Cervical & Lumbar Foraminotomy

A foraminotomy is indicated when a patient experiences symptoms caused by nerve root compression, and has failed 6-8 weeks of conservative treatments such as physical therapy, injections, and medications.

Common conditions that may warrant a cervical or lumbar foraminotomy include:

1. Radiculopathy: Nerve compression causing radiating pain, numbness, tingling, or weakness in the arms (cervical radiculopathy) or legs (lumbar radiculopathy).
2. Herniated Disc: Protrusion of disc material into the foramen, pressing on spinal nerves.
3. Bone Spurs: Bony overgrowths due to osteoarthritis that narrow the foramen.
4. Spinal Cysts: facet arthritis may produce cysts which pinch and irritate the nerves
5. Spinal Stenosis: General narrowing of the foraminal openings caused by degenerative changes, or persistent narrowing despite anterior cervical surgery.
6. Spondylosis: Age-related wear and tear on the spine leading to nerve impingement.

Patients are carefully evaluated through imaging studies such as MRI, CT scans, or X-rays, as well as possibly with nerve conduction tests to confirm the source of nerve compression and determine whether foraminotomy is an appropriate intervention.

A minimally invasive foraminotomy is a modern surgical technique designed to relieve nerve compression in the spine with minimal disruption to surrounding tissues. This procedure is performed through a small incision, often using specialized tools such as tubular retractors and an endoscope or microscope to access the affected area with precision.

By removing bone spurs, thickened ligaments, or disc fragments that narrow the foraminal openings, Dr. Colman creates more space for the nerves, alleviating pain, numbness, and weakness. Compared to traditional open surgery, minimally invasive foraminotomy offers several advantages, including no need for instrumentation or fusion, smaller incisions, reduced blood loss, less post-operative pain, and faster recovery times. This approach is particularly beneficial for patients seeking effective relief with minimal downtime and quicker return to daily activities.

Minimally invasive foraminotomies are typically performed on an outpatient basis, allowing patients to return home the same day. Traditional open surgeries may require a short hospital stay. Pain is managed with prescribed medications, and patients are encouraged to move cautiously to prevent stiffness.

Recovery from a minimally invasive foraminotomy is typically faster and less painful compared to traditional open surgery. Patients may experience some discomfort at the surgical site, but this is usually manageable with over-the-counter or prescribed pain medication.

Most patients are encouraged to begin light activities within a few days and gradually increase movement as healing progresses. Physical therapy is often recommended to restore strength, flexibility, and stability in the affected area. Many patients can return to normal activities, including work, within a few weeks, though high-impact or strenuous activities may require more time. Regular follow-up appointments with the surgeon ensure proper healing and address any concerns.

The key advantages of foraminotomy include:

• Relief from radiating pain, numbness, and weakness caused by nerve compression.
• Minimally invasive techniques result in smaller incisions, less blood loss, and quicker recovery.
• Preservation of spinal stability, as the procedure does not involve fusing vertebrae or removing large portions of bone.
• High success rates, especially when nerve compression is the primary source of symptoms.

Fortunately, risks are very low and include bleeding, infection, or nerve injury (rare). Additionally, since no fusion or structural change is performed during a foraminotomy, symptoms may come back or persist despite successful surgery. In these cases, more extensive fusion or disc replacement surgery may be required.