Foraminotomy
Definition
Foraminotomy is surgery that widens the opening in your back where nerve roots leave your spinal canal. You may have a narrowing of the nerve opening (foraminal stenosis).
Alternative Names
Intervertebral foramina; Spine surgery - foraminotomy
Description
Foraminotomy takes pressure off of a nerve in your spinal column and allows it to move more easily. It may be performed on any level of the spine. You will be asleep and feel no pain (general anesthesia).
- You will lie face down on the operating table. A cut (incision) is made in the middle of the back of your spine. The length of the incision depends on how much of your spinal column will be operated on.
- Skin, muscles, and ligaments are moved to the side. Your surgeon may use a surgical microscope to see inside your back.
- Some bone is cut or shaved away to open the nerve root opening (foramen). Any disk fragments are removed. Other bone may also be removed at the back of the vertebrae to make more room.
- If your surgeon is worried that your spine will not be stable after the bone has been removed, you may also need to have spinal fusion.
- The muscles and other tissues are put back in place, and the skin is sewn together.
Why the Procedure Is Performed
A bundle of nerves (nerve root) leaves your spinal cord through openings in your spinal column, called the neural foramen. When the openings for the nerve root become narrow, it may put pressure on your nerve. This condition is called foraminal spinal stenosis.
This surgery may be considered if you have severe symptoms that interfere with your daily life. Such symptoms include:
- Pain that may be felt in your thigh, calf, lower back, shoulder, arms or hands. It is often deep and steady
- Pain when doing certain activities or moving your body a certain way
- Numbness, tingling, and muscle weakness
You will have an MRI to make sure foraminal stenosis is causing your symptoms.
You and your doctor can decide when you need to have surgery for these symptoms. Spinal stenosis symptoms often become worse over time, but this may happen very slowly.
References
Curlee PM. Other disorders of the spine. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 41.
Park AL. Lower back pain and disorders intervertebral discs. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 39.
Weinstein JN, Tosteson TD, Lurie JD,et al. Surgical versusnonoperative treatment for lumbar spinal stenosis four-year results of the Spine
Patient Outcomes Research Trial. Spine (Phila Pa 1976). 2010 Jun
15;35(14):1329-38.
Review Date: 12/20/2010
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Intervertebral foramina; Spine surgery - foraminotomy
After the Procedure
You will probably be wearing a soft neck collar afterwards 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.
You should be able to leave the hospital the day after the surgery. You should be able to drive within a week or 2 and get back to light work after 4 weeks.
Outlook (Prognosis)
Foraminotomy for spinal foraminal stenosis will often provide full or partial relief of symptoms.
Future spine problems are possible for all patients after spine surgery. If you had spinal fusion and laminectomy, the spinal column above and below the fusion are more likely to have problems in the future. Also, if you needed more than one kind of back surgery (such as foraminotomy and spinal fusion), you may have more of a chance of future problems.
References
Curlee PM. Other disorders of the spine. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 41.
Park AL. Lower back pain and disorders intervertebral discs. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 39.
Weinstein JN, Tosteson TD, Lurie JD,et al. Surgical versusnonoperative treatment for lumbar spinal stenosis four-year results of the Spine
Patient Outcomes Research Trial. Spine (Phila Pa 1976). 2010 Jun
15;35(14):1329-38.
Review Date: 12/20/2010
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Intervertebral foramina; Spine surgery - foraminotomy
Risks
Risks for any anesthesia are:
Risks for any surgery are:
- Bleeding
- Infection in wound or for vertebral bones
- Damage to a spinal nerve, causing weakness, pain, or loss of feeling
- Partial or no relief of pain after surgery
- A return of back pain in the future
- Thrombophlebitis
References
Curlee PM. Other disorders of the spine. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 41.
Park AL. Lower back pain and disorders intervertebral discs. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 39.
Weinstein JN, Tosteson TD, Lurie JD,et al. Surgical versusnonoperative treatment for lumbar spinal stenosis four-year results of the Spine
Patient Outcomes Research Trial. Spine (Phila Pa 1976). 2010 Jun
15;35(14):1329-38.
Review Date: 12/20/2010
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 12/20/2010
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.