Overview

This procedure is often performed to treat cervical radiculopathy, where a herniated disc, bone spurs, or other degenerative changes compress the spinal nerves, causing pain, numbness, or weakness in the arms.

Why Choose Posterior Cervical Foraminotomy?

Posterior Cervical Foraminotomy is typically chosen when conservative treatments such as physical therapy, medications, or injections have not provided sufficient relief. This less invasive procedure preserves the stability and motion of the cervical spine while effectively relieving nerve compression. Alternative treatments like ACDF or Cervical Disc Replacement will be discussed during your preoperative consultation.

What Happens During Surgery?

Preparation

• Hospital Admission: You will be admitted on the day of surgery. Fasting is required as directed by your anaesthetist.
• Anaesthesia: The procedure is performed under general anaesthesia to ensure you are pain-free.

Surgical Approach

• Patient Positioning: You will be positioned face down (prone) on the operating table with your head secured using a specialized frame.
• Incision: A small incision is made in the back of the neck over the affected vertebra. Muscles and soft tissues are carefully retracted to expose the vertebrae and foramen. Intraoperative X-rays confirm the correct operative level.

Foraminotomy Procedure

• Bone Removal: Specialized instruments remove small portions of bone and other tissues (such as ligaments or bone spurs) that compress the nerve as it exits the foramen.
• Microscopic Assistance: The procedure is performed using a high-powered surgical microscope to enhance precision and minimize collateral damage.
• Disc Material Removal: If a herniated disc is contributing to nerve compression, the protruding portion may also be removed (discectomy) to further relieve pressure.

Closure

After decompression, the surgical site is carefully closed with sutures and covered with a sterile dressing. Muscles and tissues are repositioned to minimize complications.

Postoperative Care and Recovery

• Hospital Stay: Most patients go home the same day or within 24 hours, depending on recovery progress.
• Pain Management: Medications are used to manage pain. Early mobilization is encouraged to reduce risks such as blood clots or pneumonia.
• Outpatient Rehabilitation: A rehabilitation program focusing on restoring neck mobility, strength, and function is initiated shortly after surgery.
• Activity Restrictions: Patients should avoid heavy lifting, twisting, and overhead activities for several weeks after surgery.
• Follow-Up: Regular follow-up appointments are scheduled to monitor healing and adjust rehabilitation plans as needed.

Risks and Complications

• Infection: There is a risk of infection at the surgical site.
• Bleeding: Excessive bleeding during or after surgery is possible.
• Nerve Injury: There is a risk of injury to the spinal nerves, which may result in weakness, numbness, or other neurological symptoms.
• Incomplete Pain Relief: In some cases, the surgery may not fully relieve symptoms, necessitating additional treatment.
• Spinal Instability: Although uncommon, there is a small risk of developing instability, which might require further surgical intervention.

Patient Reported Outcomes

To explore the results and outcomes reported by patients following posterior cervical foraminotomy, please click here.