Posterior Cervical Laminectomy or Foraminotomy

Cervical posterior foraminotomy is a surgical procedure performed to treat foraminal stenosis, a condition in which the openings for nerve roots to exit the spinal canal have become too small, resulting in painful nerve compression. These openings, called foramen, may have gradually become clogged by herniated discs, calcified ligaments or joints, or bone spurs. Whatever the cause, once the foramen are narrowed, the pressure of bone against the cervical nerves may cause pain, numbness, weakness or tingling sensations.

Some patients with foraminal stenosis can be effectively treated with anti-inflammatory medications, corticosteroid shots, physical therapy exercises or a neck brace to immobilize the spine. When the condition does not respond to these conservative treatments, however, surgery may be required. The cervical posterior foraminotomy will eliminate the compression on the affected spinal nerve, providing relief from painful symptoms. As its name suggests, a cervical posterior foraminotomy is performed on the spine in the neck area with the surgeon making an approach through the upper back.

The Procedure

A cervical posterior foraminotomy is performed with the patient under general anesthesia. With the patient lying face down on the operating table, the surgeon makes an incision in the back of the neck. Muscles, ligaments and other tissues in the area are retracted to provide a view of the spine. The bone at the affected site is shaved down or cut back slightly to enlarge the size of the foramen and provide more room for the nerve roots to pass through.

The surgeon assesses the spine to see whether any other nearby structures are exerting pressure on the nerves. A portion of the lamina, the covering of the vertebrae, disc fragments, thickened tissue, or bone spurs are removed as necessary. For some patients, a spinal fusion is required to for greater stability. Once the procedure is completed, the surgeon repositions the muscles and other tissues and sutures the incision. A cervical posterior foraminotomy typically lasts for approximately 2 hours.

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