Foraminotomy, conventionally performed in a hospital setting, is a fairly-invasive surgical procedure to enlarge an area around a bone in your spinal column. This surgery is effective in relieving pressure on your compressed nerves. The spinal column consists of a chain of bones referred to as vertebrae. The area above and below the flat area of your vertebrae consists of intervertebral discs that provide support. The spinal column houses the spinal cord, preventing it from damage or injury. The spinal cord plays a crucial role in sending sensory information from your body to the brain and sending commands from your brain to the body. This information is transmitted through the nerves that spread from the spinal cord. These nerves exit the spinal column via tiny holes known as the intervertebral foramen.

Sometimes, the openings become too small, compressing the nerves. The compressed nerves cause several symptoms, including pain, weakness, and tingling in the legs and hands. The exact symptoms vary depending on the part of the nerve that is compressed along the spinal column. For example, you could experience tingling in your arm or hand when you have a compressed nerve in your neck. During foraminotomy, a surgeon makes an incision in your back or neck to widen the foramen and remove any blockages. If you or your loved one needs to undergo a foraminotomy in Los Angeles, contact Dr. George Rappard.

When You Can Undergo Foraminotomy

Various conditions could block your intervertebral foramen and compress the nerves exiting the spinal cord. Spinal stenosis is known as blockages that affect the intervertebral foramen or narrow your spinal column. Some of the medical conditions that could lead to spinal stenosis include:

  • Tumors and cysts
  • Enlargement of your nearby ligaments
  • Degenerative arthritis affecting the spine, commonly known as spondylosis — Could lead to bony spurs.
  • When your intervertebral discs degenerate, making them bulge into the foramen
  • Spondylolisthesis
  • Congenital conditions like dwarfism
  • Skeletal issues, for example, Paget disease

Among the leading causes of spinal stenosis is degenerative arthritis of the spine, a common occurrence in old age.

Nerves could be compressed at any section of your spinal column. The compressed nerves could cause typical symptoms like weakness and tingling in the limbs or pain in the affected area. Perhaps you have undergone other forms of treatment, but the pain or the tingling persists. Foraminotomy could be what you need. Foraminotomy often occurs when other treatments like pain medicines, physical therapy, and epidural injections fail.

In most cases, surgeons perform foraminotomy as an elective procedure to relieve the symptoms of compressed spinal nerves. However, if your symptoms are extensive and getting out of hand, you would have to undergo an emergency foraminotomy. An emergency foraminotomy could also be necessary if the compressed nerves make you have issues with your bladder.

Risks And Complications Of Foraminotomy

In most people, foraminotomy is successful. However, like with other medical procedures, complications could arise, but these are rare. Some of the potential complications of foraminotomy are:

  • Nerve damage
  • Bleeding or too much blood loss
  • Infection
  • Damage to your spinal cord
  • Complications from anesthesia
  • Stroke

Sometimes, there is a risk that the procedure will not be successful or will not relieve your pain. The specific risks of foraminotomy will vary depending on the following factors:

  • The location or the anatomy of the intervertebral foramen
  • Your age
  • The type of foraminotomy you undergo
  • Any underlying medical conditions

After examining you and understanding your medical history, your surgeon will help you understand the potential risks applicable to you.

Preparing To Undergo Foraminotomy

You should consult your surgeon regarding how you should prepare before undergoing a foraminotomy. On the night before the surgery, you should avoid taking any food or medication after midnight. Other necessary preparations before undergoing foraminotomy include:

  • When you leave the hospital after surgery, you should ensure that you prepare your home so that you can move freely during recovery
  • You should not smoke a few weeks before the surgery if you are a smoker. If you continue smoking, your recovery period will be slower and probably not as effective. Consult your doctor for help
  • The surgeon could advise you to stop taking certain medications, usually blood thinners, a few weeks before the surgery. Some of the common blood thinners include ibuprofen, aspirin, and naproxen. If you are taking medication like clopidogrel, rivaroxaban, or apixaban, you should consult your doctor before you stop the medication or change how you take the medication.
  • Your surgeon could advise you to consult your regular doctor before the operation if you have conditions like heart disease, diabetes, or other chronic medical conditions
  • Inform the surgeon if you have been consuming large amounts of alcohol
  • Some medications are allowable, and you can still take them on the day of the surgery. Confirm with your surgeon about these medications
  • You could also consult a physical therapist to learn about some of the exercises you can do before the surgery, including practicing using crutches

On the day of the surgery, you should:

  • Ensure that you arrive at the hospital on time
  • You could consider bringing a cane or walker. Bring non-skid shoes or shoes with a flat sole
  • Arrange for someone to drive you back home when you are discharged from the hospital
  • If you live alone, you could consider having a caretaker assist you for several weeks after the surgery until you recover and resume your regular

The surgeon must ensure that he/she understands your spinal column and the location of the nerves before performing the surgery. Usually, the surgeon could order additional imaging to help them achieve this. The most commonly recommended imaging is MRI (magnetic resonance imaging).

What To Expect During Foraminotomy

What happens during foraminotomy varies depending on the specific surgery. Your surgeon will help you understand what to expect. For example, traditional foraminotomy involves large incisions, while minimally-invasive foraminotomy involves tiny incisions. A team of healthcare professionals performs the procedure, including neurosurgeons and specialized nurses. The surgery typically takes several hours.

Here is what you should expect during a foraminotomy:

  • You will lie on your stomach during the procedure.
  • You will not experience pain because you will be under anesthesia
  • During the surgery, a medical professional will monitor your vital signs, blood pressure, and heart rate.
  • The surgeon will make a tiny incision next to your spine, usually on the side where you are experiencing symptoms, at the level of your affected vertebra.
  • Your surgeon will then use special tools to push away the muscles surrounding your spine to expose the affected foramen.
  • The next step involves using special tools to clear the blockage inside the affected foramen — The blockage could be a bulging disc or a bone spur. Removing the blockage will relieve pressure from your nerves.
  • Depending on your unique condition, the surgeon would perform an additional procedure, like removing a portion of your vertebra, a process known as a laminectomy.
  • After unblocking the blocked foramen, the medical team will remove the surgical tools, put your muscles back in their position, and close the tiny incision on your skin.

Wound Care After Foraminotomy

After foraminotomy, the length of recovery will vary depending on how bad your condition was before the surgery. Here are some of the guidelines that you should follow to take care of the wound:

  • The tape or the bandage on the wound could fall off within seven to ten days. If the bandage does not fall off, consider removing it yourself, provided your surgeon says it is okay.
  • You could feel pain or numbness around the incision site. It is also normal for the area to appear a little red. Ensure that you check the incision regularly to check whether it seems redder or swollen, it feels warm, extra fluid is draining from the wound, and the wound begins to open up. If you notice any of these warning signs, consult your surgeon immediately. You should also consult your surgeon if you experience a persistent headache that does not improve even if you take medication.
  • Confirm with your surgeon when you can take a shower again. Some of the recommendations that your surgeon could give include:
  1. You should ensure that your bathroom is safe to reduce the risk of slipping
  2. For the first five to seven days, you should keep the incision dry
  3. Have someone assist you the first time you take a shower
  4. Use plastic wrap to cover the incision
  5. Do not splash water from the showerhead on the incision

It is best not to smoke or use other tobacco products after spine surgery. Avoiding tobacco if you have a graft or fusion is even more critical. Using tobacco products or smoking delays the healing process.

Physical Activity After Foraminotomy

You will need to adjust how you do some things. For example, you should avoid sitting for more than twenty or thirty minutes soon after the surgery. When sleeping, assume a position that will not cause back pain. Your surgeon will advise you regarding when you can resume sex.

Your surgeon could recommend a corset or a back brace that you should wear to support your back. You should ensure that you wear the brace when walking or sitting. You do not have to wear a brace when using the bathroom at night or to sit on the side of your bed for a short time.

Avoid bending at the waist. If you have to pick something, bend your knees and squat. Avoid lifting or carrying something heavier than ten pounds or around 4.5-kilograms. Therefore, you should avoid lifting grocery bags, laundry baskets, or even small children. You should also avoid lifting or placing items on your head until you heal.

Below is a guide for other activities:

  • For the first two weeks after surgery, you should only take some short walks. After this, you can gradually increase your activity.
  • For the first 1 or 2 weeks, you can go up or down the stairs daily. However, you should only do this if it does not cause you discomfort
  • You should not resume strenuous activities like running, golfing, swimming, or other activities before seeing your doctor. You should also avoid strenuous household cleaning activities like vacuuming

In most cases, your surgeon will recommend physical therapy to ensure that you learn how to move or do activities to keep your back in a safe position and prevent pain. Some of the activities include:

  • Dressing and undressing
  • Getting up from a chair or out of bed safely
  • Doing exercises that strengthen your spinal muscles while keeping your back safe and safe
  • Ensuring that your back is safe as you engage in activities like carrying and lifting items

You could be wondering when you can resume your job after surgery. Your physical therapist or surgeon will advise you when you can resume normal activity.

Driving A Vehicle After Foraminotomy

Your doctor could advise you not to drive for the first two weeks following the surgery. After two weeks, you can always take short trips, but only if the surgeon says it is okay.

You should only travel for short distances as a passenger. If the ride from the hospital to your home is long, you should ensure that you stop every 30 to 45 minutes. You should also stretch after every stop.

Managing The Pain

After surgery, your doctor will recommend prescription medication to manage your pain. You will have this medicine at home after your discharge from the hospital. Do not wait until your pain becomes unbearable for you to take the medication. If you intend to engage in physical activity, you can take medicine around half an hour before you begin.

When You Should Contact A Doctor

You should call your surgeon if you experience any of the following:

  • More pain than you experienced when you first had the surgery
  • Fever or chills of 38.3 degrees Celsius or 101 degrees Fahrenheit
  • Any form of drainage from the wound, especially if the drainage is yellow or green
  • A change of feelings in your arms or a loose feeling, especially if you had neck surgery — If you have lower back surgery, you should consult a doctor if you have a loose feeling or a change of feeling on your feet or legs.
  • Calf pain
  • Swelling
  • Shortness of breath or chest pain
  • Your back pain worsens or does not improve, even with pain medication.
  • You have a challenge controlling your bowel movements or difficulty when urinating.

Find Reliable Foraminotomy Services Near Me

Foraminotomy provides significant or total relief of the symptoms of compressed nerves. If you have pain or a tingling feeling in your limbs, it could be a sign of compressed nerves. Dr. George Rappard’s Clinic provides reliable foraminotomy services in Los Angeles, CA. Call us at 424-777-7463 to speak to one of our surgeons.