What Is Microforaminotomy?

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Microforaminotomy is a type of minimally invasive spine surgery that helps relieve pressure on your spinal cord and/or nerve roots (also known as decompression). This decompression is achieved by expanding the space or opening—called a foramen—where your spinal nerve roots exit your spine.

Traditional open foraminotomies have been around a lot longer than microforaminotomies, but they usually involve more cutting of your back muscles and tissues and a much larger incision.
In surgerySurgeons use highly specialized instruments to make very small incisions to reduce damage to your back muscles.However, during microforaminotomy, surgeons use highly specialized instruments to make very small incisions to reduce damage to your back muscles. There are many benefits of this technique, but some of the most important are: a faster recovery, less risk of infection, and less post-operative pain.

When Is Microforaminotomy Used?
Several spine conditions can cause your foraminal space to narrow, including degenerative disc disease, spinal stenosis , and spondylosis (spinal osteoarthritis). With less room to pass through, your spinal nerves can become pinched. Microforaminotomy is performed to relieve this pressure.

How Is Microforaminotomy Performed?
Microforaminotomies can be performed using one of the following techniques:

  • Mini-open: This technique is similar to an open foraminotomy, but with mini-open microforaminotomy, your surgeon uses highly specialized instruments and visualization tools to view your spine through smaller incisions.
  • Tubular: During this technique, your surgeon inserts a tube through a small incision, which is gently pushed through your muscles until it reaches your spine. Then, a series of progressively larger tubes is inserted, one tube around the other. These tubes help to slowly open up the area where your procedure will be done. The surgery is done through the tube using special instruments.
  • Endoscopic: This technique involves inserting an endoscope—a tiny video camera—through a tube, so your surgeon can get a better view of your spine. He or she will then use miniaturized instruments to remove the necessary bone.

During this procedure, you'll be lying on your stomach. Typically, you'll also be given general anesthesia. Then, your surgeon will decompress the nerve and open up your foramen by removing bone, disc fragments, or any other material that's pressing on your spinal nerves.

This surgery usually takes about 2 hours to perform.

Microforaminotomy Risks
All surgeries have some risks, such as blood loss during the procedure and infection, but there are other possible complications associated with microforaminotomy:

  • Your back pain and/or leg pain can return (ie, your surgeon may not have relieved enough pressure on your spinal cord and/or nerve roots).
  • Your spinal cord, nerves, and blood vessels can be damaged.
  • In rare instances, you can develop spinal instability (eg, spondylolisthesis).
  • If one of these complications arises, you may need an additional corrective surgery.

Microforaminotomy Recovery
Most patients have pain relief after a microforaminotomy and can quickly return to their normal routines. However, talk to your doctor about how fast you can return to exercise or your other daily activities.

Updated on: 03/13/18
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Jason M. Highsmith, MD
This article was reviewed by Jason M. Highsmith, MD.
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