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Vertebrae are a chain of bones that make up your spinal column. Each vertebra is supported by a pair of intervertebral discs sitting above and below.

In addition to protecting your spinal cord, the spinal column also houses the spinal nerves. The spinal cord sends sensory signals from the body to the brain. In addition, it transmits commands to the body parts from the brain. This information is sent and received by the nerves surrounding the spinal cord. A small hole between the vertebrae (intervertebral foramen) allows them to exit the spinal column.

It is possible for these opening to become too narrow at times. As a result, the nerve can become compressed, causing pain, tingling sensation, and weakness in the upper and lower limbs. A compressed nerve will produce different symptoms depending on where it is located along the spinal column. For instance, if a spinal nerve is compressed in the neck, this may cause neck pain, tingling sensation, and numbness in the hand and arm.

A foraminotomy is a surgical method that enlarges the narrow space between the bones of your spinal column. The procedure helps to relieve pressure on the nerves that are compressed.

Who might need a foraminotomy?

The narrowing of the spinal column or the obstruction of an intervertebral foramen is referred to as spinal stenosis. The nerve leaving the spinal cord can be compressed by a number of processes that block the intervertebral foramen. Some of these conditions include:

  • Spondylosis – a condition in which the spine degenerates and causes bone spurs
  • As the discs degenerate, they can protrude into the foramen
  • When the nearby ligament becomes enlarged or ossified 
  • Spinal instability Spondylolisthesis
  • Development of cysts or tumors in the spine
  • A skeletal disorder like Paget’s disease
  • Problems related to congenital disabilities, such as dwarfism or achondroplasia 
  • Degenerative arthritis of the spine in older people is another common cause.

People may experience nerve compression at any point along their spinal column. The nerve compressed results in symptoms such as pain along with the damaged area and limb weakness. When other treatment options fail, a foraminotomy is a viable option to fix the problem. The procedure involves taking pain medication, epidural injections, and physical therapy.

To alleviate the symptoms, surgeons usually perform foraminotomy as an elective procedure; if the symptoms are quickly getting worse or associated with bladder problems, an emergency foraminotomy needs to be performed. 

Foraminotomy Surgery

The doctor explains all the details of the surgery before they proceed. The surgery will be performed by a neurosurgeon along with a specialized team of healthcare professionals. The entire procedure might be completed in a couple of hours. In general, the following procedure can be expected during a minimally invasive type of foraminotomy:

  • Surgical procedure will be done under Gen anesthesisa in prone position .
  • Your vital signs such as heart rate and blood pressure during  will be carefully monitored during the surgery by an experienced anesthesiologist
  • A small incision will be made alongside your spine on the side where you are experiencing the symptoms. At the level of your affected vertebrae, the surgeon will make the incision. But in a traditional foraminotomy, the incisions are wider.
  • A special microscope and  fluoroscopic guidance are used to guide the surgeon during surgery.
  • Special surgical tools are inserted through the incision, and the back muscles adjacent to the spine are pushed away to reveal the blocked intervertebral foramen.
  • Then the surgeon removes the obstruction from the intervertebral foramen. Bone spurs or bulging discs are likely to cause the obstruction. If they are removed, nerve pressure will be relieved.
  • In some cases, other procedures like laminotomy or laminectomy may be done at this time if the surgeon feels it is necessary. It involves removing portions from the vertebra.
  • Whereas in some cases, a spinal fusion is done to stabilize the spinal column. 
  • Your back muscles and tissues will be put back into place, and the small incision made on your skin is sutured.

In most cases, patients are able to get up and move around within two hours of surgery. However, you need to move carefully. If the surgery is done to your neck, you may need to wear a soft neck collar following the surgery. Most people will be discharged on the next day after they undergo surgery. However, one should follow post-surgical instructions very carefully, particularly in caring for the wound and the back. Usually, patients can resume to light work after four weeks from the surgery.

For details about this surgical procedure or have any spinal problems consult Dr. Surya Prakash, one of the best spine surgeons in Hyderabad. He has more than two decades of experience managing various spinal disorders surgically. Call +91 9848024699 to book an appointment with the doctor.


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