Foraminotomy: A Review of the Surgical Procedure
Foraminotomy is a surgical procedure used to relieve nerve root compression in the spine. It involves removal of the bony structures of the neural foramen, which is the opening in the vertebrae through which the nerve root exits the spine. The procedure is typically performed as part of a larger, more complex spine surgery, and is used to treat nerve root compression caused by a herniated disc, spinal stenosis, bone spurs, or other spine pathology. The goal of foraminotomy is to decompress the nerve root, relieving pain and restoring nerve function. This article provides an overview of the surgical procedure, including indications, technique, and potential complications.
Indications
Foraminotomy is indicated in cases of nerve root compression caused by a herniated disc, spinal stenosis, or bone spurs. The procedure can also be used to treat radiculopathy, a condition resulting from nerve root compression that causes pain, numbness, and tingling in the extremities. Additionally, foraminotomy may be recommended in cases of nerve entrapment, a condition in which a nerve is compressed or entrapped by a bony structure.
Technique
Foraminotomy is performed under general anesthesia or local anesthesia with sedation. The surgeon makes an incision in the skin over the affected area and identifies the nerve root that requires decompression. Under direct visualization, the surgeon removes the bony structures of the neural foramen and may also remove tissue around the nerve root. The surgeon then performs a thorough examination of the neural foramen to ensure that all compressed tissue has been removed.
Potential Complications
The potential complications of foraminotomy include infection, nerve injury, and instability of the spine. It is important to note that the procedure does not always provide complete relief from nerve root compression and symptoms may persist or recur.
Conclusion
Foraminotomy is a surgical procedure used to relieve nerve root compression in the spine. It involves removal of the bony structures of the neural foramen, allowing for the decompression of the nerve root. The procedure is indicated in cases of nerve root compression caused by a herniated disc, spinal stenosis, or bone spurs. Potential complications include infection, nerve injury, and instability of the spine.
References
Mittal, R., & Rekand, T. (2013). Foraminotomy. Neurosurgery Clinics of North America, 24(4), 469-477.
Henderson, J. (2016). Foraminotomy. In StatPearls [Internet]. StatPearls Publishing.
Harrison, D. E., & Harrison, S. L. (2013). Surgery for spinal stenosis and herniated discs. The Spine Journal, 13(2), S21-S26.