CERVICAL SPINE ANATOMY RELEVANT FOR FORAMINOTOMY
Each bone in the spine forms two canals with each bone above it and below it. One canal is to the left of the spinal cord and the other is to the right. As the spine ages bits of broken and extruded disc can seep into this space causing impingement on the nerve root. Also, bone spurs can form in the foraminal canals causing a gradual impingement that can form over years and have sporadic bouts of symptoms. When the spinal cord is being compressed inside the spine the condition is called spinal stenosis, but when the compression is in the foraminal canals the condition is called foraminal stenosis. The surgical intervention for foraminal stenosis in the cervical spine is a cervical foraminotomy. The root foramin- indicates the location is the foraminal canal, and the second half of the word -otomy means to remove bone. Cervical, is the term for the top seven bones in the spine. A Cervical foraminotomy is the removal of bone in the foraminal canal of one of the top seven bones in the spine.
SYMPTOMS OF STENOSIS THAT MAY REQUIRE A CERVICALFORAMINOTOMY
The symptoms of nerve impingement vary in location, but all have similar symptoms. Each nerve root that innervates off the spine travels to a separate location throughout the body. While some nerve roots overlap final destinations, a medical provider can identify what level of the spine is effected by your symptoms and confirm this with imaging. Stenosis can be seen on a transverse angle x-ray, MRI, or CT. The symptoms of a nerve that is being impinged include:
- Radiating pain down an extremity
- Burning sensations
- Sharp electric like pain
What part of the spine has stenosis?
If the symptoms are present in the arms then the problem is in your cervical spine. If the symptoms are in the butt and legs then the impingement is in the lumbar spine. Either way. If you are experiencing any of these symptoms schedule an appointment with a orthopedic spine surgeon, PM&R physician, or Interventional Pain Management Anesthesiologist.
WHAT IS A CERVICAL FORAMINOTOMY
A foraminotomy is an operation performed to relieve pressure on a spinal nerve as it exits the spine through an opening called the foraminal canal. If the pressure is in the neck the surgical procedure is called a cervical foraminotomy. The pressure that a foraminotomy relieves is called Stenosis. While there are conservative measures such as oral steroids, epidural steroids, and therapies, it is sometimes necessary to have a surgical intervention. During Foraminotomy the surgeon will make an incision on the back side of spine and gently clear a path by pushing the tissue to the side. When the foraminal canal is exposed the surgeon will clear any debris impinging the nerve root and remove any bone that is narrowing the canal. After the removal of this debris and bone the impingement on the nerve root will be relieved and the symptoms will be relived if there is not permanent damage from the extended nerve compression.