Cervical Foraminotomy (Posterior Approach)

What is Cervical Foraminotomy and Why is it Done?

Cervical foraminotomy is a minimally invasive surgery to relieve pressure on nerves in the neck (cervical spine) caused by conditions like a herniated disc, bone spurs, or spinal stenosis. These issues can narrow the foramen (the small openings where nerves exit the spine), leading to arm pain, numbness, tingling, or weakness. The surgery widens these openings to free the compressed nerves, reducing pain and improving function. The posterior approach means the surgeon accesses the spine from the back of the neck.

How is the Surgery Performed?

• Anesthesia: You’ll be under general anesthesia, so you’ll be asleep and feel no pain during the procedure. 
• Incision: The surgeon makes a small incision (about 1-2 inches) in the back of your neck according to the affected level of the spine. 
• Accessing the Spine: Muscles are gently moved aside to reach the cervical spine on the affected side (left or right). The surgeon uses a microscope and specialized tools for precision, minimizing tissue disruption. 
• Decompression: Small amounts of bone or tissue (such as part of a vertebra or a herniated disc) pressing on the nerve are removed to widen the foramen, relieving nerve compression. 
• Closing: The incision is closed with stitches, leaving a small scar that usually fades over time.

The procedure typically takes 40 minutes to 1 hour, and most patients go home the next day after the surgery.

Benefits of Cervical Foraminotomy (Posterior Approach)

• Minimally Invasive: The small incision and careful approach reduce muscle damage, leading to less pain and scarring. 
• Quick Recovery: Most patients return to light activities within 2-3 days, with full recovery in 3-4 weeks. 
• Effective Relief: The surgery often reduces arm pain, numbness, and/or weakness, improving comfort and mobility. 
• Preserves Motion: Unlike fusion surgeries, foraminotomy doesn’t restrict neck movement.

Possible Risks and Complications

While complications are rare, all surgeries carry some risks, including: 

• Nerve Irritation: In rare cases, nerves may be affected, causing temporary numbness, tingling, or weakness in the arms. 
• Dural Tear: The protective covering around the spinal cord may tear, but this can usually be repaired during surgery. 
• Recurrence of Symptoms: Nerve compression may return at he same or neighbouring levels if the underlying condition progresses. 
• Persistent Pain: Due to various reasons, some patients may still have pain or limited relief after surgery. 
• General Surgery Risks: These include infection, bleeding, blood clots, or reactions to anesthesia.

Following your surgeon’s pre- and post-surgery instructions can help minimize these risks. Discuss all potential risks with your Neurosurgeon/Spine Surgeon to understand what to expect.

Who is a Candidate for Cervical Foraminotomy?

You may be a candidate if you have a herniated disc, bone spurs, or spinal stenosis in the cervical spine causing significant arm pain, numbness, or weakness that hasn’t improved with non-surgical treatments, and other surgical options (ACDF or ADR surgeries) are considered less appropriate for your particular case. Your surgeon will assess your condition through a physical exam, imaging (like an MRI or CT scan), and a discussion of your symptoms to determine if this procedure is right for you.

Talk to Your Surgeon

Cervical foraminotomy with a posterior approach is a safe and effective option for many patients with nerve compression in the neck. It can relieve pain and restore function without the need for spinal fusion. If you’re considering this surgery, talk to your Neurosurgeon/Spine Surgeon about your symptoms, treatment options, and any questions to make an informed decision.