Foraminectomy

Foraminectomy

A surgical procedure aimed to increase the foraminal canal and relieve aggravated nerve roots by eliminating excessive bone, vertebral disc material, and other spinal irregularities.

What is a Foraminectomy?

  • Alleviates pressure on spinal nerves pinched from foraminal stenosis, or a narrowed foraminal nerve opening.
  • The abnormal structures that are narrowing the foraminal canal are completely removed to decompress the affected nerves. Any bones, tissues, disc material, or excessive ligament are removed.
  • Foraminectomy is usually combined with a laminectomy (lamina bone is removed), discectomy (vertebral disc is removed), or both. A spinal fusion may also be performed if instability of the spine may become an issue.
  • Procedure is minimally-invasive.

Foraminectomy is a spinal procedure that decompresses spinal nerves pinched by bone, tissues, disc material, and other spinal abnormalities that have narrowed the foraminal canal. The procedure removes all of the irregularities and may be combined with another procedure to fully decompress the pinched nerves. Foraminectomy differs from foraminotomy in that it removes more spinal irregularities and is almost always combined with a laminectomy, a procedure that removes the lamina bone.

The foraminal canal refers to the openings in the vertebrae where nerve roots leave the spine and into the specific areas of the body. With foraminal stenosis, the foramen in a set of one or more vertebrae is narrowed from anomalies in the spine, which pinches nerve roots and causing pain. Foraminal stenosis may occur from different spinal conditions, but commonly happen from degenerative disc disease, herniated or bulging discs, spondylosis, and facet joint syndrome.

Most patients requiring foraminectomy have foraminal stenosis for at least 3 to 6 months, and experience debilitating symptoms that may affect their quality of life. Spinal conditions that cause foraminal stenosis may occur from aging, injuries, sudden trauma, repetitive physical activity, wear and tear, and spinal tumors. Patients usually experience pain of varying degrees that is constant, sharp, dull, throbbing, or shooting.

What does it treat?

  • Foraminal Stenosis
  • Degenerative Disc Disease
  • Spondylosis
  • Herniated or Bulging Discs
  • Pinched Nerve

Who are good candidates?

Candidates for foraminectomy may have different spinal conditions, but most are afflicted with foraminal stenosis. Ideal candidates should have neck or back pain for at least 3 to 6 months and experience one or more of the following symptoms:

  • Acute or chronic pain in the neck or back of varying strength that is constant, dull, deep, throbbing, sharp, shooting, or radiating to the extremities
  • Pain that radiates from the lower back and into the buttocks, legs, calves, feet, and/or toes
  • Pain that radiates from the neck and into the shoulders, arms, hands, and/or fingers
  • Weakness, numbness, and/or tingling sensation felt in the back, neck, and/or extremities
  • Limited motor functions
  • Limited ability to perform daily activities or being involved with physical activity
  • Pain while standing, walking, or sitting for periods of time
  • History of attempting conservative methods of treatment that have failed to relieve pain and other symptoms

Good candidates for foraminectomy must understand that physical therapy may be included in their recovery process, and should be positive towards successful pain improvement and management.

What is the procedure like?

During the foraminectomy, the patient will be under general anesthesia. Contingent on the patient's case, the procedure normally takes about 1 to 2 hours to complete.

The following are the general steps of the foraminectomy procedure:

  • The area of the back or neck is prepped for the incision. A one to three inch incision is made, and then the skin, muscles, and tissues are divided to expose the affected region.
  • The laminotomy, which removes a small amount of bone on the back of the vertebrae, is removed to show the foraminal canal. Irregular spinal structures are removed to relax the pinched nerve roots.
  • A microdiscectomy or discectomy, which partially or completely removes a bulging or herniated disc, is now performed, if applicable. A spinal fusion may also be done now if instability may become a problem in the future.
  • Now that the pinched nerves are decompressed, the surgeon ends the procedure with closing the incision with sutures.