Cervical foraminotomy is an operation to enlarge the space where a spinal nerve root exits the cervical spinal canal to relieve the symptoms of a “pinched nerve.”
Compression of the cervical nerve roots can cause neck pain, stiffness, and pain radiating into the shoulder blade, arm, and hand, as well as numbness, tingling and/or weakness in the arm and hand. Protruding or ruptured discs, bone spurs, and thickened ligaments or joints can all cause narrowing of the space where the nerve exits the spinal canal and cause the above symptoms. Patients who do not improve with conservative treatment may be candidates for the operation.
Some pain at the operative site is expected, but generally resolves over time and can be controlled with oral pain medicines. Some patients can be discharged the same day of surgery, but some patients will require 24-48 hours in the hospital. Most patients will notice immediate improvement in some or all of their symptoms, however some symptoms may improve only gradually. A positive attitude, reasonable expectations, and compliance with the doctor’s recommendations all contribute to a satisfactory outcome. A cervical collar (brace) is rarely necessary. Most patients can return to their regular activities within several weeks.
A small transverse incision less than 1″ in length is made near to the midline of the neck after localizing the area of interest with an x-ray.
Dr. Lanman uses tubes to dilate the muscles and perform the surgery microendoscopically. He uses the microscope for all work done around the spinal cord and nerve roots in order to prevent injury to the nerve and spinal cord. Thickened ligament, bone spurs and/or bulging discs are removed to decompress the exiting nerve, which is checked with a probe to insure adequate space around the nerve root.
The muscles and tissues are closed in layers with absorbable sutures. The skin may be closed with absorbable sutures and steri-strips, which are removed when the wound is well healed.