What is Foraminotomy?
A foraminotomy is a decompression surgery that is performed to enlarge the passageway where a spinal nerve root exits the spinal canal. During a foraminotomy, the spine surgeon removes bone or tissue that obstructs the passageway and compresses (pinches) the spinal nerve root, which can cause inflammation and pain. The purpose of foraminotomy is to relieve pressure on compressed nerves.
When is Foraminotomy needed?
Blockages that narrow the spinal column or block an intervertebral foramen are called spinal stenosis. Various processes can block the intervertebral foramen and compress the nerve leaving the spinal cord. Conditions that can cause spinal stenosis include:
- Degenerative arthritis of the spine (spondylosis), which can cause bony spurs
- Degeneration of the intervertebral discs, which can cause them to bulge into the foramen
- Enlargement of the nearby ligament
- Cysts or tumors
- Skeletal disease (like Paget disease)
- Congenital problems (like dwarfism)
Degenerative arthritis of the spine (from old age) is one of the most common causes.
This nerve compression can happen along any part of your spinal column. Your compressed nerve may start to cause symptoms, like pain in the affected region and tingling and weakness in the affected limb. You might need a foraminotomy if you’ve already tried other treatments and had no success. This includes physical therapy, pain medicines, and epidural injections.
Usually, your surgeon can do the surgery an elective procedure to help relieve these symptoms. You might need to have an emergency foraminotomy if your symptoms are quickly getting worse, or if you have problems with your bladder due to your nerve.
What should you know before undergoing Foraminotomy?
Not everyone can safely underdo this procedure. Eligibility depends on many factors, including the severity of your condition, your medical history and general health.
What are the complications and side effects?
Pain at the operative site is normal and should be expected. This pain resolves over time and can be controlled with oral pain medication.
Risks of anesthesia and surgery in general are:
- Reactions to medicines or breathing problems
- Bleeding, blood clots, or infection
Risks of foraminotomy are:
- Infection in wound or vertebral bones
- Damage to a spinal nerve, causing weakness, pain, or loss of feeling
- Partial or no relief of pain after surgery
- Return of back pain in the future
It is important you understand the precautions and know the possible complication and side effects before having this Foraminotomy. If you have any questions, please consult with your doctor or surgeon for more information.
How do I prepare for Foraminotomy?
- The physician may evaluate your medical history to gain a comprehensive knowledge of your overall health status including information related to the medications that are currently being taken
- Some medications increase your chances of bleeding and it may be recommended to discontinue them for a period of time before the procedure is performed
- Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents you from undergoing the procedure
- Inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
- Avoid application of any cosmetics, deodorant, or topical medicines on the area prior to the procedure
- It is advisable to quit smoking and the use of any nicotine based products for a while before the surgery
- Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
- You must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
For individuals suffering from diabetes, it is important that the blood sugar stays within the normal range; if not, their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines
What happens during Foraminotomy?
The procedure may be completed in an hour or so. You should be able to leave the hospital the day after the surgery.
During the procedure, you’ll lie on your stomach.
You will be given medicine (anesthesia) to put you to sleep through the surgery. You won’t feel any pain or discomfort during the procedure.
Someone will carefully monitor your vital signs, like your heart rate and blood pressure, during the surgery.
Your surgeon will make a small incision just beside your spine on the side you have your symptoms. He or she will make the incision at the level of your affected vertebra.
Your surgeon will use X-rays and a special microscope to guide the surgery.
Using special tools, your surgeon will push away the back muscles around the spine to expose the blocked intervertebral foramen.
Your surgeon will use small tools to remove the blockage inside the intervertebral foramen. The blockage may be a bone spur or a bulging disc. This will relieve pressure on the nerves.
In some cases, your surgeon might do another procedure at this time, like a laminectomy. This removes part of the vertebra.
The team will remove the tools and put your back muscles back in place. Someone will then close the small incision in your skin.
What happens after Foraminotomy?
You will likely wear a soft neck collar afterward if the surgery was on your neck. Most people are able to get out of bed and sit up within 2 hours after surgery. You will need to move your neck carefully.
Foraminotomy for spinal foraminal stenosis will often provide full or some relief of symptoms.
Future spine problems are possible for people after spine surgery. If you had foraminotomy and spinal fusion, the spinal column above and below the fusion could have problems in the future.
You may have more of a chance of future problems if you needed more than one kind of procedure in addition to the foraminotomy (laminotomy, laminectomy, or spinal fusion).
If you have any questions or concerns, please consult with your doctor or surgeon for more information.
What should you do after Foraminotomy?
You’ll need to move the affected area carefully. You will be told if you need to avoid any certain movements for a while. (For example, you might need to avoid bending your neck if your foraminotomy was in this region.) You’ll also likely need a soft neck collar if your surgery was in your neck.
You should be able to go home a day or two after your surgery. Be sure to follow all of your provider’s instructions about medicines, physical activity, and wound care. You may need to avoid certain movements for a while. You may be able to do light work in a few weeks, but you may need to avoid heavier work for a few months. Some people might need physical therapy as they recover.
Your provider can give you a realistic idea of what to expect after your surgery. Remember to keep all follow-up appointments. Most people will see a real improvement in their symptoms. Be sure to tell your provider if you don’t get better, or if you have new or worsening symptoms.
Hello Health Group does not provide medical advice, diagnosis or treatment.