Foraminotomy/foraminectomy

Foraminotomy/Foraminectomy

What are Foraminotomy and Foraminectomy?

The words Foraminotomy and Foraminectomy are two words that can be used to explain the same kind of surgical procedure. The foreman is the tunnel or passage between each of the spinal vertebrae through which the nerve roots leave the spinal canal on their way to a particular organ or tissue in the body. If this opening becomes too small or narrow the nerve passing through it can stop working correctly or become irritated. This often happens in conditions like herniated discs, certain types of arthritis and spinal stenosis.

A Foraminotomy is the name of the procedure that removes soft tissues and bones to make the tunnel for the nerves larger. It is often done in combination with another procedure to take pressure off the spine itself, such as with a laminectomy. Under special circumstances, a Foraminotomy can be completed from the outside of the spinal canal. A Foraminotomy does not involve any direct removal of pressure from the central canal. In order to accomplish this, particular delicate surgical instruments are needed to remove sections of bone from parts of the vertebrae and joints. Sometimes this is done by way of an osteotomy (removing portions of the bone with a chisel-like instrument).

In cases where a large amount of tissue and bone are removed the surgical procedure may be referred to as a Foraminectomy. One example of this is when the passageway is opened far enough to decompresses the nerve and also to gain access to a disc that has herniated to the outside of the spinal canal. A Foraminectomy is also often performed as part of a lumbar fusion operation.

Foraminotomy is a surgical procedure that enlarges the area around one of the vertebrae where nerve roots leave the spinal canal. This procedure takes pressure off a nerve in the spinal column and allows the spine to move more easily. A Foraminotomy is a type of procedure that can be performed on any level of the spine.

A Foraminotomy that removes a large amount of bone, tissues, or disc material and other spinal abnormalities that have narrowed the foraminal canal may occasionally be described as a Foraminectomy. Foraminectomy differs from Foraminotomy in such a way that it removes more spinal irregularities and is almost always combined with a laminectomy, a procedure that removes the bone lamina.

Indications

Various processes can obstruct the intervertebral foramen and compress the nerve leaving the spinal cord. Foraminotomy is indicated for patients with Degenerative Arthritis of the spine which could cause bony spurs.

Other indications for this procedure are degeneration of the intervertebral discs, which can cause them to bulge into the foramen, enlargement of the nearby ligament, spondylolisthesis, cysts or tumors, skeletal diseases, and congenital problems like dwarfism. Most patients requiring Foraminotomy have Foraminal Stenosis for at least 3 to 6 months and experience debilitating symptoms that may affect their quality of life.

Good candidates for Foraminotomy should have also experienced one or more of the following symptoms: an acute or chronic pain in the neck or back of varying strength that is constant, deep, dull, throbbing or radiating to the extremities, pain that radiates from the lower back and into the buttocks and lower extremities, pain that radiates from the neck into the upper extremities, limited motor functions, limited ability to perform activities of daily living, pain while standing, walking or sitting, and history of failed attempts for conservative methods to relieve pain and other symptoms.

Risks of Foraminotomy

As with any type of surgery, Foraminotomy also has some potential risks that should be discussed with the patient prior to surgery. Some of the risks involved are:

  • Bleeding
  • Infection on operative site
  • Damage to a spinal nerve
  • Causing weakness, pain, or loss of feeling
  • Partial or no relief of pain after a Foraminotomy
  • Recurrent pain after a Foraminotomy
  • Thrombophlebitis
  • Complications of anesthesia like breathing problems and drug reactions.

These risks can be minimized by choosing an experienced surgeon to perform the Foraminotomy, and by adhering to the surgeon’s instructions prior to the procedure.

Procedure for Foraminotomy

Foraminotomy is performed under general anesthesia. The patient is positioned face down on the operating table. An incision is made in the middle of the back of the spine. The length of the incision would depend on how much of the spinal column will be operated on. The skin, muscles, and ligaments are moved to the side to visualize the vertebrae. Some part of the bone may be removed during Foraminotomy to open the nerve root opening and disc fragments are removed to relax the pinched nerve roots. The surgeon may do a spinal fusion to stabilize the spinal column after Foraminotomy.

Foraminotomy: Post-Operative Care

Most people can sit up and get out of bed 2 hours after Foraminotomy. If the site of operation is in the neck region, the patient will be recommended to wear a soft neck collar to limit head and neck movement. Physical therapy may be recommended for the first several weeks after Foraminotomy. The full recovery period may range between two to three months. Foraminotomy has a very good success rate for relieving the symptoms of Foraminal Stenosis.

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Questions & Answers
Q:
What is the best way to treat permanent back and neck pain and stiffness?
A:

Here are some tips:

Neck Pain Tips: Sleep with a cervical pillow

Orthopedic or cervical pillows are made with special contours to support the space beneath the neck and head. They are also more concave for the head and provide more support to the neck.

Neck Pain Tips: Sleep on your back

The best position to lie to sleep is on your back. If you sleep on your stomach or on your side, make sure your pillow is not too thick. It should raise your head no more than 4 to 6 inches. This will keep your neck and head from turning to either side.

Neck Pain Tips: Position your computer screen at eye level

While you are working at a computer, sit comfortably in your chair with your computer in front of you. Close your eyes and then open them. When you open your eyes, you should see the middle of the computer screen. If your gaze is not in the middle of the screen, adjust the height of the screen using items like books.

To keep your head from gradually drifting forward, take frequent breaks to stretch. Getting up to walk around at least once every half-hour is one of the best neck pain tips.

Neck Pain Tips: Use a telephone headset

Never hold a phone between your shoulder and your ear. Use a headset or other hands-free system to talk on the phone and avoid abusing your neck and spine.

Neck Pain Tips: Exercise your neck muscles

One of the best neck pain tips is using the chin tuck. You can do this often throughout the day. In addition to helping strengthen the muscles that hold the head in alignment over the shoulders, it also helps strengthen the scalene and sub-occipital muscles.

Read more tips here: Neck Pain Tips: Sleeping, Posture, Exercising, Hydration & Prevention

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Temed Holdings
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Q:
What is the best treatment for neck pain and shoulder Pain?
A:

One of the best treatment for neck pain and shoulder pain is exercises:

Neck Pain Exercises: Neck Extension

  1. To begin this neck pain exercise, sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place the palm of your hand on the back of your neck, at the base of your head
  4. Apply slight forward pressure with your hand, while resisting the forward motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax
  6. Repeat the neck pain exercises 5-10 times

Neck pain exercises: Side bend

  1. Sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place your left hand, palm down, on the left side of your head (around your ear)
  4. Slightly push your head to the right side with your hand, while resisting the sideways motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax.
  6. Repeat 5-10 times
  7. Repeat the neck pain exercises with the other side.

Neck pain exercises: Neck flexion

  1. Sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place the tips of your fingers on your forehead
  4. Slightly push your head backward with your fingers, while resisting the backward motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax.
  6. Repeat the neck pain exercises 5-10 times

More exercises here: Neck Pain Exercises

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Temed Holdings
4 answers
Q:
How do I reduce the shoulder and neck pain?
A:

Here are some tips:

Neck Pain Tips: Sleep with a cervical pillow

Orthopedic or cervical pillows are made with special contours to support the space beneath the neck and head. They are also more concave for the head and provide more support to the neck.

Neck Pain Tips: Sleep on your back

The best position to lie to sleep is on your back. If you sleep on your stomach or on your side, make sure your pillow is not too thick. It should raise your head no more than 4 to 6 inches. This will keep your neck and head from turning to either side.

Neck Pain Tips: Position your computer screen at eye level

While you are working at a computer, sit comfortably in your chair with your computer in front of you. Close your eyes and then open them. When you open your eyes, you should see the middle of the computer screen. If your gaze is not in the middle of the screen, adjust the height of the screen using items like books.

To keep your head from gradually drifting forward, take frequent breaks to stretch. Getting up to walk around at least once every half-hour is one of the best neck pain tips.

Neck Pain Tips: Carry weight evenly

Many people make the mistake of carrying a heavy briefcase or their purse on their shoulder or on one side of their body. Doing this causes strain in the muscles and leads to pain.

Remove non-essentials from your briefcase or purse. Consider using a backpack to evenly distribute the weight across your shoulders. If you choose to carry a purse or backpack, keep your shoulders level while carrying it.

Neck Pain Tips: Maintain a proper posture

The most common posture contributing to neck pain is the “head-and-shoulders-forward” posture. In this position, the neck slopes forward, putting the head in front of the shoulders.

In this position, the head pulls the upper back forward also in a slumped position. This places a strain on the entire spinal column.

More tips here: Neck Pain Tips: Sleeping, Posture, Exercising, Hydration & Prevention

Read more
Temed Holdings
4 answers