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Endoscopic Foraminotomy of the Lumbar and Cervical Spine

United Spine & Joint is one of the top centers in the country for true minimally invasive spine surgery. We perform endoscopic foraminotomy for both the cervical and the lumbar areas of the spine. With our expertise in these procedures, we can help improve your quality of life with a minimal risk for complications and infections. During a foraminotomy procedure, part of your vertebral bone is removed to gain access to your pain generator. The two foraminotomy procedures (cervical and lumbar) vary slightly, so we have provided you with information about each below.

If you are interested knowing more about foraminotomy as a treatment for your spine pain, please contact us to determine what option is best for you, what your insurance will cover and any additional surgery costs.

Endoscopic Lumbar Foraminotomy (ELF)

What Is Endoscopic Lumbar Foraminotomy?

Endoscopic lumbar foraminotomy is a minimally invasive surgery used to relieve pressure caused by compression from bone spurs, disc herniations, scar tissue, or excessive ligament development. With a quick recovery time, foraminotomy surgery patients are often up and back to normal activities in no time.

Advantages of endoscopic lumbar foraminotomy surgery include the following:

  • Minimally invasive
  • Small incision
  • Short recovery
  • Same day surgery with no hospitalization (outpatient procedure)
  • High success rates
  • Local anesthesia
  • Preservation of spinal mobility
  • Minimal or no blood loss
  • Minimal scar tissue formation

What Conditions Can Endoscopic Lumbar Foraminotomy Surgery Treat?

Endoscopic lumbar foraminotomy can be used to treat a number of conditions in the lumbar region of the spine (lower back). The following are some of the spinal conditions that can be effectively treated with this procedure.

When Is Endoscopic Lumbar Foraminotomy Recommended?

Endoscopic lumbar foraminotomy is generally recommended in the following situations:

  • Severe back pain radiating down to the lower extremities.
     
  • Conventional treatments fail to work after three months, such as pain medications, rest, physical therapy, and/or chiropractic adjustment
     
  • CT scans and MRI showing nerve compression in the lumbar region of the spine

How Is Endoscopic Lumbar Foraminotomy Surgery Performed?

During endoscopic foraminotomy surgery, the patient is brought to the operating room, and intravenous sedation is administered. Under local anesthesia, a small metal tube, the size of a pencil, is inserted into the lumbar spinal nerve hole (neuroforamen). The surgical tools are inserted through this tube so that your muscles do not need to be torn or cut open. The spinal nerve is found with a camera looking through the tube, and protected. Under direct vision, bone spurs, scars, ligament overgrowth, protruded discs, and part of the troubled lumbar facet are removed with appropriate tools (eg, a laser, radiofrequency or mechanical tools) to enlarge the nerve hole and to release the compressed nerve(s). Finally, the tube is removed and the incision is closed with a stitch or two.

Upon completion, the patient is encouraged to walk around and is free to leave the surgical center, with a companion, the same day. After a follow-up visit with the surgeon the next day, the patient can typically go home for a quick recovery.

foraminotomy foraminotomy
                      (Bone cleared)                                               (Nerve examined)
foraminotomy
    (Herniated portion of disc removed)

Endoscopic Cervical Foraminotomy

What Is Endoscopic Cervical Foraminotomy?

Our endoscopic foraminotomy for the cervical spine is a same-day minimally invasive surgery that is used to relieve pain caused by cervical spine degenerative diseases that involve spinal nerve compression.

Advantages of endoscopic cervical foraminotomy surgery include the following:

  • Minimally invasive
  • Small incision
  • Short recovery
  • Same-day surgery with no hospitalization (outpatient procedure)
  • High success rates
  • Minimal to no blood loss
  • Preservation of spinal mobility
  • Minimal scar tissue formation

What Conditions Can Endoscopic Cervical Foraminotomy Surgery Treat?

  • Cervical spine degenerative disease with spinal nerve compression
  • Failed previous neck surgery
  • Cervical spinal nerves pinched by disc herniations and bone spurs

When Is Endoscopic Cervical Foraminotomy Recommended?

  • Persistent neck, shoulder, and arm pain, tingling, numbness, and muscle weakness in upper extremities
  • Positive signs of peripheral nerve compression affecting the upper extremities
  • Symptoms unresponsive to conservative treatments, such as anti-inflammatory medications, physical therapy, chiropractic adjustments, and spinal steroid injections for 8-12 weeks
  • Nerve diagnostic test positive for radiculopathy or nerve irritation
  • Selective nerve root blocks showing positive indication for pain relief
  • CT scans, discograms, and MRI showing cervical spinal nerve compression

How Is Endoscopic Cervical Foraminotomy Surgery Done?

During endoscopic cervical foraminotomy, the patient is put under with general anesthesia. A small metal tube of about 4 mm in diameter is inserted into the cervical spine nerve canal through the disc under x-ray guidance. This tube serves as the passage for the surgical tools so that the muscles do not have to be torn or cut open, as what happens with open spine surgery. Then, a small piece of enlarged bone (ulcinate) is removed with a micro instrument to open the nerve canal. Disc herniation, bone spurs and scars in the spinal nerve canal are now removed for satisfactory nerve decompression. The degenerative disc may be treated with a laser, which vaporizes disc material, kills pain nerves inside the disc, and hardens the disc to prevent leakage of disc material to the surrounding nerves. Finally, the tube is removed and the incision is closed with a stitch or two.

Upon completion, the patient is encouraged to walk around and is free to leave the surgical center, with a companion, the same day. After a follow-up visit with the surgeon the next day, the patient can typically go home for a quick recovery.

 
 

 

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