Endoscopic Posterior Cervical Foraminotomy/Discectomy

What is an endoscopic posterior foraminotomy/discectomy?

Endoscopic posterior foraminotomy/discectomy is performed through a small tube placed through a small skin incision at the back of the neck. The small tube allows the surgeon to place an endoscope through the tube and to use tools through the endoscope to remove disc (discectomy) or to free the nerve from compression (foraminotomy). Endoscopic means that the surgeon performs the procedure through a channel in the endoscope, while watching with the endoscope camera.

How is a endoscopic posterior foraminotomy/discectomy performed?

Endoscopic posterior foraminotomy/discectomy is a minimally invasive procedure for the treatment of pain arising from compression of the nerve as it travels through the natural passage ways of the spine. To start the procedure, a tiny skin nick is made on the skin at the back of the neck. A small tube is placed through the skin and, using x-ray guidance, the tube is advanced to the facet or neck joint. The facet joint is a joint in the neck that not only connects vertebra to one another but also forms the back of a passage way for nerves to travel out of the neck. Using specialized instruments surgery is performed through the small tube and a small hole (foraminotomy) is made along part of the joint. This small opening frees up the nerve and allows the surgeon to remove some forms of herniated discs (discectomy). The procedure is guided by an endoscope, placed through the tube, and x-rays.

What are the advantages of endoscopic posterior foraminotomy/discectomy?

This procedure allows the surgeon to free up compressed nerve in the neck or remove some types of disc herniation through a tiny opening. The tiny opening means that there is minimal disruption to the facet joints or the muscles and ligaments of the neck. Performing surgery through a tiny skin nick and leaving healthy tissues intact means a same day procedure with a quicker recovery.

How long will the procedure take?

The procedure typically takes an hour to an hour and a half, depending on how many levels are operated on. After the procedure you will recover for two to four hours before going home.

What is the recovery like?

You will walk out the door and go home the same day with pain medications. For the first two to three days we advise plenty of rest with light neck stretching exercises. Activity should be tolerably increased over 7 days and should consist of short walks at first and a gradual return to normal daily activities. Avoid strenuous activity and heavy lifting (over 10 to 15 pounds) for the first several months. If one’s job is sedentary then work can be resumed in 7 days. At 4 weeks physical therapy can be resumed. Since the procedure is minimally invasive rehabilitation will generally be easier and faster than with traditional surgery. Recovery time will vary based on individual factors.

The 4 Pillars of Treating Chronic Spinal Pain

George Rappard MD discusses the 4 key pillars of spine care. The 4 pillars are physical therapy and chiropractic care tailored to your condition, appropriate selection of medical therapy, pain injections targeting your specific pain source and, as a last result, minimally invasive motion and stability preserving spinal surgery performed as an outpatient procedure. Through effective use of the first 3 pillars only about 5% of our patients need to go on to have back surgery or neck surgery.

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