Orange County Neurosurgery

What is a Foraminotomy?

Patients with foraminal stenosis often go through a surgical procedure called foraminotomy. The foramen is a hole in the middle of the spine where the spinal nerves pass through to exit the spine. When a patient has foraminal stenosis, this foramen becomes narrower until the nerves that pass through it are pinched. This condition often occurs when a patient has a degenerative spine disease. Patients with this condition present with neurological symptoms like a tingling sensation, numbness, muscle weakness, and pain.

With this surgical procedure, the nerve is decompressed in order to relieve patients from the symptoms of foraminal stenosis. This is done by removing soft tissue and bone that is causing the narrowing of the foramen and the compression on the nerves. This surgery can be done on both the cervical and lumbar regions of the spine where foraminal stenosis is present. The procedure can be done as a part of a more comprehensive spinal surgery to resolve spinal stenosis or herniated discs, but this surgery can also be done on its own if necessary.

Candidates for Foraminotomy

Foraminotomy is recommended for people suffering from spinal stenosis and other conditions that may need some form of spinal decompression to treat, such as osteoarthritis, rheumatoid arthritis, sciatica, bone spurs, and herniated discs. Patients who don’t respond to conventional, non-surgical treatment methods such as physical therapy, medication, and cortisone injections are also good candidates for this procedure.

To be considered as a candidate, a patient may have to undergo imaging tests such as magnetic resonance imaging (MRI) to determine whether the narrowing of the foramen is the cause of the neurological symptoms. The MRI could show other conditions that need surgical treatment aside from decompressing the nerves in the foramen, so candidates for this surgery should also prepare themselves for other possible surgical procedures. Other factors involved in making the decision to perform this procedure on patients with foraminal stenosis include age, and the patient’s overall health.

How the Procedure is Performed

When done alone, a foraminotomy can be done with minimally invasive surgical techniques. As a part of a larger surgical procedure, however, an open surgery may be possible depending on what other procedures have to be done.

Similar with most spinal surgeries, this procedure is done under general anesthesia. The surgeon begins the surgery by making a tiny incision on the patient’s back right where the nerve compression is. After making a way through the muscles and tissue, an endoscope is inserted. A laminectomy is then performed in order to gain access to the discs.

If there is a herniated disc, the surgeon can address that problem at this point. Once the discs are cleared, the surgeon will then proceed to work on the foramen. Tissues and bone are extracted giving the nerves some room inside the foramen. Once the nerves have successfully been decompressed, the surgeon can then begin to close up the incisions, first using absorbable sutures on the muscle and then surgical staples to close up the skin incision.

For more information on foraminal stenosis and the foraminotomy procedure, call us and schedule an appointment with one of our reputable and well-trained neurosurgeons.

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