Laminoforaminotomy

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Cervical radiculopathy occurs when a nerve root in the neck is irritated or pinched, sometimes in the neuroforamen. The neuroforamen are nerve passageways between two vertebral bodies.  There is a neuroforamen at the left and right.  A herniated disc or bone spur  Disc material or bone spur can “block” all or part of the neuroforamen and cause nerve root compression.

Laminoforaminotomy is a surgical procedure to treat cervical radiculopathy; neck pain that radiates into the upper back, shoulders and down the arms.  Symptoms may affect the hands too.  During laminoforaminotomy, nerve root compression is relieved; called decompression.

Lamino refers to the spine’s lamina – a thin plate of bone at the back of the neck that helps to protect the spinal canal.

Foraminotomy refers to the neuroforamen – the spinal nerve root passageways.  Neuro refers to nerve.

Otomy means to remove bone by cutting.  During laminoforaminotomy, the surgeon cuts a small window in the lamina and removes disc material and other tissue (i.e., bone spur) pressing on a nerve root. The 'small window' increases the size of the neuroforamen and decompresses the nerve.

Cervical foraminal spinal stenosis, lateral (side) disc herniation, osteoarthritis (spondylosis), and bone spurs (osteophytes) are common causes of cervical radiculopathy.

Not every patient with a neck problem requires spine surgery.  A surgeon may recommend laminoforaminotomy if:
 

  • Nonoperative treatment fails to relieve symptoms
  • Neurologic symptoms progressively worsen
  • Pain is unrelenting

The Procedure

Laminoforaminotomy is performed under general anesthesia. A sophisticated monitoring system assesses spinal cord and nerve function throughout the procedure. The procedure can be performed through an open approach or using minimally invasive techniques. Fluoroscopy captures real-time X-ray images during surgery.  Whether the procedure is performed open or minimally invasively, it is the same.  Part of the lamina is removed to expose the tissue compressing nerve structures. The surgeon removes disc, bone, and/or other tissue crowding nerves in the neuroforamen.

After Surgery

Many patients experience remarkable and immediate reduction in arm pain following surgical intervention. If cervical radiculopathy has been a longstanding condition, the patient can expect a more gradual reduction in pain. Sensations of tingling and/or warmth are common as the nerve heals. Regaining strength in the arm and hand occurs over time.

A postoperative cervical brace or soft collar may be prescribed for a short time after surgery to help immobilize and support the neck while healing. The length of hospital stay varies, depending on the surgical approach. Well in advance of their surgery date, patients are given instructions pertaining to self-care and follow-up after discharge.