The neural foramen is an opening where nerve roots exit the spine and travel throughout the body. It creates a protective passageway for nerves that carry signals between the spinal cord and the rest of the body. A cervical foraminotomy is a surgical procedure that is done to enlarge that passageway. This narrowing can be caused by a herniated disc, bone spurs, or thickened ligaments or joints, which may result in painful pinched nerves. The procedure is performed from the back (posterior) with the patient on his or her stomach.

Traditional, open spine surgery involves cutting or stripping the muscles from the spine. Today, a cervical foraminotomy may be performed using a minimally invasive procedure that allows your spine surgeon to separate the fibers of the muscles surrounding the spine rather than cutting and stripping the muscles away from the spine.

How is it done?

The Operation

The operation is performed with the patient on his or her stomach.

Decompression

A 1- to 2-cm small incision is made on the symptomatic side of the neck. Using an operating microscope and x-ray guidance, the muscles are gradually dilated and a tubular retractor inserted to allow access to the cervical spine. Bone or disc material and/or thickened ligaments are then removed to decompress and relieve pressure on the spinal cord and/or nerves.

The tubular retractor is removed, allowing the dilated muscles to come back together and the incision is closed. This procedure typically takes 2 hours to perform.

Closure

The incision is closed, and in most instances results in only a small scar.

After Surgery

This minimally invasive procedure typically allows many patients to be discharged the same day of surgery; however, some patients will require a longer hospital stay. Most patients will notice immediate improvement of some or all of their symptoms; however, other symptoms may improve more gradually.

A positive attitude, reasonable expectations and compliance with your doctor’s post-surgery instructions all may contribute to a satisfactory outcome. Many patients are able to return to their regular activities within several weeks.

It is important that you discuss the potential risks, complications, and benefits of spinal surgery with your doctor prior to receiving treatment, and that you rely on your physician’s judgment. Only your doctor can determine whether you are a suitable candidate for this treatment.