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A posterior cervical foraminotomy is a minimally-invasive procedure designed to enlarge to space through which the nerve root exits from the spinal cord (the so-called neural foramen) and at the same time try to remove any piece of disk which is pushing on the nerve. Interestingly, sometimes the foraminotomy alone can alleviate symptoms without a diskectomy being needed. The whole disk is not removed, just the fragment pressing the nerve root. A fusion is not performed and most patients typically do not require a neck collar after the surgery.
A disc protusion per se may not cause symptoms. If the anulus is acutely torn, neck pain may result, but the management is usually not operative. If the disc pushes on a nerve, as shown in the previous scans, then symptoms down one or occasionally both arms may result. The symptoms can include pain, numbness, ?pins and needles?, and weakness.
Anatomy
The Anatomy Of A Typical Intervertebral Disc As Shown Below : -
(Below): The intervertebral disc lies in front of the spinal nerves and is situated between the vertebral bodies. It carries 80% of the load transmitted through the neck and is the shock absorber for the spine. The lowermost discs of the neck (C56 and C67) are most prone to wear and tear and potential rupture.
What are some of the reasons I might need a Posterior Cervical Laminectomy & Discectomy?
This surgery is usually recommended to address problems of : -
Herniated Nucleus Pulposus
Bone Spurs
Foraminal Stenosis
The main reason for this surgery is pressure on a nerve going to the arm.
Cervical cord compression causing myelopathy (weakness in arms and legs).
How Is The Surgery Done?
An incision is made at the back of the neck, and the muscles pulled to one side. The lamina (the "roof" of the spine) may be removed in order to decompress the spinal cord, or only the part of the lamina may be removed that is over the foramen where the nerve roots are being trapped. A foraminotomy, making more room for the nerve root, or a discectomy, removing protruding part of the disc or disc fragments, may be done to relieve pressure on a nerve. The muscles are released and the incision is closed.
The cervical spine begins at the base of the skull and supports the weight of the head. The spinal cord runs from the brain down through the cervical spine, controlling the function of the body's organs and limbs. In between each of the 7 vertebrae of the cervical spine are soft pads or discs which act as shock-absorbers and allow for bending and movement of the head. Each disc is made up of two parts, a soft center called the nucleus and a tough outer band called the annulus.
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