A lumbar foraminotomy is a surgical procedure that involves enlarging the small opening, known as a foramen, between two vertebrae in the spine. The foramen serves as a channel for spinal nerves, allowing them to transmit messages between the body and the brain. When the foramen becomes narrowed or constricted, it can put pressure on the nerves, resulting in symptoms such as:

• Lower back pain radiating to the buttocks
• Tingling in the arms and legs
• Weakness in the legs or spine
• Numbness in the back or legs

A lumbar foraminotomy relieves symptoms in the lower part of the spine. However, a foraminotomy can be done on any part of the spine, depending on where the compression is. A cervical foraminotomy, for example, treats nerve compression in the neck.

Several spinal disorders may result in nerve compression. The below conditions can all cause the foramen to become too small, putting pressure on the surrounding nerves.

• Degenerative disc disease can cause the height of the foramen to collapse and pinch a nerve
• Stenosis, which causes the narrowing of the spinal and nerve root canals
• A Herniated disc, when its contents protrude against one of the nerve roots exiting the spine
• Spondylosis, which is degenerative arthritis in the spine that causes bone spurs

Nerve compression can happen at any part of the spinal column. Depending on which part of the spine is affected, your surgeon may recommend cervical foraminotomy, which is done on the upper spine or neck, or lumbar foraminotomy surgery, which is done on the lower back.

Lumbar foraminotomy surgery may be necessary if you’re dealing with chronic back pain, discomfort, or weakness that hasn’t responded to conservative treatments like physical therapy, medication, or injections. Dr. Gottlieb starts each treatment plan with these non-surgical techniques.

However, if you’re finding that your symptoms are impacting your overall quality of life, it may be time to consider spine surgery. Lumbar foraminotomy surgery can provide significant relief for symptoms caused by spinal stenosis, disc herniation, or stenosis. Your surgeon will ultimately determine if this surgery is the best course of action for your condition.

Your surgeon will provide you with a comprehensive explanation of the procedure. The surgery itself is typically performed on an outpatient basis and usually takes a few hours.
Dr. Gottlieb typically follows this step-by-step process:

1. Anesthesia will be administered to ensure that you are comfortably asleep throughout the entirety of the procedure.
2. You will be positioned face-down on the surgical table.
3. Your surgeon will make a small incision near the affected area.
4. Utilizing a special microscope, the surgeon will carefully guide a tube through the incision to reach the targeted region.
5. Small tools will be employed to expose and widen the affected foramen.
6. If required, the surgeon will address any blockage that is exerting pressure on the nerve, including bulging discs or bone spurs.
7. Once the procedure is completed, the incision will be closed.

An endoscopic foraminotomy is performed using a small camera and instruments, which are inserted through tiny incisions. This allows for greater precision and less tissue damage. The choice of procedure by your surgeon will depend on your specific needs.