Cervical Foraminotomy

Cervical foraminotomy is a decompression surgical procedure that involves the widening of the neural foramen, the space through which the spinal nerve roots pass. The widening of the foramen helps in relieving pressure over the spinal nerves due to compression at the foramen.

The compression of spinal nerves in the foramen may occur as a result of degenerative changes in the spine that causes development of bone spurs which may lead to foraminal stenosis. Nerve compression can also result from a disc collapse caused by excessive strain and stress in the neck area.

Procedure

The basic steps of cervical foraminotomy include:

• The procedure is conducted in an operating room with the patient under general anesthesia.
• The patient lies face down, on the operating table.
• An X-ray is used to identify the location of the incision.
• A small incision is made over the middle of the neck, at the back.
• The muscles are retracted (moved aside) with the help of a retractor.
• A surgical microscope is employed to magnify the view of the area being operated.
• Specially designed cutting instruments are then used to remove bone spurs, thickened ligaments and segments of the herniated disc.
• Removal of the bones and tissues around the neural foramen also releases the compression over the nerve roots.
• Finally, all the muscles and the soft tissues are placed in their appropriate positions and the wound is sutured.

Post-operative care

Patients are usually discharged on the same day of the surgery and can resume driving within 1-2 weeks. General post-operative instructions for the patient after a cervical foraminotomy include:

• Use of soft neck brace
• Keep the incision clean and dry
• Move the neck with care and comfort
• Patient can return to work after 3-4 weeks
• Avoid heavy work or any sports for at least 2-3 months
• Physical therapy is recommended for the strengthening of the weak muscles

Risks and complications

Every major surgery is associated with complications. Some of the complications associated with cervical foraminotomy include:

• Complications related to anesthesia
• Conditions such as thrombophlebitis
• Infection
• Spinal nerve damage
• Persistent pain