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Foraminotomy Surgery

Why do I need surgery?

The main reason for surgery is to relieve the pain that radiates down your arm. If there is evidence of nerve damage causing weakness in your arm, surgery may also be advisable, even if the pain is not severe. Surgery is not usually performed to relieve neck pain.

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There are 2 procedures for doing this surgery. It can be a full open surgery, under general anesthesia. This would include spinal incision, muscle dissection to remove more bone. If the surgeon is trained in minimally invasive procedures, then the operation can be done with an endoscope. This will save the patient much recovery time, pain, and damage to healthy tissue.
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This procedure is done by using general anesthesia.Cervical foraminotomy involves an incision on the back of the neck, usually just to one side of centre over the lower part of the spine.  The muscles are separated from the spine, and the bone overlying the point of pressure is exposed.  Frequently, the x-ray department will have injected a small amount of blue dye into the spinal fluid just prior to the operation.  The dye is visible to the surgeon near the point of pressure.  This is an additional method often used to ensure that the correct point has been identified.

A highly sophisticated drill is then used to open the channel in the spine through which the compressed nerve passes.  If the problem is due to bone spurs, then this is all that is required, as the opening of the channel involves removal of at least some of the bone spurs automatically.

If the pressure is due to disc prolapse, then removing the bone gives access to the part of the disc that is actually protruding.  If this can be exposed easily, and particularly if there is a "loose" piece of disc jammed under the nerve, then that piece is extracted.  The vast bulk of the disc is left undisturbed.  If the disk is bulging, but not ruptured, then the surgeon may elect not to remove any of the discs at all, in which case the removal of bone is normally sufficient to relieve pressure on the nerve.

The surgeon will access the problem area and use sophisticated tools to carefully enlarge the neuroforamen, thereby decompressing the spinal nerve root. When this opening is large enough to once again allow healthy nerve signal, the surgeon will close the incision.
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This information is not designed to replace a physician's independent judgment about the appropriateness or risks of a procedure for a given patient.
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