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Cervical Foraminotomy or Decompression

Minimally Invasive Cervical Foraminotomy or Decompression Surgery

Minimally invasive cervical foraminotomy or decompression surgery is performed to alleviate the pain that is caused by a narrowing of the foramen (opening) for the spinal nerve. The most common causes of this narrowing are disc herniations or spinal stenosis. Depending on the location of the affected spinal level, a small part of the facet or lamina may be removed during the procedure as well. 

Using minimally invasive techniques, the surgeon will make a small incision which allows them to access the affected area. Then the muscles and tissues are gently pulled back using a tubular system. Due to the minimally invasive nature of this procedure, it can be completed in less time and with less pain than the traditional open surgical method. It also allows the patient to recover quicker since there was less damage incurred during the surgery.

What Happens During the Surgery

Minimally invasive cervical foraminotomy or decompression surgery is carried out while the patient is under general anesthesia. This means you will be unconscious while the procedure is performed and will not feel any pain or discomfort. The patient is then placed face down on an operating table and after the surgical area is cleaned and sterilized, a tiny incision measuring about 1.5 centimetres will be made above the affected spinal level. An X-ray is then done to confirm the proper area is being operated on. After the X-ray is taken the surgeon uses soft tissue dilators to gently pull back the muscle fibres. After a tubular retractor is inserted over the dilators they are removed. The surgery is then carried out using a microscope and specialized surgical tools. These specialized surgical tools allow the surgeon to make a small keyhole which is used to remove part of the bone which makes up the back of the spinal canal, which is medically known as the lamina. A portion of the facet joint is also removed. The removal of a portion of the lamina and facet relieve the compression on the nerve which is causing the patient pain, discomfort, or reduced mobility. Once the offending materials have been removed, your surgeon will investigate the surgical area for any bone spurs or disc material and may remove them as well, depending on what caused your spinal problem in the first place. 

After the surgery has been completed the incision will be closed using dissolvable sutures and surgical tape to hold the sutures in place. A small dressing will be used to cover the area where the incision was made. 

In total, minimally invasive cervical foraminotomy or decompression surgery typically takes about one hour to be completed.

After Surgery Care

This day surgery allows for the patient to be discharged from the hospital once the effects of general anesthesia have worn off. While recovering, your surgeon will provide you with comprehensive postoperative care instructions. Due to the minimally invasive nature of this procedure, less trauma and cutting will have been experienced, so pain in the affected area should be very minimal. For the first one to two weeks after your surgery, you are advised to avoid bending or moving your neck in an excessive manner. Once the pain dissipates and your neck muscles regain their strength in the second and third weeks after your surgery, you will be able to twist and bend your neck more freely. For the first month following your surgery you will be prohibited from lifting anything heavy.

How Long After Surgery Can I Return to Work or Recreational Activities? 

By using minimally invasive techniques to perform cervical foraminotomy or decompression surgery, we are able to reduce the amount of time it takes to recover from this procedure compared to the open or traditional surgical method. For most patients, they are usually able to return to work in a limited or reduced capacity two weeks after the procedure. If your recovery is progressing well and your pain has subsided and neck muscles have regained their strength, you can most likely return to full work and recreational activities 4-6 weeks after surgery.

How Successful Is the Surgery? 

When it comes to addressing the narrowing of the nerve canal which occurs due to spinal stenosis or disc herniation, minimally invasive cervical foramintomy or decompression surgery has been shown to be extremely successful. In studies that have been conducted, patients generally report their results as being good or excellent 84-95 per cent of the time. These patients also report a rapid and significant reduction in the pain they previously experienced, with them being able to successfully return to most or all of their recreational and regular activities.

How Much Care Is Required for the Surgical Wound?

Following the procedure, minimal surgical wound care is required. A small dressing will be placed over the incision area before you leave the hospital, which must be kept on for three days. Once three days have passed, you can remove the dressing and expose the area to air. The surgical tape that was placed over the incision to keep the sutures in place should not be removed though. You must also take great care to keep the incision area dry and clean during this time. If you are taking a shower, cover the incision area with a bandage and try not to get water directly on it. You should abstain from having a bath for at least five days following your surgery.

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