Disc Prolapse & Cervical Foramenotomy
Cervical posterior foraminotomy is an operation carried out from the back of the neck for arm pain. It endeavours to relieve compression on the nerve root in the nerve root canal through which the nerve passes as it leaves the cervical spine. It should relieve arm pain in 80-85% of people. It can also help weakness in the arm. Cervical posterior foraminotomy however has a mixed effect on neck pain. Sometimes neck pain improves, in a small number of people it will be worse or it will remain unchanged. When we talk about this operation relieving arm pain we really mean any pain experienced from the mid upper arm downwards. Neck pain includes that felt over the shoulders, neck, back of the head, between the shoulder blades and sometimes over the scalp to the forehead. This operation can also help symptoms of pins and needles and muscle weakness but may not resolve areas of numbness.
Overall cervical posterior foraminotomy is a very safe and effective operation but as with all operations there are risks. The risks include nerve root damage, which can leave you with a numb/floppy hand/arms, haemorrhage, infection and fluid leaks. The latter three complications can lead to a longer stay in hospital and/or second or third procedures. These risks total some 1-2%. Cervical posterior foraminotomy does not protect you from the small possibility of further disc prolapses and further wear and tear in the neck.
Most people are admitted on the day of surgery and can expect to go home the same day or sometimes the day after. The operation usually takes less than an hour. We get you up as soon as you are able and you are able to go home as soon as you are comfortable, usually the same day. Most people will experience some neck pain afterwards, but this is considerably less with the keyhole technique.
The recuperation period varies between people but on average is 2-4 weeks, with keyhole surgery. During this time we encourage people to walk as much as possible. You should refrain from driving for 1-2 weeks, longer if you are still in pain. We do not routinely recommend any further physiotherapy at this early stage. At the 2-3 month stage you should be thinking about taking some more vigorous exercise. Walking, swimming, aerobic classes are all very suitable but please avoid contact sports, rowing machines and lifting weights! Physiotherapy can help if you are having difficulties at this stage.