What is a Foraminotomy?

A foraminotomy is a type of back surgery used to reduce pressure on the nerves of the spinal canal. To perform a foraminotomy, a surgeon works to make the spinal-nerve passageway larger. This procedure can be used to correct an opening that is too small because of an injury or spine-related condition. When the opening is too small, the nerves do not have enough room, resulting in such conditions as pinched nerves, pain or inflammation.

A surgeon works on the neuroforamen when performing a foraminotomy. Neuroforamen is the medical name given to the openings found on both sides of a person’s upper and lower vertebra bones in the spinal column. Each section of upper and lower vertebra is cushioned by a disc, which keeps the vertebra bones separated and dictates how large the neuroforamen is. Nerve roots extend from the spinal cord and out of the neuroforamen.

Sometimes bone or other types of tissue get in the way and block part of neuroforamen, reducing its size and pressing on the spinal nerve root where it leaves the spinal canal. A person with this type of nerve condition may experience pain, weakness and tingling. He may also feel stiff and develop numbness. Pain and other symptoms can affect other parts of the body besides the back, such as the extremities and buttocks.

Depending on the needs and preferences of the patient, his health status, and the skill and experience of the surgeon, a foraminotomy may be performed. The procedure is invasive and involves the use of general anesthesia. A less-invasive procedure option is possible, using an endoscope—a thin instrument that allows a surgeon to see inside the body. The minimally invasive procedure option may allow the patient to recover faster and with less pain. It also involves less trauma to the patient’s other bodily tissues.

To perform a foraminotomy, a surgeon cuts into the back of the spine. He then moves the patient’s skin and muscles so that he can reach the affected spinal area. He cuts or shaves the bone to enlarge the opening for the nerve root, and he may remove other bone tissue or fragments to make additional room. When a surgeon performs an endoscopic foraminotomy, he uses a smaller incision or several small incisions through which he inserts a tiny camera. The camera allows him to view the area without creating a large opening in the patient’s body. He also inserts his surgical tools through these smaller incisions.

Risks of foraminotomy include reactions to anesthesia, excessive bleeding, leaking of spinal fluid and damage to the nerves. Some people may also develop infections following back surgery. Unfortunately, not everyone feels relief of symptoms following this procedure, and others may feel more comfortable for a while but have back pain return later.