Foraminotomy in New Jersey

T

he spinal column contains small openings between each vertebra called neural foramina. These openings create space for the spine’s nerve roots, but when the spine suffers injury or damage, the foramina can narrow and compress the spinal nerves. A foraminotomy is a type of decompression surgery that can create space for the nerves to pass through unobstructed. The Centers for Neurosurgery, Spine & Orthopedics (CNSO), located in New Jersey, offers this surgical treatment for eligible patients.

What Is a Foraminotomy?

Foraminotomy is a form of spine surgery that removes a small portion of the bone around the foramina widening the opening where nerve roots exit the spinal canal. A foraminotomy procedure can provide pain relief for patients with foraminal stenosis, a condition in which the foramina space becomes too narrowed because of an overgrowth of bone tissue, compressing the nerve root as it exits the spinal column. Narrowing of the foramina or spinal column can happen as a result of:

• Degenerative disc disease: As spinal discs break down, they can bulge into the foramen and pinch the adjacent nerves. Disc degeneration affects the majority of older adults, but not every patient will develop disc disease or notice symptoms.
• Spondylosis: This condition refers to degenerative arthritis of the joints, discs, and bones of the spine. It is common among older adults, especially patients over the age of 60.
• Spondylolisthesis: This is a condition in which a vertebra slips out of its proper position, sliding over the vertebra below it and causing spinal instability. While it can happen to older adults because of natural wear and tear to the spine, it also can be a congenital condition.
• Tumors or cysts: Unusual growths near the spinal canal can press against and irritate spinal nerves, as well as limit the space in the spinal openings.
• Congenital defects: Certain conditions, such as dwarfism, can cause a patient to have insufficient space in their neural foramina.

These conditions can cause chronic neck or back pain that may radiate down a patient’s arms or legs. Consistent inflammation of the nerves also can lead to symptoms such as numbness, tingling feelings, or muscle weakness which is referred to as radiculopathy. Severe stenosis can lead to the loss of the function of a limb.

Diagnosing Foraminal Stenosis vs. Spinal Stenosis

Spinal stenosis versus foraminal stenosis is typically diagnosed with a physical examination and confirmed with imaging. A doctor may have a patient sit, stand, and bend in different positions to identify the source of their pain. The physician also may check for numbness in the arms, legs or feet or test the patient’s reflexes. They also may use imaging tests to visualize the spinal column and the foraminal openings such as an X-ray, MRI, or CT scan. Typically, spinal stenosis presents with bilateral symptoms while one level of foraminal stenosis only affects either the right or left side of the body. Spinal stenosis affects the spinal cord and nerve roots and requires a laminectomy and possible fusion while foraminal stenosis only affects the nerve roots.

Before recommending surgery, a physician may treat spinal stenosis with:

• Injection treatments: Periodic injections of steroid medication can reduce inflammation at the nerve roots, helping to manage symptoms.
• Physical therapy: Working with a physical therapist can help a patient with spinal or foraminal stenosis improve their balance, maintain their muscle tone, and preserve flexibility in their spine, which may help reduce their pain.
• Medication: Oral pain medication or anti-seizure drugs can help manage nerve pain.

If these treatment methods do not lessen a patient’s symptoms, they may be a candidate for foraminotomy.

Foraminotomy Procedure and Recovery

Before a foraminotomy, a patient may need to stop taking certain medications, such as blood thinners. Immediately before the procedure, they may need to fast for a few hours. Foraminotomy is typically performed under general anesthesia by a neurosurgeon or an orthopedic spine surgeon.

During the procedure, the patient is asleep on their stomach or side while on the operating table. The surgeon makes an incision, to remove a small portion of bone to open up the nerve root opening. They also may need to remove all or part of the lamina, the bony arch that extends from the back of the vertebrae. This procedure is called a laminectomy. If spinal stability is a significant concern, the surgeon may perform a spinal fusion to improve the strength of the spine. Once the procedure is complete, the surgeon will close the incision and the patient will move into the recovery room once they are awake.

After the procedure, mild pain and soreness at the incision site are common. A patient may feel drowsy as the anesthesia wears off. Most patients can return home within a day or two and will receive instructions for aftercare, including activities to avoid. Patients should monitor their symptoms and contact their doctor if they have a fever or any concerns after returning home.

Often, patients will have physical therapy after their surgery to strengthen the muscles around their spine and maintain flexibility. Patients can resume driving after one or two weeks but will need to avoid heavy lifting for a few months. Patients who have had a foraminotomy in their cervical spine may need to wear a foam collar to support their neck afterward.

Each patient is different, but most experience noticeable pain relief after foraminotomy surgery.

Choose CNSO for Comprehensive Spine Care

Patients with spinal stenosis will find compassionate care from an award-winning medical team at CNSO. Taking a comprehensive approach to treating patients, CNSO is staffed by board-certified orthopedic surgeons, neurosurgeons, pain management specialists, and physical therapists. These medical professionals work collaboratively to achieve the best health outcomes possible for each patient. While CNSO’s surgeons have extensive experience performing foraminotomy and other types of back surgery, surgery is always a last resort after conservative care options have failed to resolve the discomfort.

CNSO is based in Northern New Jersey and serves patients throughout the surrounding area with multiple convenient locations as well as telemedicine appointments. For more information or to schedule an initial consultation, call 973-633-1122 or contact CNSO online today.