Lumbar Foraminotomy

What is Lumbar Foraminotomy and Why is it Done?

Lumbar foraminotomy is a minimally invasive surgery to relieve pressure on nerves in the lower back (lumbar 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 lower back pain, leg pain (sciatica), numbness, tingling, or weakness. The surgery widens these openings to free the compressed nerves, reducing pain and improving mobility and function.

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 inch) in your lower back. 
• Accessing the Spine: Muscles are gently moved aside to reach the lumbar spine. The surgeon uses a microscope and specialized tools for precision, minimizing tissue disruption. 
• Decompression: Small amounts of bone, ligament, 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 1 hour, and many patients go home the next day after the surgery. 

Benefits of Lumbar Foraminotomy

• Minimally Invasive: The small incision and careful approach reduce muscle damage, leading to less pain and scarring compared to traditional open surgery. 
• 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 leg pain, numbness, and weakness, improving comfort and mobility. 
• Preserves Motion: Unlike fusion surgeries, foraminotomy typically doesn’t restrict spinal 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 legs. 
• Dural Tear: The protective covering around the spinal cord or nerves may tear, but this can usually be repaired during surgery. 
• Recurrence of Symptoms: Nerve compression may return if the underlying condition progresses. 
• Persistent Pain: 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 surgeon to understand what to expect.

Who is a Candidate for Lumbar Foraminotomy?

You may be a candidate if you have a herniated disc, bone spurs, or spinal stenosis in the lumbar spine causing significant leg pain, numbness, or weakness that hasn’t improved with non-surgical treatments and if other types of surgical treatment are considered less favorable in your particular case. Your Neurosurgeon/Spine 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

Lumbar foraminotomy is a safe and effective option for many patients with nerve compression in the lower back. 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.