Posterior foraminotomy and discectomy is one of the oldest operations for cervical disc disease, and remains effective with few variations from the original surgery. It is generally used for disc herniations off to one side, but is also effective in relieving arm pain caused by nerve pressure from arthritic bone spurs.
The patient is placed face down on the operating table and the head is secured with three pins and flexed forward. After the surgery the patient will have three small holes, usually behind the hairline, will heal up quickly and without the need for sutures.
An incision is made in the back of the neck and the muscles are removed from the bones on the affected side. A drill is then used to widen the opening through which the nerve passes, and any bone spurs pressing on the nerve are removed with special instruments. This is generally done with an operating microscope for improved vision.
After the opening for the nerve is widened, the disc space is explored. Any bulges or extruded disc material is removed, but the majority of the disc is left undisturbed. The incision is then closed with sutures and bandaged. The bandage can be removed 48 hours after surgery, but should be kept dry for about a week.
