The vertebrae (spinal bones) have openings known as neuroforamen on either side for the passage of spinal nerves. The neuroforamen are surrounded by tiny joints known as facet joints, present in pairs at the back of each vertebra, which connect and stabilize them together. Bone spurs herniated intervertebral disc material, and thickened ligaments can obstruct the neuroforamen, causing compression of the nerves, and pain in your arms and legs.
What are Lumbar Facetectomy and Foraminotomy?
Facetectomy and foraminotomy are the most common spinal surgical procedures recommended for chronic pain due to spinal nerve compression. Lumbar foraminotomy is a decompression surgery involving the removal of bone and tissue obstructing the neuroforamen to release the pressure on the spinal nerve roots. In severe cases, the entire facet joint is removed which is referred to as lumbar facetectomy.
Lumbar Facetectomy and Foraminotomy Procedure
- The procedure is performed under sedation. You will be made to lie on your abdomen, on the operation table. An incision is made through the skin to approach the spine.
- An X-ray is used to determine the position of the incision. The muscles are retracted with the help of a retractor. Specially designed cutting instruments are then used to remove bone spurs, thickened ligaments, and segments of the herniated disc.
- Micro-instruments are also employed to confirm whether the compressed nerves are completely free or not.
- Removal of the bones and tissues around the neuroforamen releases the compression over the nerve roots.
- Unlike foraminotomy, the fusion of the spine is required in facetectomy for stabilizing the spine. Finally, the incision is sutured
Postoperative Care following Lumbar Facetectomy and Foraminotomy
After undergoing a foraminotomy, you will usually be discharged on the same day of the surgery, whereas, facetectomy usually requires a stay in the hospital for a day or two. You will usually experience pain relief immediately after the surgery. However, sometimes, you may experience pain due to muscle spasms for a few days after the surgery. Your doctor will prescribe medications such as muscle relaxants and pain killers for the management of such pain.
General postoperative instructions for the patient after a lumbar foraminotomy or facetectomy include:
- Keep the incision clean and dry
- Avoid movements such as bending and twisting for at least 6 weeks
- Regularly take your prescribed medications
- Avoid lifting heavy objects
Risks and Complications of Lumbar Facetectomy and Foraminotomy
Lumbar foraminotomy or facetectomy is comparatively safe with minimal complications. Some of the potential risks of these procedures include bleeding, infection leakage of the spinal fluid, nerve injury and injury to the spinal cord.