An endoscopic foraminotomy is a minimally invasive technique used to enlarge the nerve root openings by eliminating the cause of foraminal narrowing, and to help resolve the patient’s spinal impingements. In most patients, the endoscopic technique is preferred over an open surgery, which requires a much larger incision and typically has a longer recovery period as well as an increased risk of infection.
WHAT IS AN ENDOSCOPIC FORAMINOTOMY?
This is a procedure used to widen the intervertebral foramina, the small openings in each vertebra through which the spinal cord, spinal artery and other vessels and nerves pass. In some cases, these openings can become partially blocked in a condition known as spinal stenosis,, causing nerves and blood flow to become impinged, which results in pain, numbness and/or a reduction in range of motion. Several spinal conditions can cause changes in the foramina, but the most common include bulging or herniated discs, degenerative disc changes, facet joint syndrome and spondylosis. Aging, injury and excessive wear-and-tear can be contributing factors to the condition.
What symptons should I look out for?
There are several characteristics that make a patient ideally suited for the procedure. Our spine surgeons will discuss these with you, which can include:
- Persistent pain that radiates into the extremities
- Pain which has persisted for three months or more
- Limited range of motion in the neck (cervical) or back
- Weakness, tingling or numbness in the extremities
- Difficulty performing daily activities without pain
- Difficulty standing, sitting or walking for an extended period
- Failure to achieve relief through more conservative approaches
- Ability and willingness to undergo physical therapy
In addition, ideal candidates will not be excessively overweight, since obesity can result in additional stress and strain to the spine during the healing and recovery process. As always, discussing the procedure and having realistic expectations is critical to the overall outcome.
If you are suffering from chronic pain, weakness or numbness, our skilled team of spine surgeons can help you achieve relief.
A shorter recovery
Our doctors are highly skilled at both procedures and combine the two into one, quick treatment session. Patients receive a quick, outpatient experience without having to undergo multiple surgeries, resulting in a reduced recovery period.
WHO QUALIFIES FOR AN ENDOSCOPIC FORAMINOTOMY?
The endoscopic procedure is fairly straightforward, typically taking only one or two hours to be completed and generally being performed as an outpatient procedure under general anesthesia. A small area on the neck or back will be prepped and a one-inch to three-inch incision will be made to allow the surgeon access to the damaged area. The foraminotomy is performed using specialized instruments including a tiny camera.
The endoscopic approach is designed to minimize damage to muscles which otherwise must be moved aside in order to visualize the spine. Next, the surgeon will carefully and gently remove a small amount of bone in the foramina to help relieve pressure being exerted on nerves and other structures. When necessary, other procedures may be performed in conjunction with this surgery to address underlying conditions that may be contributing to impingement, including the treatment of herniated discs. The area is then irrigated to remove any debris and the incision is closed.
Following the procedure, the patient will be placed in a recovery area and monitored for an hour or two before being sent home. A follow-up visit will be scheduled, usually within the first few days following the procedure, to evaluate the outcome. In most cases, the patient will be encouraged to walk around in the afternoon or evening following the procedure to help ensure a speedy recovery and avoid unwanted stiffness.
What are the advantages?
The foraminotomy relieves the pressure on the nerves and blood vessels, resulting in relief from pain, numbness, tingling and other symptoms as well as restoring a more normal range of motion in involved limbs without the need for spinal fusion. The endoscopic approach offers several other advantages, including a smaller scar, less blood loss and a decreased risk of infection. As noted, the technique also results in less muscle damage so recovery is generally much faster compared to a traditional or “open” procedure where a larger incision is used. The endoscopic approach can also be performed as an outpatient procedure, and normally the patient can be up and moving within a couple of hours of surgery.
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