Foraminotomy
The spine is made up of a chain of vertebrae through which the spinal cord passes. The bones are arranged in such a way as to protect the spinal cord from any injury that may affect it; Additionally, there are a series of intervertebral discs that give flexibility and cushioning to the spine.
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The nerve roots transmit and receive different signals emitted by the spinal cord, these travel along the spine passing through small bony holes called foramina. When the foramina narrow, press on the nerves, and bothersome and painful symptoms begin to appear, this is known as spinal stenosis or foraminal stenosis.
Foraminotomy is a medical procedure frequently used to fix narrowing of the spinal space. Below, we will tell you what this technique is all about, when it is recommended, what recovery is like, and what its risks are.
What is Foraminotomy?
Foraminotomy is a surgical technique that allows the size of the blocked foramen or intervertebral foramen to be increased, achieving nerve decompression and the disappearance of symptoms derived from nerve impingement.
Why is Foraminotomy done?
There are many reasons why a patient may require a foraminotomy; most of them include constant symptoms that limit your daily life (pain, weakness, numbness, tingling, etc.). Among the most common causes we can mention:
Degenerative arthritis, causing bone spurs.
Disc degeneration, causing the discs to encompass the foraminal space.
Widening of nearby ligaments.
Spondylolisthesis (displacement of a vertebra).
Tumors or cysts.
Paget's disease (abnormal bone growth).
Foraminotomy may also be an option when conservative treatments such as physical therapy, medications, or epidural injections do not lead to improvement. In some patients, foraminotomy must be performed in an emergency because of the rapid intensification of symptoms, and urination may be affected by nerve compression.
How to prepare for Foraminotomy?
Before undergoing this type of surgery, the specialist in charge will check the diagnosis of foraminal stenosis through CT scans or MRIs. They will also evaluate your medical history, allergies and daily medications.
Your doctor will recommend that you avoid smoking, alcohol, and taking medications that may slow your clotting and recovery. Because foraminotomy requires general anesthesia, you will be asked not to eat or drink for 8 to 12 hours before the procedure.
Foraminotomy Surgical Technique
Foraminotomy can be performed on any segment of the spine (cervical, dorsal or lumbar), always requiring generalized anesthesia. The first step will be to place the patient in a suitable position, either prone or partially seated on the operating table.
The surgeon then proceeds to make an incision in the back just above the affected vertebrae (the length of the incisional cut varies depending on how extensive the nerve condition is). Next, the doctor sets aside the skin, muscles, and ligaments to achieve better internal visualization.
In surgical technical foraminotomy, special instruments are used to remove disc or bone fragments that block the foramen. Finally, the tissues, muscles, and skin are put back in place, closing the incision with stitches.
Recovery of lumbar and cervical foraminotomy
After a cervical foraminotomy, your doctor will most likely advise you to wear a soft cervical collar for a few days to prevent sudden movements with your neck. In the case of lumbar foraminotomy, this does not apply.
Despite being an open spine surgery, foraminotomy has a fairly favorable prognosis for recovery. Mostly, patients can sit within a few hours of surgery; However, it is essential that they move their bodies slowly and carefully.
Because foraminotomy fixes a problem that affects the nerves, you will likely continue to feel pain, weakness, or numbness after a few days as your nerve pressure drops. Symptoms usually show significant improvement within a couple of weeks.
It is advisable to drive after about 2 weeks and return to work after 2 months. It should be noted that this time may vary depending on the evolution of each patient.
Foraminotomy Risks and Side Effects
Foraminotomy is a surgery like any other; Complications may include:
Infection.
Excessive blood loss.
Allergic reaction to anesthesia.
Nerve damage.
Stroke.
Worsening of symptoms.
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I invite you to schedule a medical appointment with me; In this way, I will be able to carefully evaluate your condition and offer you the best treatment or surgery alternatives to eradicate back pain and recover your general well-being.
