Nowadays, cervical spine disease is a reasonably common issue seen in adults. Various parts of the cervical spine are generally well-balanced & capable of smoothly handling all of the movements, strains & stresses of the body. However, when spinal nerve compresses, it results in continuous pain, tingling of the extremities & weakness in patients. Foraminotomy is basically decompression surgery which can be performed to widen the pathway where a spinal nerve root exits the spinal canal & thereby provide relief to patients. Expression foraminotomy is derived from the clinical term for a hollow pathway – ‘foramen’. The latter half of the expression ‘otomy’ indicates to open. According to health reports, foraminotomy has higher success rates & 80 percent of the patients observe improved spinal health after surgery.
Foraminotomy is surgery performed from back of the neck to alleviate pressure on one or more spinal nerves. It precisely involves eliminating a small part of the joint & bone which stand over the spinal nerve, as well as any delicate tissue which may also be the reason for nerve compression. In a few cases, a prolapsed disc is also taken off (microdiscectomy).
Patients who are suffering from the following conditions may be considered as good candidates for foraminotomy surgery.
- Weakness – Patients who have significant weakness, numbness & pain in leg or foot.
- Failure of Alternative Treatments – Severe leg pain worse than back pain which has not improved with any medication or physical therapy.
- Poor Posture – Patients who experience trouble walking or standing which affects their quality of life.
- Diagnostic Tests – Several diagnostic tests such as CT, MRI or myelogram that show stenosis in the lateral recess or central canal.
Noticeable signs & symptoms of nerve compression, which is also known as radiculopathy, include the following.
- Aching or stiffness
- Severe pain
- Tingling sensations
When patients experience these symptoms in hands, arms or neck, they should consult a doctor right away.
Doctors will clearly ask patients about their symptoms & alongside conducting a physical evaluation. When doctors suspect nerve compression, patients may have to undergo several tests. These tests may include the following.
- Nerve Conduction Study – This test evaluates & measures electrical nerve impulses & functioning in patient’s nerves & muscles. Respective surgeons will place electrodes on patient’s skin. Nerve conduction will precisely measure electrical impulses in nerve signals of patients when a light current passes through the nerve. Results of this test identify if patients have any damaged nerve.
- Electromyography – During an electromyography test, the doctor injects a needle electrode into different muscles of patients. This test accesses electrical activity of patient’s muscles when they settle & also when they contract. Results of this test are able to detect whether there is any damage to nerves leading to muscles of patients.
- Magnetic Resonance Imaging Scan (MRI) – This procedure involves a powerful magnetic field & radio waves to generate detailed views of patient’s body in different multiple planes. Doctors may recommend MRI scan if they suspect the condition of nerve root compression.
Patients should take an appointment with neurosurgeons in order to discuss doubts relating to spinal problems. It is extremely necessary that patients convey the following information to surgeons.
- Bleeding Problems – Patients should honestly tell the orthopedic / neurosurgeons if they have any bleeding problems or blood clotting.
- Deep Venous Thrombosis – Patients need to tell doctors if they have ever had blood clots in legs (Deep Venous Thrombosis or DVT) or lungs.
- Medications – Patients should notify surgeons if they are consuming warfarin, aspirin or any herbal supplements that might thin blood.
- Blood Pressure – If patient is having high blood pressure.
- Allergies – If patients have any allergies.
- Other Health Issues – If patients are suffering from any other health conditions.
- Avoid Smoking – Before foraminotomy surgery, it is imperative that patients avoid or completely quit smoking.
- Weight – If patients are sort of overweight, it is recommended that they focus on weight loss prior to foraminotomy surgery.
- Zinc Supplement – Patients may be advised to take a zinc tablet every day, commencing one month prior to foraminotomy surgery & continuing for a few months afterwards. Doctors suggest it helps wound healing.
- Ceasing Certain Medications – For preventing unwanted bleeding during or after foraminotomy surgery, it is essential that patients avoid taking aspirin & any other blood-thinning medicines at least 15 days prior to undergoing surgery.
Consecutive list of questions may help patients to understand the procedure. Patients may take the help of below-listed questions to ensure smooth medical treatment. If patients are too nervous to ask any doubts, they can bring a friend along with them to the hospital.
- What type of surgery do you suggest? Why?
- What is Foraminotomy Surgery?
- Can you please explain foraminotomy procedure in great detail?
- If I do not wish to undergo this surgery, what are my nonsurgical alternatives?
- What are the potential risks, side effects & potential complications of foraminotomy surgery?
- How long will foraminotomy surgery take?
- What will be done if a different spine issue is also detected during the procedure?
- How many times have you performed this procedure of foraminotomy?
- According to statistics, what is the success ratio for foraminotomy surgery? Please tell me what your personal success ratio is?
- Can I have a word with any of your previous patients who have undergone foraminotomy surgery?
- What type of pain should I expect after foraminotomy surgery & for how long?
- How long will I have to stay in the hospital?
- Which pain medications will I have to take at home? What are the common side-effects of these medications (e.g. drowsiness, constipation, etc.)?
- When can I return back to normal routine activities?
- When will I be able to drive again?
- When will I recover completely after foraminotomy surgery?
- When can I resume sexual activities?
- How soon after foraminotomy surgery can I start exercising & physical therapy?
Foraminotomy surgery is generally performed in the following steps.
- Anesthesia – Most commonly a general anesthetic will be given to patients to put them in a sleepy state.
- Intravenous Antibiotics – Endotracheal tube or breathing tube will be inserted & steroids & intravenous antibiotics are injected for preventing post-operative nausea & infection. Calf compression machines are used during surgery to reduce chances of blood clotting in patient’s legs.
- Incision – Patient’s skin is carefully cleaned with an antiseptic medication & some local anesthetic is injected. An incision of about 2 – 4 cm is made by surgeon down the back of the patient’s neck. The incision is made vertically & in the midline. Muscles at the back portion of patient’s neck are carefully & gently disconnected from spinal bones & bony roof over the spinal nerve is eliminated using tiny drill instruments.
- Closing Incisions – Any delicate tissue causing compression is also taken off. Spinal nerve is thus decompressed & other tissues are removed & this is called as ‘rhizolysis’. At the end, the wound is closed with staples or sutures.
It is normal to experience some pain after foraminotomy surgery, especially at the incision site. Surgeons may give medications to help control harsh pain that patients usually suffer after surgery. Majority of patients are able to move around within a short span after surgery. They are encouraged to stay active in order to maintain normal blood circulation & avoid blood clot formation in legs. Patients are able to drink after 3 to 4 hours & should be able to eat a little amount later in the day. Patients will be discharged after 2 to 3 days when they feel comfortable. Patients need to take it easy for 8 weeks, but should start walking & performing normal activities.They should bear in mind that the time span for returning to daily routine is different for everyone. Maintaining an optimistic attitude, a well-balanced & healthy diet & ensuring sufficient amount of rest are brilliant ways to speed up recovery. Signs of infection like redness, swelling or discharge from the incision site & fever should be brought to the doctor’s attention immediately. Regularly attending follow-up sessions with neurosurgeons will ensure a healthy recovery.
Most common complications associated with foraminotomy surgery include the following.
- Adverse anesthesia reaction
- Nerve damage
- Increasing leg or arm pain, numbness or weakness
- Problems with balance or walking
- Worsening neck pain
- High fever
- Redness, swelling or high temperature
- Swelling or pain in calf muscles
- Shortness of breath or chest pain
- Leakage of fluid from the wound
These complications can be properly managed by following the surgeon’s instructions. Whenever patients observe any of these complications after foraminotomy surgery, they should immediately call the neurosurgeon.
It has been observed that almost 80 – 90 percent of patients get significant benefits from foraminotomy surgery & which are generally maintained in the long term as well. Mostly, a major symptom which highly improves after foraminotomy surgery is the harsh arm pain. However, neck pain & headaches may still persist. Next symptom to effectively feel better is normally weakness. Patient’s strength may not entirely return back to normal but a remarkable improvement is experienced over several months. Pins & needles or numbness may or may not improve with foraminotomy surgery, due to the fact that the nerve fibers emitting sensation are vulnerable to pressure & thinner. They are more handily & permanently hurt than other nerve fibers. The condition of numbness may take up to a year to improve.
Medical Tourism for Radiculopathy (Pinched Nerve)
Patients suffering from the condition of pinched nerve or nerve compression usually opt for foraminotomy surgery. Apart from high success ratio, foraminotomy surgery dramatically improves the condition from worsening pain in most of the patients. Medical tourism across the world is gaining leverage & according to recent statistics, countries like India, South Korea, United Arab Emirates, Turkey & Germany are some of the favorites. They are recognized as centers of healthcare excellence due to the fact that they have a large pool of world-class neurosurgeons & orthopedic surgeons who excel in performing spinal surgeries such as foraminotomy surgery. Moreover, the cost of foraminotomy surgery in these destinations is economical & within the reach of a common man. International patients only have to pay one-third of the total amount that they might have to pay in other western developed countries like Canada & the United States.
Foraminotomy Surgery with Travcure Medical Tourism
Travcure Medical Tourism is a globally trusted name in the field of healthcare tourism helping a wide range of international patients to acquire finest & cost-effective procedures.Travcure has tie-ups with a massive number of leading multispecialty hospitals & clinics across the globe including hospitals in Turkey, Germany, United Arab Emirates & India. Healthcare experts at Travcure ensure that overseas patients get excellent nursing care & medical provisions in hospitals maintaining international standards of quality & outstanding practice. High-class neurological treatments & other medical services offered by Travcure are the best a patient can get, both in terms of affordability & reliability. Patients can depend on the staunch facilities provided by Travcure & expect hassle-free medical tours.
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