Posterior Cervical Foraminotomy

INTRODUCTION: Posterior cervical foraminotomy is a motion-sparing technique utilized to treat radiculopathy resulting from herniated discs and/or osseous foraminal stenosis. This procedure allows for decompression of the target nerve root without the need for an anterior approach, thus mitigating the risk profile of anterior procedures. Posterior cervical foraminotomy has demonstrated equivalent outcomes to anterior cervical discectomy and fusion in improving pain and weakness, while allowing for rapid recovery. SURGICAL TECHNIQUE: Careful evaluation of preoperative imaging is necessary to assess the location and nature of the compressive pathology. The procedure consists of resecting the lateral lamina and medial aspect of the corresponding facet to decompress the exiting nerve root by unroofing the foramen. Discectomy can be performed as needed. Complications include nerve root injury, durotomy, incomplete symptomatic relief, and rarely instability and/or postoperative kyphosis. CONCLUSION: Posterior cervical foraminotomy is an effective, motion-sparing treatment for cervical radiculopathy that provides durable symptomatic relief and rapid recovery in well-selected patients while avoiding the risk profile associated with anterior cervical approaches. Careful attention to each surgical step and ensuring an adequate decompression are necessary for maximizing patient benefit and minimizing potential complications.