Guide to Advanced Surgery for The Spine
Why Choose Cedars-Sinai Marina del Rey Hospital for Foraminal Stenosis Treatment?
The highly skilled surgeons at Cedars-Sinai Marina del Rey Hospital offer minimally invasive surgical procedures for patients diagnosed with foraminal stenosis, such as endoscopic foraminotomy and laminotomy. Thus, depending of the complexity and type of the condition, patients can be further guided towards the most suitable treatment option.
Foraminal stenosis is the narrowing of the cervical disc space. The foramen is constricted and compressed against the spinal cord and/or spinal nerves. Most symptoms are usually caused by one nerve root on one side and the condition is characterized by non-continuous pain developing slowly over many years, being related to an activity or a body position.
It can also occur in the lumbar spine, but it is more common in the neck area. The average age of the patient with foraminal stenosis is 55 years and older, but the disease may affect men and women of varying ages and physical activity levels.
If you smoke, are obese, have a sedimentary lifestyle, and if you lack proper nutrition, you have a higher risk of suffering from foraminal stenosis.
Although the primary cause of foraminal stenosis is aging, the wear and tear of daily activity can create debris that collects in the foraminal canals causing them to narrow and press on nerves. Other causes include: bone spurs, herniated disc, bulging disc, arthritis, ligament thickening.
Foraminal Stenosis Surgical Procedures Performed at Cedars-Sinai Marina del Rey Hospital
Cedars-Sinai Marina del Rey Hospital offers minimally invasive, laparoscopic procedures:
Endoscopic foraminotomy is a minimally invasive surgical procedure during which the performing surgeon makes a small incision, and introduces a small tube to the spine section that needs decompression. Breakthrough, tiny tools are then used to clean out bone, tissue or other blockages that cause the narrowing of the passageways between the vertebrae. Endoscopic foraminotomy at Cedars-Sinai Marina del Rey Hospital has several benefits:
- Minimally invasive procedure, with small incisions and no tearing of the muscles
- Outpatient procedure, requires no hospitalization
- Shortened recovery period after surgery
Our surgeons are experienced, highly skilled medical specialists, who perform minimally invasive foraminotomy procedure with great success.
Laminotomy is another common minimally invasive decompression surgery that Cedars-Sinai Marina del Rey Hospital offers. Through laminotomy, the performing surgeon removes a small portion of the lamina – a bony structure attached to each vertebra – in order to widen and decompress the spinal canal.
- Traditional Open Surgery Laminotomy
- Minimally Invasive Laminotomy
- 5-6 inches long incision
- 1-inch incision on the neck or the back
- Access to the spine
- the surgeon cuts through the surrounding muscle and tissue to gain access to the spine
- the surgeon moves muscle fibers to gain access to the spine
- scar tissue likely to develop
- no scarring
- several days of hospitalization
- outpatient procedure, the patient returns home on the same day
- Recovery period
- shortened, more efficient
Age, general health, medical history and other individual specificities are all factors that our trained and skilled surgeons at Cedars-Sinai Marina Del Rey Hospital will take into account, so that each laminotomy procedure can be performed according to each patient’s individual needs.
Drugs and Other Treatment Needed for Foraminal Stenosis
Unlike many other back or neck conditions, most nonsurgical treatments (such as pain medication) are unlikely to be of much benefit. Conservative treatment can include:
Pain medications »
Hot therapy »
Physical therapy »
Cold therapy »
These conservative methods of treatment are usually recommended before surgery is discussed. If these treatments are unsuccessful, surgical procedures (such as foraminotomy) can be an option. Minimally invasive procedures alleviates pressure on the nerves and/or spinal cord.
Types of foraminal stenosis by foramina impact type
Far Lateral Stenosis »
Unilateral Stenosis »
Bilateral Stenosis »
Types of foraminal stenosis by location
Cervical Foraminal Stenosis »
Lumbar Foraminal Stenosis »
Thoracic Foraminal Stenosis »
Symptoms of Foraminal Stenosis
The most common symptoms of foraminal stenosis include:
Symptoms however, vary depending on which section of the spine is affected:
- cervical foramen symptoms include: pain located in the neck and/or shoulders and may radiate to the arms, hands, and fingers. It may be numbing, sharp, tingling or burning.
- lumbar foraminal stenosis symptoms include: numbing, sharp, or tingling pain in the lower back, which may radiate to the buttocks, legs, calves, feet and toes.
Diagnosis of Foraminal Stenosis
In order to properly diagnose foraminal stenosis, you will undergo a consultation, which begins with a medical history. During a physical exam, your doctor will look for limitations on movement, pain, loss of reflexes or other symptoms when you move your spine. Other procedures that can help confirm the diagnosis include:
- bone scan – can detect arthritis, fractures, tumors and infections
- computerized tomography (CT scan) – can show the shape, size and nearby structures of the spinal canal
- magnetic resonance imaging (MRI) – can be helpful in detecting damage or disease in the soft tissues, such as the discs between vertebrae or ligaments
- myelogram – an opaque dye is injected into the spinal column followed by an MRI or CT scan; can show pressure on the spinal cord or nerves from herniated discs, bone spurs or tumors
- X-rays – can help rule out tumors, injuries or abnormalities
Painful compression of the spinal nerves occurs in the case of the narrowing of the foramina in the spinal column. Risk factors of foraminal narrowing include:
- Frequent participation in high-impact sports
- Genetic factors
- Occupations that require long periods of sitting, standing, driving, bending, lifting or twisting
- Sedentary lifestyle
- Spinal conditions such as bulging or herniated discs, arthritis, bone spurs, etc.
Causes of foraminal stenosis include can often root in aging-related degenerative conditions, such as:
The great majority of the conditions listed above are usually related to the aging process and accordingly, older people are more vulnerable to foraminal stenosis.
Other causes include:
Before surgery is discussed, our patients might be advised to seek out and try alternative medicine treatments, which may act as effective pain relievers, and may help reduce inflammation, stiffness and motion loss.
Our recommendation: though yoga exercises can have exceptionally beneficial effects on the overall health, never perform bending, twisting or inversion exercises without prior consultation with our medical experts.
- Deep tissue massage – direct pressure for tension release tension in the ligaments, tendons and muscles
- Cranialsacral therapy – gentle manipulation of the soft tissue and bones of the head, spine and pelvis
- Swedish massage – rubbing, kneading or stretching of the muscles
Chiropractic techniques are specific adjustment methods applied to the neck, arms, back and legs to relieve pressure in the spine and help treat foraminal stenosis pain. Chiropractic techniques may realign dislocated components of the spine. Manual realignment is able to create more space in the foraminal canal, which results in the decompression of the affected nerve.
Acupuncture consists of inserting thin needles into pressure points in order to interact with the energy flow running through the body. For foraminal stenosis, these needles are usually concentrated on the points that affect the area of the body affected by the condition. Acupuncture is often applied in combination with modern medicine treatments.
It is important to note that developed spine degenerations can hardly be changed. However, preventive lifestyle will significantly increase chances to keep a healthy spine and reduce foraminal stenosis risks. Lifestyle tip for the best possible spine health include:
- Avoiding the consumption of foods high in saturated fat
- Consuming foods high in calcium and omega-3 fatty acids
- Keeping alcohol consumption and smoking at a minimal level
- Keeping the body hydrated
- Avoiding the lifting or pulling of heavy objects
- Practicing regular stretching, restorative yoga, etc.
- Sticking to a regular exercise plan, while avoiding high-impact activities with a potential risk for back or neck injury
For any foraminal stenosis related questions, information or guidance, consult our specialty-trained, skilled medical experts at Cedars-Sinai Marina del Rey Hospital.