Cervical Endoscopic Foraminotomy

What is a foraminotomy?

The foramen are small openings in the spinal vertebrae through which the spinal nerves exit the spinal canal and carry nerve signals to and from the shoulders, arms, hands and fingers. When the foramen become narrowed by arthritic bone spurs and herniated discs it can compress or pinch the spinal cord or nerve roots leading to symptoms. Foraminotomy is a term that means removing bone spurs and tissue to enlarge the neural foramen to relieve pain and improve function.

What is a cervical endoscopic foraminotomy?

A cervical endoscopic foraminotomy is a minimally invasive surgical technique that is used to relieve pressure on spinal nerves in the neck by widening the neural foramen. While a cervical foraminotomy can be performed using an open technique (large incision in the back of your neck), endoscopic foraminotomy offers significant benefits that make it a preferred technique in qualified hands such as Dr. Singh’s. It is safe and effective for patients with arthritic bone changes and herniated discs in the neck.

What are the symptoms of foraminal nerve compression?

Compression of the nerves in the neck can lead to:

• Radicular pain – a sharp, shooting or burning pain that radiates along a compressed nerve
• Numbness and tingling in the shoulder, arm, hand and fingers
• Muscle weakness
• Altered reflexes
• Changes in sensations like pins and needles in the neck and arm

What is the cervical endoscopic foraminotomy procedure?

The procedure involves two incisions smaller than the size of a pen tip. One incision is used to place a small camera similar to those used in knee and shoulder arthroscopy. The other incision is used to insert small instruments smaller than 5mm to remove the bone spurs. The procedure is outpatient meaning you go home the same day of surgery. This technique has a high success rate for reducing arm pain (radiculopathy).

By removing the sources of nerve compression and widening the neural foramen, cervical endoscopic foraminotomy aims to alleviate pain, numbness, tingling, and other symptoms associated with nerve compression in the neck.

What are the benefits of cervical endoscopic foraminotomy?

• Cervical endoscopic foraminotomy limits complications by allowing for direct, enhanced visualization of the affected region with a high-definition camera.
• It is an ultra – minimally invasive procedure that avoids disruption to the facet joints, muscles, and ligaments of the neck, decreasing tissue damage and postoperative pain.
• Performing the surgery through a small skin incision and minimizing surgical trauma and allows for a quicker recovery time and a same day procedure.

When is a cervical endoscopic foraminotomy indicated?

Cervical endoscopic foraminotomy may be indicated in several different conditions that cause blockage or narrowing of the intervertebral foramen and compress the nerves leaving the spinal cord. These includes:

• Spinal stenosis – narrowing of the spinal canal
• Spinal Arthritis (Spondylosis) a degenerative condition
• Disc Herniation

Who is a candidate for cervical endoscopic foraminotomy?

• Any patient that has failed conservative treatment and yet has persistent neck and arm pain with narrowing of the cervical spinal canal.
• Patients with the above conditions and symptoms of nerve compression.

What is recovery from this procedure?

The patient is discharged within a few hours after the procedure because of the less invasive nature of the procedure, which reduces the overall trauma to the body and allows for quicker healing. Full recovery can take a few weeks to months.

Dr. Singh will provide each patient with complete post-operative recovery information.

Patients can expect minimal postoperative pain or discomfort at the surgical site and typically only require over the counter Tylenol after surgery. Patients may resume normal daily activities a few short days after surgery.

After surgery, physical therapy may be recommended to help restore strength, flexibility and range of motion. As recovery progresses, Dr. Singh will provide guidance on when to resume specific activities, such as driving, working, or exercising. It’s important to follow these guidelines to avoid any setbacks in your recovery. Follow up appointments are important to monitor your healing.

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Dr. Kern Singh, MD is an internationally renowned spine surgeon specializing in outpatient minimally invasive and motion-preserving techniques and endoscopic spine surgery at Midwest Orthopedics at RUSH and Professor in the Department of Orthopedic Surgery at RUSH University Medical Center in Chicago, Illinois. Dr. Kern Singh is one of the nation’s Top 100 spine surgeons and beloved by his patients for his compassionate care and excellent outcomes.  He welcomes nationally and internationally – based patients.

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References

• Zou T, Wang PC, Chen H, Feng XM, Sun HH. Minimally invasive posterior cervical foraminotomy versus anterior cervical discectomy and fusion for cervical radiculopathy: a meta-analysis. Neurosurg Rev. 2022 Dec;45(6):3609-3618. doi: 10.1007/s10143-022-01882-5. Epub 2022 Oct 18. PMID: 36255547.