substantial improvement in walking distance. Success depends far more on patient selection than on technique - people whose main complaint is leg symptoms with matching imaging do well, and those whose main complaint is back pain do not.
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Will it fix my back pain?
Probably not, and this is the most important expectation to set. Decompression relieves pressure on nerves, which is what causes leg pain, numbness and claudication. Degenerative back pain comes from the discs and facet joints, which the operation does not address. Some back pain improves because you can move more, but it should not be the reason for surgery.
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How much does private lumbar decompression cost in the UK?
A single-level decompression runs £8,000–£13,000, multi-level £11,000–£18,000, and decompression with fusion £18,000–£30,000. A lumbar MRI adds £400–£800 and an epidural injection £1,000–£2,000. We confirm firm figures within one working day.
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Do I need a fusion as well?
Only if there is genuine instability - a significant spondylolisthesis, movement on flexion-extension radiographs, or a decompression extensive enough to destabilise the segment. Fusion roughly doubles the cost, lengthens recovery considerably and increases the risk of problems at the adjacent level. If it is being proposed, ask specifically what evidence of instability supports it.
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How long is recovery?
You walk the same day, and most people go home within one to two nights or as a day case. Office work resumes at two to four weeks, physical work at six to twelve, and driving at two to four once you can perform an emergency stop. Back soreness settles over four to six weeks, and nerves compressed for years may take months to fully recover.
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What happens if I do not have surgery?
Lumbar stenosis usually progresses slowly rather than dramatically. Many people manage for years with physiotherapy, exercise, weight management and occasional injections, and delaying surgery does not generally make the eventual result worse. The exception is progressive weakness or any suggestion of cauda equina syndrome, which changes the urgency entirely.
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Is minimally invasive surgery better?
For suitable cases, tubular and microscopic techniques cause less muscle damage, less blood loss and faster early mobilisation, with equivalent decompression. They are not better for everyone - multi-level severe stenosis, revision surgery and cases needing fusion are often better served by an open approach. The right choice depends on the anatomy, not on marketing.
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Will the stenosis come back?
Degenerative change continues after surgery, so recurrent stenosis at the same level or new stenosis at the adjacent level does happen - roughly one in ten patients needs further surgery within ten years. That is a reason for realistic expectations, not a reason to avoid the operation.
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How do I know if I have vascular rather than neurogenic claudication?
Neurogenic claudication typically eases when you lean forward or sit, and people often find they can walk further pushing a trolley or cycling. Vascular claudication eases simply on standing still and does not depend on posture. Where it is unclear, an ankle-brachial pressure index settles it - and it is worth doing, because the treatments are entirely different.
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When should I go to A&E rather than wait for an appointment?
Numbness in the saddle area, difficulty starting or controlling urination, loss of bowel control, or rapidly worsening weakness in both legs. That combination suggests cauda equina syndrome, which needs surgery within hours to avoid permanent damage. Do not wait for a clinic appointment.
Related treatments
Looking for something else?
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Lumbar laminectomy
The open decompression in detail.
Learn more -
Lumbar discectomy surgery
When a disc rather than bone is the problem.
Learn more -
Lumbar spine microsurgery
The microscopic and tubular approach.
Learn more -
Epidural steroid injection
The non-surgical option that often comes first.
Learn more