Foraminotomy is a surgical procedure performed to expand the opening in the spinal column where the nerve roots exit the spinal canal. Its purpose is to relieve the pressure resulting from foraminal stenosis. This is a painful condition caused by a narrowing of the foramen, the opening within each of the spinal bones that allows nerve roots to pass through.
As a result of aging or other musculoskeletal conditions such as arthritis, the foramen may gradually become clogged and develop bone spurs that press on the nerves and cause pain, numbness, stiffness and weakness, and may also develop into spinal stenosis. Herniated discs and thickened ligaments and joints may also be the cause of the narrowing of the foramen.
When foraminal stenosis does not respond to conservative treatments, it may require a foraminotomy. The procedure, which frees the nerve from pressure and allows it to move again within the spinal column, can be performed on any part of the spine but is most common on the cervical (neck) or lumbar (lower back) regions.
The patient is given general anesthesia and lies face down on the operating table. The surgery typically takes about two hours. An incision is made on the back to access the spine. A portion of bone is cut or shaved down to open up the passageway of the foramen. If any disk fragments are present, they are removed. Bone at the back of the vertebrae may also be taken out if that is necessary to provide more space. Foraminotomy may be combined with spinal fusion surgery to provide greater stability to the affected area of the spine.
After the surgery, you will most likely be released from the hospital the same day. If the foraminotomy was in the cervical region, you will probably be required to wear a soft neck collar to limit your head and neck movement. Physical therapy may be recommended for the first several weeks after surgery. The full recovery time is typically between two and three months.
Foraminotomy has a very good success rate for relieving the symptoms of foraminal stenosis. Complications are rare, but can occur during any surgical procedure. The risks for any surgery include reactions to anesthesia, bleeding, infection, damage to a spinal nerve, pain after surgery, blood clots and the potential return of back problems. These risks can be minimized by choosing an experienced surgeon to perform your procedure, and by adhering to your surgeon’s instructions before and after your procedure.
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