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Lumbar Foraminotomy

What Is Lumbar Foraminotomy?

Lumbar foraminotomy is a procedure to enlarge the small hole between two vertebrae in your spine through which nerves pass through. This small hole is known as a foramen. Spinal cord nerves exit through the foramen and then spread out to other parts of your body. They’re continually sending messages back and forth between your body to your brain.

When the foramen hole becomes narrowed or constricted, it puts pressure on the nerves. If the openings where these nerves exit is in your lower back, called your lumbar spine, your spine surgeon may recommend a procedure called a lumbar foraminotomy to relieve symptoms of a compressed nerve, which include:

  • Lower back pain, which may radiate to other areas, such as your buttocks
  • Tingling in your arms and legs
  • Numbness in your back or legs
  • Weakness in your legs or spine

A foraminotomy can be done on any part of the spine, including your middle back and cervical spine. Because low back pain is one of the major sources of back pain in the country, Dr. Branko Skovrlj at NU-Spine in Edison, New Jersey has perfected the procedure.

Who Can Benefit from Lumbar Foraminotomy Surgery?

Many disorders can lead to nerve root compression, also called lumbar radiculopathy. You can benefit from the procedure if you have a condition that causes a foramen to become too small, such as:

  • Lumbar degenerative disc disease that causes disc damage and deterioration
  • Lumbar stenosis, a type of spine deformity
  • Lumbar disc herniation, when a disc is ruptured and its contents protrude against one of the nerve roots exiting the spine
  • Lumbar slipped disc that occurs when a disc loses all or part of its integrity
  • Spondylosis, which is degenerative arthritis in the spine that causes bony spurs

Low back pain that conservative treatments, like physical therapy, haven’t helped will likely improve after a foraminotomy. Minimally invasive back surgery, a foraminotomy may be combined with a lumbar laminectomy, or a discectomy to decompress nerves. Your neurosurgeon recommends the best surgery for you, based on the location of your pain and the severity of your symptoms.

What Happens During a Lumbar Foraminotomy Procedure?

Your spine surgeon explains the details of your procedure, which may also be called endoscopic lumbar foraminotomy or posterior lumbar foraminotomy. You’re asked not to eat or drink anything for six to 12 hours before your lumbar foraminotomy procedure.

For this minimally invasive procedure, surgery is done on an outpatient basis and usually takes a couple of hours, although you may require a hospital stay of a day or two. The steps of the procedure involve:

  • You’re given anesthesia, so you’ll be asleep for the procedure.
  • You’re positioned face down on the surgical table.
  • Your neurosurgeon makes a small incision near the affected area.
  • A special microscope is used to guide the surgeon as he inserts a tube through the incision to the target.
  • Small tools are used to expose and widen the affected foramen.
  • If necessary, the surgeon removes the blockage that’s pressing on the nerve, whether it’s a bulging disc or bone spur.
  • Once complete, the incision is closed.

What Should I Expect After Lumbar Foraminotomy?

You may experience some discomfort at the incision site for a few days, which can usually be controlled with over-the-counter medications. You may have to avoid certain activities for a few weeks such as:

  • Driving
  • Strenuous exercise
  • Lifting, pushing or pulling heavy objects

After about four weeks, you should be able to resume light work and exercise. You may not be able to do heavier work for a few months. Your doctor may recommend physical therapy to help you regain strength and flexibility, and it also reduces your post-operative discomfort.

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