Treatments

Foraminotomy

What is a foraminotomy?

The spine comprises vertebrae, nerves, intervertebral discs, and the spinal cord. The spinal nerves radiate out from the spinal cord through a small hole (intervertebral foramen) between the vertebrae, sending sensory information from all parts of the body to the brain. In some individuals, this small hole is narrowed, causing the spinal nerve to be compressed and resulting in symptoms such as pain, muscle weakness, and tingling in the arms and legs. This condition is known as a foraminal stenosis.

A foraminotomy is an open-back surgery that increases the space of the intervertebral foramen, easing the pressure on the spinal nerves, and alleviating symptoms.  

foraminal stenosis
Foraminal stenosis occurs when the intervertebral foramen is too small, resulting in spinal nerve compression.

How does a foraminotomy work?

A foraminotomy is executed in several stages. Below is an outline of how a foraminotomy procedure is performed: 

  1. General anaesthesia is administered to the patient to ensure they are pain-free and asleep during the procedure.
  2. An incision is made on the skin over the affected area of the spine.
  3. Retractors are used to move and separate muscles and soft tissues to expose the affected vertebra.
  4. Your neurosurgeon identifies the cause of the narrowing or blockage of the intervertebral foramen. This may include bone spurs or bulging discs.
  5. These blockages are removed to relieve pressure on the compressed spinal nerves.
  6. Your separated muscles and soft tissues are put back in place and the incision is closed with sutures.

Benefits of a foraminotomy

  • Improved strength
  • Reduced pain and tingling in the arms and legs
  • Restored quality of life
  • Reduced back pain
spinal pain
Spinal nerve compression causes pain, muscle weakness, and tingling in the arms and legs.

What conditions can a foraminotomy treat?

Many patients with foraminal stenosis experience symptoms of nerve compression, such as sciatic pain (thigh, lower back, shoulder, arms or hands), numbness, tingling, and muscle weakness in different body parts. Apart from foraminal stenosis, other conditions that may require a foraminotomy include:

  • Herniated disc: a herniated disc or slipped disc can compress the nerves in the spine and cause pain, numbness, and weakness. 
  • Bone spurs: bone spurs are bony growths that can develop on the vertebrae and compress the nerves in the spine, causing pain and other symptoms. 
  • Degenerative disc disease: degenerative disc disease is when the discs between the vertebrae break down and cause pressure on the spinal nerve. 
  • Spondylolisthesis: spondylolisthesis occurs when one vertebra slips forward over the vertebra below it, causing pressure on the nerve roots. 
  • Spinal tumours: spinal tumours can compress the spinal nerves and cause pain, numbness, and weakness. 

If you have any of the conditions listed above, make an appointment with Chou Neuroscience Clinic for customised treatment.

What results can I expect from a foraminotomy?

The post-operation recovery after a foraminotomy varies depending on the individual and the extent of the surgery. 

Most patients spend 1-2 nights in the hospital after foraminotomy to ensure they recover well after the surgery. Antibiotics will also be prescribed to prevent infections.

Pain after surgery is normal and can be managed with pain medications prescribed by your neurosurgeon. Avoid non-steroidal anti-inflammatory drugs (NSAIDs), as they can increase the risk of bleeding. Avoid lifting or carrying anything over 3 kg for at least six weeks after surgery. 

You may also be required to undergo physical therapy to aid in your recovery. You will be requested to visit our clinic within a week or two for a follow-up. You will also be asked to visit us for a routine check-up to monitor your general well-being.

Most patients require 4-6 weeks to recover from a foraminotomy. Following your neurosurgeon's instructions before and after surgery is vital to ensure a smooth recovery and minimise the risk of complications. 

spine physical therapy
Physical therapy may be prescribed to aid in your recovery.

How many foraminotomy sessions are needed?

For most individuals, only one foraminotomy is necessary. However, you may need another foraminotomy if you develop another foraminal stenosis or other spinal conditions.

Frequently asked questions  

What are the risks and complications associated with a foraminotomy?

A foraminotomy can be performed on any spine level and is successful in most people, but complications can occasionally happen. Here are some of the risks: 
-- Infection in the wound or vertebral bones 
-- Too much blood loss
-- Nerve damage
-- Damage to the spinal cord 
-- Stroke
-- Complications from anaesthesia 
-- Symptoms may not improve or may worsen after surgery 
-- Revision surgery may be necessary 

Is a foraminotomy a major surgery?

Yes, a foraminotomy is a major open-back surgery.

What is the difference between a foraminotomy and a laminectomy?

A foraminotomy involves the removal of bone spurs or growths that cause a narrowing of the intervertebral foramen, easing pressure on the spinal nerves. A laminectomy involves the removal of the lamina (back of the vertebral) to alleviate pressure on the spinal nerves.

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Copyright © 2023 Chou Neuroscience Clinic. All Rights Reserved
Copyright © 2023 Chou Neuroscience Clinic. All Rights Reserved
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