Foraminotomy

Cervical foraminotomy is an operation to enlarge the space where a spinal nerve root exits the cervical spinal canal to relieve the symptoms of a "pinched nerve."

Indications for Operation:
Compression of the cervical nerve roots can cause neck pain, stiffness, and pain radiating into the shoulder, arm, and hand, as well as numbness, tingling and/or weakness in the arm and hand. Protruding or ruptured discs, bone spurs, and thickened ligaments or joints can all cause narrowing of the space where the nerve exits the spinal canal and cause the above symptoms. Patients who do not improve with conservative treatment may be candidates for the operation.

What happens afterward?
Some pain at the operative site is expected, but generally resolves over time and can be controlled with oral pain medicines. Some patients can be discharged the same day of surgery, but most patients will require 24-48 hours in the hospital. Most patients will notice immediate improvement in some or all of their symptoms, however some symptoms may improve only gradually. A positive attitude, reasonable expectations, and compliance with the doctor's recommendations all contribute to a satisfactory outcome. A cervical collar (brace) is rarely necessary. Most patients can return to their regular activities within several weeks.

The Operation

Incision
A small incision is made in the middle of the neck after localizing the area of interest with an x-ray.

Decompression
The muscles on the side of the spine involved are dissected and a retractor is placed. (Sometimes an endoscope and tubular retractor or microscope are used). Bone from the posterior arch of the spine and joint over the nerve are removed using special cutting instruments and/or a drill. Thickened ligament, bone spurs and/or bulging discs are removed to decompress the exiting nerve, which is checked with a probe to insure adequate space around the nerve root.

Closure
The muscles and tissues are closed in layers with absorbable sutures. The skin may be closed with absorbable sutures and steri-strips, or surgical staples, which are removed when the wound is well healed.

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