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Cervical Laminoforaminotomy

Cervical laminoforaminotomy is a minimally invasive spinal surgery that is performed to relieve pressure on one or more nerve roots or on the spinal cord in the cervical (neck) region.  It is commonly used to treat cervical radiculopathy.  The procedure may be recommended when pain is not resolved by more conservative therapies such as physical therapy and medication.

When a disk is herniated, either by a sudden injury or over time with age, the jelly-like center of the disk can “bulge” through and create pressure on the nerve root, and painful bone spurs can develop from arthritis in the neck.  These compressed nerves in the neck can cause cervical radiculopathy, with symptoms that include radiating neck pain that spreads into the shoulders, the arms and sometimes the hands.

Procedure

During the procedure, the patient is on his or her stomach under general anesthesia while the surgeon makes a small incision on the side of the neck.  Using very small instruments, the surgeon shaves the spine’s lamina, which is a thin plate of bone that protects the spinal cord, in order to access the offending nerve. The surgeon then removes bone spurs and/or disk fragments on the foramen, which is the small opening on both sides of the vertebra, before the incision is closed.

Recovery and Physical Therapy

Once surgery is complete, the patient will remain in the hospital for monitoring and treatment of post-surgical pain with medication. Most patients are encouraged to begin walking in the hospital within a few hours of surgery once they have recovered from the anesthesia. It is normal for continued pain immediately after surgery, particularly around the incision, and as the inflammation around the offending nerve root slowly decreases. Patients are typically discharged the same day, and should gradually increase the amount of walking every day, trying to do a little more each time. Outpatient physical therapy may be prescribed to help with pain and inflammation, and to regain function and control of the neck muscles. Recovery times vary for every patient, but on average, patients recover within two to four weeks.

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