The vertebrae (spinal bones) have openings known as neuroforamen on either side for the passage of spinal nerves. The neuroforamen are surrounded by tiny joints known as facet joints, present in pairs at the back of each vertebra, which connect and stabilize them together. Bone spurs, herniated intervertebral disc material, and thickened ligaments can obstruct the neuroforamen causing compression of the nerves and resulting in pain in the arms and legs.
Facetectomy and foraminotomy are the most common spinal surgical procedures recommended for patients suffering from chronic pain due to spinal nerve compression. Lumbar foraminotomy is a decompression surgery involving the removal of bone and tissue obstructing the neuroforamen to release the pressure on the spinal nerve roots. In severe cases, the entire facet joint is removed which is referred to as lumbar facetectomy.
The surgical steps involved in foraminotomy and facetectomy are:
Patients undergoing a foraminotomy are usually discharged on the same day of the surgery whereas the facetectomy patients have to stay in the hospital for a day or two after the procedure. Most patients experience pain relief immediately after the surgery. However, some may experience pain, due to muscle spasms, for a few days after the surgery. The doctor will prescribe medications such as muscle relaxants and pain killers for the management of such pain. General post-operative instructions for the patient after a lumbar foraminotomy or facetectomy include:
Lumbar foraminotomy or facetectomy is comparatively safe with minimal complications. Some of the potential risks of these procedures include bleeding, infection, leakage of the spinal fluid, nerve injury and injury to the spinal cord.