What Is a Foraminotomy?

• In simple terms: A foraminotomy makes the “exit tunnel” for spinal nerves bigger, so they’re no longer pinched.
  
  

• Scientifically: Foraminotomy involves removal of hypertrophic facet joint, osteophytes, or ligament overgrowth narrowing the intervertebral foramen. It may be combined with laminotomy or discectomy for complete nerve root decompression.
  
  

Conditions Treated

• Foraminal stenosis (narrowing of the nerve exit canals)
  
  

• Radiculopathy (sciatica, arm or leg pain from pinched nerves)
  
  

• Herniated disc with foraminal encroachment
  
  

• Bone spurs (osteophytes) from arthritis
  
  

• Degenerative changes causing nerve root compression
  
  

• Cases where conservative treatments (PT, medications, injections) fail
  
  

The Foraminotomy Procedure: Step by Step

Plain-English Overview

1. Anesthesia: You’re asleep under general anesthesia.
   
   

2. Incision: A small incision is made over the affected area of the spine.
   
   

3. Muscle-sparing approach: Tubular retractors spread muscles instead of cutting them.
   
   

4. Bone removal: Small amounts of bone and ligament are trimmed to widen the foramen.
   
   

5. Nerve decompression: The nerve is freed and confirmed to move without pressure.
   
   

6. Closure: The incision is closed with sutures or glue; patients often walk the same day.
   
   

Surgeon-Level Detail

• Docking: MIS tubular retractor or open paramedian exposure; microscope/endoscope provides magnification.
  
  

• Partial facetectomy: Medial portion of superior articular process removed with drill/Kerrisons.
  
  

• Osteophytectomy: Removal of bony overgrowth encroaching the foramen.
  
  

• Ligament trimming: Thickened ligamentum flavum or capsule resected.
  
  

• Disc fragments (if present): Herniated disc material removed to free nerve root.
  
  

• Confirmation: Nerve root visualized, pulsatile, and decompressed.
  
  

• Closure: Hemostasis; layered closure; sterile dressing applied.
  
  

Benefits of Foraminotomy

• Direct relief of pinched nerve symptoms
  
  

• Preserves spinal stability (minimal bone removal)
  
  

• Can be performed with very small incisions (MIS)
  
  

• Often outpatient or 1-night stay
  
  

• Immediate relief of arm or leg pain for many patients
  
  

Risks & Limitations

• Infection, bleeding, dural tear/CSF leak
  
  

• Nerve injury or persistent numbness (rare)
  
  

• Recurrent stenosis or scar tissue over time
  
  

• Instability if too much bone removed (fusion may be required in rare cases)
  
  

• Best for nerve compression symptoms, not isolated back pain
  
  

Recovery Timeline

• Day 0–1: Walking same day; most discharged within 24 hours
  
  

• Weeks 1–2: Wound healing; short walks encouraged
  
  

• Weeks 2–6: Desk work resumed; structured physical therapy may begin
  
  

• 6–12 weeks: Activity expanded; restrictions gradually lifted
  
  

• 3–6 months: Strong recovery; return to normal activity for most patients
  
  

Why Choose Desert Spine and Pain?

• Expert neurosurgeon: Dr. Greenwald brings decades of experience in microsurgical decompression
  
  

• MIS focus: Smaller incisions, less muscle trauma, quicker recovery
  
  

• Tailored care: Surgery only when conservative care fails
  
  

• Compassionate support: We guide patients step-by-step, reducing the anxiety of spine surgery
  
  

Frequently Asked Questions

What’s the difference between foraminotomy and laminectomy?

Laminectomy enlarges the entire spinal canal; foraminotomy targets the nerve exit hole (foramen). They are often performed together if needed.

Will a foraminotomy cure my back pain?

It’s best for nerve symptoms (leg or arm pain, tingling, weakness). Back pain relief is less predictable.

Do I need a fusion with foraminotomy?

Not usually. Fusion is only added if instability is present or develops.

How soon will I feel relief?

Most patients notice immediate improvement in nerve-related pain.

How does Desert Spine and Pain perform foraminotomy differently?

We use microsurgical and minimally invasive techniques to relieve pressure precisely, while preserving stability and promoting faster recovery.