Laminoforaminotomy is a spine surgery performed to treat cervical radiculopathy; a type of neck pain that spreads (radiates) into the upper back, shoulder(s) and down the arm(s). Sometimes symptoms are felt in one or both hands. The goal of laminoforaminotomy is to relieve nerve root compression (eg, pinched nerve) and related symptoms.
Lamino refers to the spine’s lamina; a thin plate of bone at the back of the neck that helps to protect the spinal canal.
Foraminotomy refers to the foramen; the spinal nerve root passageways. These passageways are naturally created at either side of the disc between two vertebral bodies. Sometimes these passageways are called neuroforamen (neuro means nerve). Otomy means ‘to cut’. During a foraminotomy, Dr. Stieber creates a small window in the lamina and removes disc and/or bone spurs pressing on the nerve root. This increases the size of the neuroforamen and decompresses the nerve, if necessary.
Cervical foraminal spinal stenosis, a disc herniation that occurs at the side (lateral) of the vertebral body, osteoarthritis (spondylosis), spinal degenerative problems and bone spurs (osteophytes) may cause neck radiculopathy. Symptoms of cervical radiculopathy may include pain in the neck, upper back, shoulders, arms, and hands. Other symptoms may iniclude weakness, numbness, and/or sensations of pins and needles.
Not every patient with a neck problem requires spine surgery. Dr. Stieber may recommend laminoforaminotomy for the following reasons: if non-operative treatment fails to relieve symptoms, progressive worsening of neurologic symptoms or pain, and/or serious neurological problems. Numbness, loss of function, and weakness are examples of neurologic dysfunction.
Laminoforaminotomy is performed under general anesthesia. The neck is shaved, cleansed and prepared for surgery. The surgery is generally performed with the patient face down on the operating table. The patient’s skull is held securely in position and the neck immobilized by means of a device made for this purpose. A special computerized monitoring system checks the spinal cord and nerve function throughout the procedure to prevent injury.
The procedure may be performed by approaching the spine from behind (posterior) using minimally invasive techniques or as an open procedure (large incision). Dr. Stieber determines which surgical approach is best and discusses the entire procedure with the patient well in advance of the surgery date.
Fluoroscopy (real time x-ray) captures pictures of the patient’s anatomy before, during and after surgery. Whether the procedure is performed open or using minimally invasive surgical instruments and techniques, part of the lamina is removed to expose the tissue compressing nerve structures. Dr. Stieber removes disc, bone, and/or other tissue that is crowding nerves in the neuroforamen. When the procedure is complete, the wound is closed and bandaged.
After surgery, the patient is moved into the recovery area. In recovery, nurses and other members of the medical team closely monitor the patient’s vital signs – pulse, respiration, blood pressure, and pain. Some post-operative pain should be expected and patients receive pain medication either through their IV (intravenous line) or by mouth.
- A post-operative cervical brace or soft collar may be prescribed for a short time period after surgery to help immobilize and support the neck while healing.
- Many patients go home the same day as surgery. Dr. Stieber discusses the likelihood of hospitalization with patients before their surgery date.
After Care at Home
Dr. Stieber provides laminoforaminotomy patients with information about what to expect and self-care after hospital discharge. This information includes instructions to control pain, medications, brace use and care (if prescribed), diet and managing constipation, bathing and incision care, activity restrictions, and the surgical follow-up appointments. As always, Dr. Stieber and his staff welcome questions and ensure that all patient concerns are thoroughly addressed.