Posterior cervical foraminotomy/discectomy is an operation performed on the upper spine to relieve pressure on one or more nerve roots. The term is derived from the words posterior (back), cervical (neck), foraminotomy (to open the foramen), and discectomy (remove a portion of the intervertebral disc).
When a spur of bone forms, or an intervertebral disc ruptures in the cervical spine, it puts pressure on one or more nerve roots (often called nerve root compression). This causes pain and other symptoms in the neck, arms, and even legs. In this operation, the surgeon reaches the cervical spine through a small incision in the back of the neck. After the muscles of the spine are spread, the nerve root is exposed by removing part of the boney joint which covers the nerve root. This is called a foraminotomy. If necessary a portion of the intervertebral disc is then removed taking the pressure off of the nerve root.
Today, collars are typically worn for a shorter period of time after surgery than in the past. The collar can often be removed after just several days or weeks depending on your surgery and your symptoms. The collar is worn for comfort and should not be worn when driving.
At home you will have medication to help with any discomfort. Any severe increase in pain not controlled with the medication should also be reported to your physician or the physician's nurse. You should report any elevation in your temperature, drainage from you incision, or increase in numbness or weakness. Successful recovery from posterior cervical foraminotomy/discectomy requires that you approach the operation and recovery period with confidence based on a thorough understanding of the indications, alternatives, and risks. Your surgeon has the training and expertise to correct physical defects by performing the operation; he or she and the rest of the health care team will support your recovery. Your body is able to heal the involved muscle, nerve, and bone tissues. Full recovery, however, will also depend on you having a strong, positive attitude, setting small goals for improvement, and working steadily to accomplish each goal.
The surgery is usually performed with you totally asleep. An intravenous catheter will be started and then the anesthesiologist will use IV medications to put you to sleep. A catheter may be placed in your bladder if the surgery is planned to take a long time.
Surgery for posterior cervical foraminotomy/discectomy may be performed with the patient lying on his or her stomach or sitting up. A small incision is made in the back of the neck.
A small tubular retractor is used to gain access to the spine by separating the fibers of the skin and muscle. A microscope or an endoscope is used to look down the tube and visualize the spine. The bone over the nerve root is exposed and then a portion of this is removed to expose the nerve root. The disc is visualized underneath the nerve root. Part of disc is removed with special instruments taking any remaining pressure off of the nerve.
The operation is completed when the neck incision is closed in several layers. Dissolving suture material may be used and a waterproof dressing is applied so that you can shower.
The anesthesiologist awakens you and you are watched in the recovery room. You then go to your room and may go home that day or the next day. You will be given medication to control any discomfort.
Technique Contributed By Dr. Sylvain Palmer
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It is important that you discuss the potential risks, complications, and benefits of spinal surgery with your doctor prior to receiving treatment, and that you rely on your physician's judgment. Only your doctor can determine whether you are a suitable candidate for this treatment.