What is a Lumbar Foraminotomy?
A lumbar foraminotomy is a minimally invasive procedure that enlarges the intervertebral foramen by removing the roof of the tunnel, and any other tissue seen pressing on the spinal nerve. The thick back muscles cover and protect the nerve after the small amount of bone is removed.
The inter-vertebral foramina are the two tunnels between adjacent vertebra that allow the spinal nerves to leave the spinal canal and pass to the rest of the body. The width of this tunnel can be decreased by degenerative disc collapse, facet joint or vertebral body osteophytes, or inter-vertebral disc herniation. The decreased tunnel size can compress the spinal nerve and cause buttock or leg pain, paresthesia, weakness or numbness.
A foraminotomy does not treat back pain, it only treats leg symptoms. 80% of patients receive good or excellent relief of leg pain.
Indications
A lumbar foraminotomy may be considered where conservative treatment has not eased:
- Persisting leg pain
- Paresthesia
- Pins and needles
- Numbness
- Weakness
It will only be considered where these symptoms have been shown to be due to spinal nerve compression.
If there is severe leg muscle weakness, or severe leg pain that is not controlled by strong pain relievers, Dr Parkinson may recommend immediate surgery to relieve the symptoms.
Goals
The goals of a lumbar foraminotomy are to remove the tissues pressing on the spinal nerve, while maintaining spinal stability, motion and alignment. This should decrease the pain and weakness in the leg.