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Posterior Cervical Discectomy / Foraminotomy

The cervical region (neck area) forms the upper portion of the spine. A series of cervical vertebrae, C1-C7 connects the cervical spine to the skull. The massive nerve supply to the head and neck, upper portions of the shoulders and the arms is by the spinal nerve roots that branch out from the cervical spine. Pinched nerves in the cervical region can cause pain, limited movement in the hands and arms.

A posterior cervical microforaminotomy/discectomy is performed to remove pressure from a nerve root in the cervical spine.

Indications:

Patients who experience:

  • Neck, shoulder or lower arm pain from pinched nerves in the cervical region
  • Swollen or bulging discs
  • Bone damage caused by trauma or conditions like arthritis or osteoporosis.
  • Throbbing and radiating pain to the fingers, hands, and lower portion of the arm
  • Weakness and restricted movement and range of motion caused by compressed nerves in the neck area.
  • Various spinal disorders that cause foraminal narrowing include degenerative disc diseases, spinal stenosis, and spondylosis.

Posterior cervical discectomy surgical procedure:

The goal of posterior cervical microforaminotomy/discectomy is to relieve pressure on the spinal cord and/or nerve roots. This decompression is achieved by expanding the foramen (tunnel or space through which a spinal nerve exits the spine) or removing the portion of the intervertebral disc (broken or bulged) that exerts pressure on the spinal nerves and causes pain.

It is a type of minimally invasive spine surgery that involves use of highly specialized miniature surgical instruments and very small incisions to reduce injury to the surrounding structures.

Method of surgery:

The surgical approach is from the back portion of the neck. A herniated disc or a spinal stenosis in the neck can cause pain and weakness. As the nerves exit the spinal cord and branch out to the arms, they pass through the foramen. With disc herniations, these tunnels can narrow and a nerve may become pinched leading to pain and loss of sensation. A small segment of the spinal bone is dissected to relive pressure and provide space for the spinal nerve root.

In this technique, the patient lies face down on the operating table. A small incision is placed along the back of the neck. The muscle which lies behind the spine is cut and the affected spine bone exposed. Miniature surgical instruments are inserted through the incision to move the bone and muscles and expose the compressed nerve or herniated disc. A small amount of bone surrounding the nerve root is carefully removed. This is called microforaminotomy. Any bulging or herniated portion of the disc will be removed if it continues to bulge against the nerve root which is known as microdiscectomy. Once the nerve root is decompressed the muscles are re-approximated and the skin is closed with sutures.

Post-operative care:

  • Following are the post-surgical guidelines to be followed after the surgery:
  • Make sure you get plenty of rest.
  • Take medications and antibiotics to help alleviate pain and inflammation as prescribed by your doctor.
  • Avoid neck bending or straining activities.
  • Absolutely no driving for about 2 weeks or while taking pain medicines.
  • Braces such a soft cervical collar may be advised to wear after surgery to reduce the pain and stress on the neck.
  • Start rehabilitation (physiotherapy) as recommended by your spine surgeon.
  • Return to work and sports once the neck has regained normal strength and function.

Risks and complications:

With any procedure some risks factors will always be there. Likewise, posterior cervical microforaminotomy/discectomy has complications such as

  • Bleeding or infection
  • Unrelieved neck pain
  • Damage to spinal cord, nerves, and blood vessels
  • Spinal may lose its stability
  • Need for additional surgery due to occurrence of above complications.

Discuss with your spine surgeon if you have any concerns or queries regarding posterior cervical microforaminotomy/discectomy.