When a patient is experiencing neck and radiating arm pain due to a spinal disc pressing on nerve roots exiting the spine, Dr. Albert may use a cervical posterior foraminotomy to relieve the compression.
What is cervical posterior foraminotomy?
The goal of this procedure is to create more space for a compressed spinal nerve in the neck. The procedure relieves the pressure that is being caused by a herniated or bulging disc that is pressing on a nerve root.
The term posterior refers to the procedure being done from the back of the neck. Foraminotomy refers to enlarging the foramen, the opening in the vertebra the nerve passes through as it exits the spine.
Either the spinal cord or, more commonly, the nerve roots exiting through the foramen of the cervical vertebrae can be affected by the compression. If the patient has degenerative disc disease, the bone itself can begin to wear out and develop bone spurs. These can push on the nerve roots. Otherwise, the usual cause of this compression is the spinal discs. They can weaken and bulge outwards. In more extreme cases, the disc can herniate, allowing the inner gel to push outward and impact the adjacent nerve root.
This pressure on the nerve roots leads to neck pain and pain that can radiate out into the arms and hands. There can be tingling or a pins and needles sensation in the arms and hands. This is called radiculopathy.
If not addressed, this nerve compression can lead to permanent nerve damage and impaired function of the hands and fingers.
What are the benefits of a cervical posterior foraminotomy?
This surgery creates more space for the compressed spinal nerve in your neck. It relieves the pressure on the nerve and ends the corresponding pain in the neck, arms, and hands. This procedure has an 85-95 percent success rate in relieving the pain of nerve compression in the neck.
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candidacy for a cervical posterior foraminotomy
When a nerve root is compressed in the neck, the symptoms can range from mild neck pain to severe numbness in the hand and electric-like pain shooting down the shoulder, arm, and hand. Depending on the degree of compression, the patient may have significant weakness in the arm or hand.
As with all patients, except in cases of emergency trauma, the last resort for Dr. Albert is surgery. Conservative treatments such as physical therapy or corticosteroid injections are possible alternatives. However, if the pain doesn’t respond to these measures, surgery to relieve pressure on the nerve could be necessary.
How is a cervical posterior foraminotomy done?
For this procedure, the patient lies face down and is given general anesthesia. Dr. Albert begins by creating a 1-2 inch incision vertically down the back of the neck above the area of compression. The muscles and other tissues are moved aside to gain access to the spine.
To increase the space for the nerve root as it travels through the foramen, Dr. Albert may remove a portion of the foramen, basically enlarging the opening. He also may remove a portion of the lamina, the portion of the vertebra that forms the rear of the spinal canal. If a herniated disc is pressing on the nerve, Dr. Albert carefully lifts the nerve root and removes the portion of the disc causing the problem.
When the nerve root has ample space, the incision is closed and the procedure is complete.
What is recovery like after a cervical posterior foraminotomy?
You’ll spend 1-2 nights in the hospital. During this period physical and occupational therapists will meet with you to instruct you on the proper techniques for walking, getting in and out of bed, and other common movements. You’ll be instructed to avoid excessive bending or twisting of your neck for the first one to two weeks after surgery. Patients can gradually begin to bend and twist their neck after 2-3 weeks, and as pain dictates. Heavy lifting needs to be avoided for the first 4-6 weeks.
Pain varies between patients, but it can be moderate. Dr. Albert will prescribe pain medication for you. Most patients can begin driving in just 1-2 weeks, depending on their level of pain. Patients can return to desk work as early as 1-2 weeks after surgery, again depending on the level of pain. Light recreational sports can resume in as early as one month, with heavy lifting and other sports activities in 1-2 months.
the risks of a cervical posterior foraminotomy
As noted, this procedure with Dr. Albert is very successful for alleviating the neck and arm pain associated with this type of cervical nerve compression. This is considered to be a low-risk procedure. These are the risks involved: excessive bleeding, infection, reaction to anesthesia, neck stiffness, repeat disc herniation, incomplete relief of the pain, or damage to the nerve root or spinal cord.
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If you would like to learn more about the Orthopedic services that Dr. Albert offers, call our office at (212) 606-1004 and schedule a consultation. Dr. Albert proudly serves patients from Manhattan and surrounding areas in New York.