Foraminotomy for Sciatica
A foraminotomy for sciatica is another spine surgery option which may be preferable for patients who show evidence of significant obstructive tissue or bone in the spinal canal. If there is a large area of osteophyte growth narrowing the foramen then a traditional open procedure may be more effective in removing this material than the minimal access surgery where it can be difficult to extract larger tissue bodies. A foraminotomy aims to widen the spaces through which the lumbar nerves exit the spine thereby removing the compression which is responsible for sciatica symptoms. Abnormal bone growth, thickened ligaments, or even a portion of bone from the vertebrae themselves may require removal to relieve patients’ symptoms of radicular pain, weakness, numbness, paraesthesia, and tingling in the lower back and down the legs into the feet.
The success rate for foraminotomy is relatively high compared to many other back surgeries. The minimally invasive surgical techniques, such as microlaminoforaminotomy, can reduce risks and improve the prognosis even further. Sometimes a surgeon may perform a discectomy after the foraminotomy if there is evidence of significant disc degeneration. The disc may be palpated if it is bulging so as to encourage decompression and proper reconfiguration of the vertebral space. Fusion is not normally necessary with a foraminotomy as only small amounts of structural material are removed. The surgeon may use a burr to shave the edge off the inside of the facet joint and possibly a small portion of the ring at the back of the vertebrae above or below the site of nerve compression. If more than one level of vertebrae is being operated on then the surgeon will either use the existing incision prior to closing the overlying skin back together, or make a separate incision at the appropriate level.