Foraminotomy

A foraminotomy is a surgical procedure that targets the area where nerve roots exit the spinal canal to relieve pressure and other build-up that is causing pain. It is most commonly used on patients who have a condition known as foraminal spinal stenosis.

The spinal cord connects the nerves that stretch all across the body. To reach the extremities, smaller nerves thread through openings in the spinal canal around the vertebrae. However, the vertebrae may become misaligned, causing the nerve openings, or foramina, to narrow. This creates pressure to build up around the spinal canal or around nerves extending out from it and may lead to chronic, shooting back pain.

A foraminotomy can be performed open-back or endoscopically. Endoscopic foraminotomies are less invasive, minimally scarring, and faster in recovery; open back foraminotomies are employed for more severe cases of back pain and are more invasive and require longer recovery times.

Conditions Treated by Foraminotomy

Foraminal spinal stenosis, a condition in which the openings between the spinal cord and the extremities narrow, is the primary situation in which a patient would receive a foraminotomy.

Other symptoms and condition that could be treated through a foraminotomy include:

  • Chronic back and neck pain
  • Numbness or pain in any part of the body
  • Tingling "pins and needles" sensation
  • General fatigue
  • Muscle weakness

You will need to have an MRI or X-ray scan to determine if you need a foraminotomy. The doctor will see that your bones or cartilage from damaged spinal discs are causing undue pressure on your spinal nerve. The surgery's main goal is to remove any unwanted bone or cartilage.

The Process

A foraminotomy proceeds as follows:

  1. Depending on whether you're doing an open-back or endoscopic procedure, you may or may not receive anesthesia as the procedure begins. An open-back foraminotomy will require a general anesthesia, whereas an endoscopic procedure will only require a local anesthesia.
  2. The surgeon will make an opening on your back and push aside your skin, muscles and ligaments to operate on the affected vertebra and nerve.
  3. The surgeon will then clean the neural foramen with irrigation and a laser. This will remove the build-up. The build-up will commonly consist of a disc fragment, scar tissue, excess ligament or even a bone spur.
  4. The surgeon may perform a spinal fusion to fuse your vertebrae together with bone grafts or metal rods.
  5. Finally, the surgeon will put your muscles and ligaments back into place and stitch your skin back together.

Recovery

After the foraminotomy has been completed, you may need to take several days or several weeks to recover, depending on the extent of your procedure. Endoscopic procedures take less time to heal, while open-back procedures may take a month or more of physical therapy, pain medication and rest.

Contact your physician for a consultation on receiving a foraminotomy. The doctor should perform all necessary tests to determine if the surgery could be a possible solution to your back pain.

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