Herniated disc surgery foraminotomy is an option for injured workers after trying nonsurgical treatment first. At McCormick Law Office most of our clients have had significant neck or back surgery, and to get the best results a workers' compensation attorney must be familiar with the different surgical options available to treat injured workers with herniated discs.
A foraminotomy, called foraminectomy if it removes a lot of bone material, is a nerve decompression surgery that is performed to enlarge the passageway where a spinal nerve root exits the spinal canal.
The neuroforamen are passageways that are naturally formed on either side (left, right) between an upper and lower vertebra. In between each upper and lower vertebra is an intervertebral disc. The height of the disc separates the two vertebrae and creates the size of the neuroforamen.
Foraminotomy alleviates the symptoms of foraminal stenosis. In foraminal stenosis, a nerve root is compressed inside the neural foramen. This compression is usually the result of degenerative (or wear and tear) changes in the spine.
An employee's job duties over time result in repeated wear and tear stresses and strains on the neck or low back causing the spinal discs to begin to collapse. As the space between the vertebral bodies shrinks, the opening around the nerve root narrows. This squeezes the nerve. The nerve root is further squeezed in the foramen when the facet joint lining the outer edge of the foramen becomes inflamed and enlarged as a result of the same degenerative changes.
The degenerative process can also cause bone spurs to develop and point into the foramen, causing further irritation. In a foraminotomy, the surgeon removes the tissues around the edges of the foramen, essentially widening the opening in order to take pressure off the nerve root.
A foraminotomy involves an incision through the skin and muscle to reach the spine. The muscles may be dissected (cut apart) or retracted using an endoscope or tubular retractor. Special cutting instruments and/or a drill are used to remove bone spurs, thickened ligaments, and debris (e.g. a herniated disc) that obstruct the neuroforamen passageway and compresses (pinches) the spinal nerve root, which can cause inflammation and pain. This process is called nerve root decompression. After the cleaning up of the neuroforamen, the muscles and soft tissues are put back in place, and the skin is stitched together.
Many injured worker's do quite well after a foraminotomy and return to work, but often with work restrictions so they do not wind up back in the doctor's office. However, for some the foraminotomy does not do the trick and more involved surgeries are performed either during the original procedure or afterward.