Cervical Foraminotomy

A cervical laminotomy/foraminotomy is an operative procedure of removing a small part of the bone (lamina and facet joint) at the back of the neck (posterior cervical spine) region to relieve pressure on the spinal nerves. No fusion or implants are used for this surgery. This operation has been used widely for isolated nerve root compression where the spinal cord is not involved.

Procedure

The surgery is performed general anaesthesia. You will lie on the operating table faced down with your chest and pelvis supported. Your head will be secured in a clamp (Mayfield™), and draped in a sterile fashion. Your surgeon makes a ~5cm incision in the midline of your posterior, and approaches the vertebrae by disconnecting the muscles and retracting them. An Xray is performed to confirm the correct level is identified. A small portion (about size of 5 cent coin) of the lamina and facet jointis removed with the use of a high speed drill and lifted away from your spinal nerves. Bleeding from the epidural vessels are cauterised.

After the procedure, your surgeon brings back the soft tissues and muscles to their normal place and closes the incision.

Risks or complications

All surgeries carry risk and it is important to understand the risks of the procedure in order to make an informed decision to go ahead with the surgery. In addition to the anaesthetic complications, spinal surgery is associated with some potential risks but not limited to:

• Transient/Long term Nerve injury (especially C5 causing weakness of deltoid and biceps)
• Transient/Long term Spinal cord injury
• Persistent nerve pain, numbness, tingling, burning, aching
• Persistent neck pain, headaches, shoulder pain, scapular (shoulder blade) and interscapular (between shoulder blade) pain
• Infection
• Postoperative hematoma (bleeding)

Benefits

• No risk to the vocal cord (recurrent laryngeal nerve)
• Less swallowing difficulties
• No fusion is required.
• No loss of motion.