What is a Foraminotomy
A foraminotomy is a minimally invasive procedure that can significantly relieve, or in some cases entirely remove, pain caused by foraminal stenosis (narrowing of the neural foramina). Conditions such as:
can cause pressure to be put on the nerves as they exit the cervical spine. This frequently results in radicular pain, with tingling, numbness, weakness, and paraesthesia in the neck, chest, and upper limbs.
When Conservative Treatment Fails
In general, patients will be treated conservatively and find that non-invasive therapy can alleviate their symptoms to a manageable level or correct the cause of the condition and prevent it from occurring again. Some cases, however, may require surgery where conservative treatment has failed to achieve success. A posterior cervical foraminotomy is the usual approach, with anterior cervical foraminotomy not achieving the same success rate as the former procedure. The posterior approach avoids some of the potential risks of other cervical spinal surgeries and has an excellent outcome in most cases, providing relief from arm pain and other symptoms of cervical spine degeneration.
Objective of a Foraminotomy
Foraminotomy is a procedure which widens the foramina (the space through which nerve roots exit the spinal cord) by removing the tissues surrounding the neural foramen. This may involved removal of portions of bone from the vertebrae, thickened ligaments, or osteophytes (bone spurs). Occasionally patients require a parallel partial discectomy (removal of portions of disc), depending on the severity of degeneration in the cervical spine. Most patients do not require a neck collar after the procedure, and spinal fusion is not performed as part of this surgery.
As the procedure is minimally invasive the recovery time after surgery is fairly short, with little blood loss or tissue damage occurring. All surgery carries risk of complications and infection and should not be entered into lightly. Jaggannathan (2009) conducted a review of 104 patients suffering from radicular pain prior to surgery and found that 95% experienced significant pain relief after the foraminotomy. Other reviews provide similar results (80-90%) and favor this procedure over anterior cervical foraminotomy and anterior cervical disc fusion alone (Hacker, 2003, Peng, 2010, Tumialán, 2010).
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