Cervical Posterior Foraminotomy
What is Cervical Posterior Foraminotomy?
Foraminotomy is a type of surgery that is performed to increase the size of an opening in the spinal column to provide more room for the nerve roots to exit from the spinal canal. Its purpose is to relieve the pressure on these nerves resulting from foraminal stenosis. This is a painful condition caused by a narrowing of the foramen, the opening within each of the spinal bones that allows nerve roots to pass through.
As a result of aging or other musculoskeletal conditions such as arthritis, the foramen may gradually become clogged and develop bone spurs that press on the nerves and cause pain, numbness, weakness and tingling sensations, and may also develop into spinal stenosis. In some cases, other factors including a herniated disc or thickened ligaments and joints can also contribute to a narrowing of the foramen.
Some patients with foraminal stenosis can be effectively treated with anti-inflammatory medications, corticosteroid shots, physical therapy exercises or use of a neck brace to immobilize the spine. However, when the condition does not respond to these conservative treatments, it may require undergoing a foraminotomy. This procedure 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 Posterior Foraminotomy Procedure
A cervical posterior foraminotomy is performed with the patient under general anesthesia. After the patient is positioned lying face down on the operating table and the skin of the treatment area has been cleaned with an antiseptic solution, Dr. Lipani will make an incision at the back of the neck. Muscles, ligaments and other tissues in the area will be retracted to provide a view of the spine. The bone at the affected vertebrae 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.
Dr. Lipani will then assess the vertebrae to see whether any other nearby structures may also be exerting pressure on the nerves. A portion of the lamina, which is the rear of the vertebrae, disc fragments, thickened tissue and bone spurs will be removed as necessary. For some patients, a foraminotomy may be accompanied by spinal fusion surgery to join the affected bones together if this is needed to attain greater spinal stability. Once the procedure is completed, the surgeon will reposition the muscles and other tissues of the neck area and suture the incision closed. A cervical posterior foraminotomy procedure typically lasts for approximately two hours.
Recovery from Cervical Posterior Foraminotomy
Following a cervical posterior foraminotomy, the patient is generally released from the hospital later in the same day. A soft neck collar will need to be worn to restrict movement of the head and neck. A physical therapy regimen is usually recommended to help restore strength and flexibility to the area. Some activities may be prohibited for a period of time, but most patients can return to work if no physical exertion is required in approximately four weeks.
Risks of Cervical Posterior Foraminotomy
Complications are rare during a cervical posterior foraminotomy, but there are risks inherent to any type of surgical procedure. The risks that may be associated with a cervical posterior foraminotomy include blood loss, infection, nerve damage, persistent pain, the development of blood clots and an adverse reaction to anesthesia. These risks may be reduced by choosing an experienced surgeon to perform the procedure and following all surgical instructions both before and after it is performed.