Minimally invasive cervical Laminoforaminotomy
Minimally invasive cervical laminoforaminotomy is a keyhole surgery performed to relieve the pain and weakness resulting from a compressed or pinched nerve. Minimally invasive cervical laminoforaminotomy is a minimally invasive approach, which does not require cutting or stripping of upper back muscles from the spine, contradictory to traditional open spine surgery. It requires neck muscles to be cut or stripped to approach the spine, in the minimally invasive way the target is reached by splitting the muscle so that the muscle architecture is well maintained.
Why do I require Minimally invasive cervical Laminoforaminotomy?
Many conditions like disc herniations, overgrowth of bone, bone spurs and thickened ligaments can narrow the neural foramen (exit area for the nerve ) and pinch the spinal nerves producing symptoms. Minimal invasive posterior cervical foraminotomy alleviates spinal nerve root compression by creating more space for the nerve root to pass through the foramen. Removing a portion of a herniated disc, thickened ligament, bone spur decompresses the nerve root and broadens the passage for the nerve.
This procedure can be done in minimally invasive fashion with a small incision, preserving muscle architecture and minimal bone removal not requiring fusion preserving mobility of the neck.
What are the symptoms?
Pain that radiates to arm and hand
Tingling and numbness in arm, hand and fingers
Weakness in arm and hand
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How is it diagnosed?
Patients presenting with these symptoms needs thorough neurological examination and magnetic resonance imaging with neutral and dynamic x rays of the cervical spine.
What are the treatment options?
Treatment option varies and depends upon severity and degree of compression. Conservative treatment
Warm and cold compression therapy.
Pain management – Analgesic, Muscle relaxants, Anti-convulsant ( Gabapentin and Pregabalin).
Surgery is required when pain is not relieved with medication and rest and weakness of hands.
Surgery is done under general anaesthesia and the patient is positioned face down on the operating table(prone). Incision less than an inch is made in the upper part of the posterior of the neck on the symptomatic side. A muscle splitting approach (as opposed to muscle-cutting), a small tubular retractor is placed to access the spine. Under microscopic vision a small opening (laminotomy) in the bone is made to access the disc herniation or bone spur which is then removed, thus decompressing the pinched nerve. The tube is then removed allowing the muscle to fall back in its normal position and a couple of stitches are placed to close the incision. The patient is mobilised the same day and can be discharged the following day without any neck collar.