Foraminotomy: Taking Pressure off Spinal Nerves

During a foraminotomy, the spine surgeon removes bone or tissue that obstructs the passageway and compresses ('pinches') the spinal nerve root, which can cause inflammation and pain. Often the nerve (neuro) passageways are called neuroforamen.

Neuroforamen: Location in the Spine
The neuroforamen are passageways that are naturally formed on either side (left, right) between an upper and lower vertebra. In between each upper and lower vertebra is an intervertebral disc. The height of the disc separates the two vertebrae and creates the size of the neuroforamen. The vertebral body and nerve structures of a single spinal segment are illustrated in Figure 1.

Figure 1

There is 31-pair of spinal nerve roots that shoot off from the spinal cord and exit the spinal canal through the neuroforamen. (See Figure 2) Spinal nerve roots branch out to form an intricate network of nerves outside of the spinal canal called the peripheral nervous system.

Figure 2

Nerve Compression: Symptoms and Causes
When the size of a neuroforamen is reduced, there is less room for the spinal nerve, which may cause nerve compression. Symptoms of nerve compression include pain, stiffness, numbness, tingling sensations, and/or weakness. Since spinal nerves branch outward to form the peripheral nervous system, these symptoms may radiate into other parts of the body. For example, cervical nerve root compression can cause symptoms in the shoulders, arms, and hands. Lumbar symptoms may radiate into the low back, buttocks, legs, and feet.

Disorders that can cause nerve root compression include spinal stenosis, degenerative disc disease, a bulging or herniated intervertebral disc, bone spurs (osteophytes), or spondylosis (spinal osteoarthritis). Figure 3 illustrates these disorders.

Figure 3