Foraminotomy

Minimally-invasive posterior cervical foraminotomy is a surgical procedure used to relieve damaging nerve pressure in your neck that develops inside gaps in your spinal bone called foramina (singular, foramen). These gaps allow your nerves to pass through your spinal column and supply sensation to your body, and pressure on them can significantly degrade your nervous system function.

Minimally-Invasive Posterior Cervical Foraminotomy Basics

The space inside one of your spinal foramina can get abnormally restricted if the associated spinal bone (vertebra) develops projections of new material called bone spurs. Some people also develop herniations, or ruptures, in the cushioning spinal discs that sit between the main bodies of the vertebrae. Both bone spurs and a leaking disc can put excessive pressure on a nerve and trigger pain and a variety of unusual nerve sensations. Minimally-invasive posterior cervical foraminotomy is typically performed on people who have space-restricting bone spurs in combination with leaking material from a nearby spinal disc.

At the beginning of the procedure, your surgeon will make a small incision to one side of your spinal column at the appropriate point on the back of your neck. After gradually working his way through your muscles and related tissues, he will expose a portion of your vertebra called the lamina, which is adjacent to your spinal cord and forms part of the wall of your spinal canal. Next, he will remove a small portion of this bone in order to gain access to the clogged foramen and the intruding spinal disc material. With guidance from a surgical microscope and live X-rays displayed on a monitor, he will then use specialized tools to scrape out the bone spurs in the foramen and remove the damaged sections of the disc.

Uses and Benefits

Surgeons typically perform a minimally-invasive posterior cervical foraminotomy on people who have disruptive symptoms stemming from narrowing in a single spinal foramen or in two neighboring foramina, combined with a disc herniation that is medium-sized or smaller. Like other forms of minimally-invasive surgery, the procedure relieves pain and other associated problems with only relatively minor damage to healthy bone and soft tissue. In comparison to more extensive surgeries, minimally-invasive procedures also usually result in lower chances of surgical complications, shorter periods of hospitalization, faster postsurgical rehabilitation and a more rapid return to normal activity.

Risks

Potential complications of a minimally-invasive posterior cervical foraminotomy include nerve damage, spinal cord damage, puncture of the membrane surrounding the spinal cord, bleeding, continuing pain in the aftermath of the procedure, adverse effects of general anesthesia, infection, failure to completely ease the pressure on your compromised nerve, and medically serious blood clots. Generally speaking, the risk of developing major complications from the procedure is quite low.

 

 

References

University of Southern California – USC Center for Spine Surgery: Microscopic Posterior Cervical Foraminotomy
SpineUniverse: Posterior Cervical Foraminotomy – A Surgical Technique to Reduce Pain
SpineUniverse: Foraminotomy – Posterior Cervical University of Maryland Medical Center: A Patient’s Guide to Complications of Spine Surgery