Foraminotomy

Definition

Foraminotomy is surgery that widens the opening in your spine 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; Back pain - foraminotomy; Stenosis - foraminotomy

Description

Foraminotomy takes pressure off of the nerve coming out of your spinal column. This reduces any pain you were having. Foraminotomy can be performed on any level of the spine.

You will be asleep and feel no pain (general anesthesia).

During surgery:

Why the Procedure Is Performed

A bundle of nerves (nerve root) leaves your spinal cord through openings in your spinal column. These openings are called the neural foramens. When the openings for the nerve root become narrow, it can 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. Symptoms include:

Risks

Risks of anesthesia and surgery in general are:

Risks of foraminotomy are:

Before the Procedure

You will have an MRI or CT scan to make sure foraminal stenosis is causing your symptoms.

Tell your health care provider what medicines you are taking. This includes medicines, supplements, or herbs you bought without a prescription.

During the days before the surgery:

On the day of the surgery:

After the Procedure

You will likely wear a soft neck collar afterward 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. At home, follow instructions on how to care for your wound and back.

You should be able to drive within a week or two and resume light work after 4 weeks.

Outlook (Prognosis)

Foraminotomy for spinal foraminal stenosis will often provide full or some relief from symptoms.

Future spine problems are possible for people after spine surgery. If you had foraminotomy and spinal fusion, the spinal column above and below the fusion could have problems in the future.

You may have more of a chance of future problems if you needed more than one kind of procedure in addition to the foraminotomy (laminotomy, laminectomy, or spinal fusion).

References

Bell GR. Laminotomy, laminectomy, laminoplasty, and foraminotomy. In: Steinmetz MP, Benzel EC, eds. Benzel's Spine Surgery. 4th ed. Philadelphia, PA: Elsevier; 2017:chap 78.

Derman PB, Rihn J, Albert TJ. Surgical management of lumbar spinal stenosis. In: Garfin SR, Eismont FJ, Bell GR, Fischgrund JS, Bono CM, eds. Rothman-Simeone and Herkowitz's The Spine. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 63.


Review Date: 11/12/2020
Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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