Posterior Cervical Foraminotomy Procedure


Posterior Cervical Foraminotomy Procedure

Your doctor may recommend a posterior cervical foraminotomy to relieve a herniated neck disc and associated arm pain if non-surgical treatment fails to improve your symptoms. This minimally invasive surgery is performed through a small skin nick in the neck, avoiding disturbance to facet joints and muscles and ligaments. General anesthesia is used, and you remain unconscious during the operation. Prescription pain medication is also given to manage your discomfort through the recovery period.

A Posterior Cervical Foraminotomy Procedure disc can press on spinal nerves in the neck region, causing arm pain, tingling, or weakness. Conditions like degenerative spine disease can cause the discs (cushion pads) between vertebrae to wear out or tear, resulting in herniation. Bone spurs and thickened ligaments can also narrow the neural foramen, compressing the spinal nerves or spinal cord. During the surgical procedure, a portion of the bone and joint covering a spinal nerve is removed along with any fragments of a prolapsed disc.

Navigating Neck Pain: A Comprehensive Guide to the Posterior Cervical Foraminotomy Approach

After the surgeon marks the operative level with fluoroscopic images, an initial dilator is inserted into the lumbar facet. A tubular retractor is then secured over the dilator to release the deep cervical fascia. A series of larger dilators are inserted, and the foramen is opened up (Fig. 2).

Once the foramen is open, use a nerve hook to gently retract the C6 nerve superiorly and inspect for any disc fragments that might be lodged in it. If necessary, remove foraminal osteophytes with a Kerrison punch until the amount of osseous resection and space available to the nerve are satisfactory (Fig. 9). A Kerrison punch is also used to remove a portion of the cephalad lamina and the medial aspect of the facet joint to expose the herniated C6 nerve root. After removing the nerve root, a micro-pituitary rongeur is used to remove any visible, loose disc fragments. Control bleeding with powdered Gelfoam and bipolar cautery, and close the wound using a standard layered closure.

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