Posterior cervical foraminotomy relieves spinal nerve root compression by creating more room for the nerve root to pass through the foramen. When disc material compresses the nerve root on one side (unilateral compression), the cervical foraminotomy can be used to remove the portion of the offending disk. When a bone spur narrows the foramen and compresses the nerve root, a posterior cervical foraminotomy can be used to chisel away the spur to widen the passageway. Some refer to this procedure as minimally invasive, in that the incision is relatively small and no fusion of the spine is required.
The procedure is performed in the back of the neck, which means that you will be lying face down on the operating table. You will be under general anesthesia so that you will feel nothing during the procedure. The spinal surgeon will make a small 1 to 2 inch skin incision and with the help of magnification, he/she will dissect away soft tissue on the side of the compression. Precision instruments are used to carefully remove a small amount of bone which serves as the outer wall of the foramen. Once the foramen is opened, the nerve root can be seen. In cases of compression due to disc material, the nerve root is gently lifted and the disc material is removed. The wound is then closed, and the surgeon may provide you with a soft collar. A variation of this technique is a truly minimally invasive procedure where the surgeon may use an even smaller skin incision and use a tubular retractor to access your spine. Regardless of which approach, standard skin incision or with minimally invasive tubes, posterior cervical foraminotomy provides relief of nerve root compression with minimal bone removal. Symptomatic relief is seen in 85- 90% of cases. Some patients may require a short course of post-operative physical therapy. Risks of this procedure are uncommon but they include: bleeding, infection, neck stiffness, repeat disc herniation, incomplete relief of symptoms, damage to nerve root or spinal cord, or problems with anesthesia.