Cervical Posterior Foraminotomy
This surgery removes bone and/or portions of a herniated or diseased disc to relieve neck and radiating arm pain caused by parts of the disc pressing on nerve roots.
Cervical posterior foraminotomy is a surgical procedure performed to treat foraminal stenosis, a condition in which the openings for nerve roots to exit the spinal canal have become too small, resulting in painful nerve compression. These openings, called foramen, may have gradually become clogged by herniated discs, calcified ligaments or joints, or bone spurs. Whatever the cause, once the foramen is narrowed, the pressure of bone against the cervical nerves may cause pain, numbness, weakness or tingling sensations.
Some patients with foraminal stenosis can be effectively treated with anti-inflammatory medications, corticosteroid shots, physical therapy exercises or a neck brace to immobilize the spine. When the condition does not respond to these conservative treatments, however, surgery may be required. The cervical posterior foraminotomy will eliminate the compression on the affected spinal nerve, providing relief from painful symptoms. As its name suggests, a cervical posterior foraminotomy is performed on the spine in the neck area with the surgeon making an approach through the upper back.
The Cervical Foraminotomy Procedure
A cervical posterior foraminotomy is performed with the patient under general anesthesia. With the patient lying face down on the operating table, the surgeon makes an incision in the back of the neck. Muscles, ligaments and other tissues in the area are retracted to provide a view of the spine. The bone at the affected site is shaved down or cut back slightly to enlarge the size of the foramen and provide more room for the nerve roots to pass through.
The surgeon assesses the spine to see whether any other nearby structures are exerting pressure on the nerves. A portion of the lamina, the covering of the vertebrae, disc fragments, thickened tissue, or bone spurs are removed as necessary. For some patients, a spinal fusion is required to for greater stability. Once the procedure is completed, the surgeon repositions the muscles and other tissues and sutures the incision. A cervical posterior foraminotomy typically lasts for approximately 2 hours.
Recovery from Cervical Foraminotomy
The procedure is usually performed on an outpatient basis, with the patient released from the hospital later the same day. The patient will have to wear a soft neck collar temporarily to restrict movement of the head and neck until healing has taken place. Typically, a regimen of physical therapy is prescribed to help the patient regain strength and flexibility in the cervical region. While some physical activities may be prohibited until healing is complete, most patients can return to work in about 4 weeks.
Risks of Cervical Foraminotomy
Complications are rare during a cervical posterior foraminotomy, but there are risks inherent to any type of surgical procedure. The risks associated with a cervical posterior foraminotomy include blood loss, infection, nerve damage, blood clots and an adverse reaction to anesthesia or medication. There is also some small risk that the pain from the stenosis will persist after surgery.