A Minimally Invasive Posterior Cervical Foraminotomy is a surgical procedure to relieve pain/weakness resulting from a pinched spinal nerve. The surgical procedure is designed to allow for more space for the spinal nerves to pass through reducing spinal nerve root compression.
Typically the patient is under general anesthesia. A small incision about an inch long is made over the treated area. Our spine surgeon will use a tubular retractor to access the area, which contributes to keeping the operation minimally invasive. An endoscope is used along with special instruments to remove a small amount of bone to allow access to the nerve root. If the patient’s disc is causing compression of the nerve root, it is carefully lifted and the disc material is removed. This helps take pressure off the nerve root.
A posterior cervical foraminotomy can provide relief of nerve root compression causing pain in the patient with minimal bone removal. The wound is then carefully stitched closed and the patient can go home later that day.
How Is A Cervical Foraminotomy Performed?
A general anaesthetic will be administered to put you to sleep. A breathing tube (‘endotracheal tube’) will be inserted and intravenous antibiotics and steroids injected (to prevent infection and post-operative nausea). Calf compression devices will be used throughout surgery to minimise the risk of developing blood clots in your legs.
Your skin will be cleaned with antiseptic solution and some local anaesthetic will be injected.
The skin incision is about 3-5cm down the back of your neck. It is vertical and in the midline. The muscles at the back of the neck are gently separated from the spinal bones, and the bony roof over the spinal nerve is carefully removed using small drills and other fine instruments. Any soft tissue causing compression is also removed.
The spinal nerve is decompressed once the bone and other tissues have been removed (this is known as a ‘rhizolysis’).
The wound is closed with sutures and sometimes staples.
What Happens Immediately After Surgery?
It is usual to feel some pain after surgery, especially at the incision site. Pain medications are usually given to help control the pain.
Most patients are up and moving around within a few hours of surgery. In fact, this is encouraged in order to keep circulation normal and avoid blood clot formation in the legs. You will be able to drink after 4 hours, and should be able to eat a small amount later in the day.
You can be discharged home when you are comfortable (usually after 2 or 3 days).
What Happens After Discharge?
You should be ready for discharge from the hospital 2-3days after surgery. Our surgeon should check your wounds 4 days after discharge. Your staples require removal around 10 days after surgery, and this can be done by surgeon or the registered Nurse.
You will need to take it easy for 6 weeks but should walk for at least an hour every day.
Bear in mind that the amount of time it takes to return to normal activities is different for every patient. Discomfort should decrease a little each day. Increases in energy and activity are signs that your post-operative recovery is progressing well. Maintaining a positive attitude, a healthy and well-balanced diet, and ensuring plenty of rest are excellent ways to speed up your recovery.
Signs of infection such as swelling, redness or discharge from the incision, and fever should be brought to the surgeon’s attention immediately.
You will be reviewed after 6-8 weeks by your neurosurgeon. Until then, you should not lift objects weighing more than 2-3kg, and should not engage in the repetitive neck or arm movements.
You should continue wearing your TED stockings for a couple of weeks after surgery.