Know somebody with arthritis, bone spurs, or bulging or herniated discs in the spine? Chances are you do – whether it’s yourself or a loved one – since these conditions are among the most common back problems experienced in the United States. The pain resulting from all of these issues stems from compressed nerves in the spine, and all can potentially be treated with a minimally invasive procedure known as endoscopic foraminotomy, according to Kaixuan Liu, MD, PhD, founder and president of Atlantic Spine Center.
The words “endoscopic foraminotomy” may be hard to pronounce, but the concept for the surgery itself is relatively simple, Dr. Liu says. A same-day procedure with a rapid recovery time, it requires only a tiny incision compared to traditional “open” surgery and releases pinched nerves by removing the source of the trouble – whether bone spurs, protruding discs, overgrown ligaments or other causes.
“A huge number of adults – about 8 in 10 – suffer from chronic lower back or neck pain at some point in their lives,” he says, “but despite the prevalence of the problem, few are aware what surgical options exist if they exhaust treatment options such as medication, physical therapy and other non-invasive measures without finding relief.”
“Many are surprised that some of the most common causes of back pain are often fixable with a quick surgical procedure they didn’t even know existed,” adds Dr. Liu, who is fellowship-trained in minimally invasive spine surgery. “I’m happy to educate them about endoscopic foraminotomy because I’ve seen again and again how well it can work.”
What conditions can be treated with endoscopic foraminotomy?
While the term “endoscopic foraminotomy” may seem a little obscure, the spinal conditions it can treat are far from it. In fact, Dr. Liu says, some of the most-seen back problems top the list, including:
Estimated to affect nearly 30 million Americans, osteoarthritis – typically referred to merely as arthritis – is caused by wear and tear in the joints. In the spine, constant movements of vertebral joints as we bend, lift, twist and stretch can cause the joints to thicken and harden as we age. Vertebral joints can end up pinching nerves in the spine, with the effects radiating along nerves to the buttocks or upper thighs. The resulting back pain and stiffness can also lead to decreased flexibility in the spine, especially when sitting, standing and walking.
Known medically as osteophytes, bone spurs can be considered a “cousin” to arthritis, since they’re often created from the joint-on-joint friction and inflammation triggered by arthritis. In the spine, the bony ends of vertebrae rub directly on each other, forming extra, irregular bony growths that can compress spinal nerves. Bone spurs can also develop as the soft discs between vertebrae become thin and collapse with age, which narrows the space between vertebrae and pushes on spinal nerves.
Bulging or herniated discs
The soft, squishy discs between spinal vertebrae cause pain when they bulge or rupture (also known as “herniate”). That’s because a disc’s ability to serve as a shock absorber for the spine – promoting easy movement – deteriorates when it protrudes or leaks, pushing on nerves in either the cervical or lumbar spine. A wide variety of factors contribute to bulging or herniated discs, including genetics; the normal aging process; severe trauma, such as a car accident; heavy lifting; an unhealthy diet; being overweight or sedentary; and alcohol or tobacco abuse. About 9 in 10 cases of bulging discs occur in the lower back.
Other conditions potentially treatable with endoscopic foraminotomy, which relieves many causes of pinched nerves, include foraminal stenosis, a narrowing of the canal through which nerve roots branch off from the spinal cord; failed back surgery syndrome; and spine degeneration.
Surgery Offers Many Advantages
For all these causes of compressed nerves, endoscopic foraminotomy has become an increasingly widespread option to help patients experience maximum pain relief with minimal downtime. During the brief surgery, a series of small tubes of increasing size are inserted into a small incision, enabling surgeons to view the problematic nerve root in the neck or lower back. Once surgical tools are in place, bone or tissue compressing the nerves is removed, and the incision is closed with just a few stitches.
In just a few hours, patients return home and are soon able to resume all their previous activities, with one big difference – the pain that may have accompanied them for months or years has subsided.
“It’s a true minimally invasive procedure,” Dr. Liu says, “and doesn’t even cut through muscle fibers in the back. The advantages to endoscopic foraminotomy are too numerous to count, but include no hospitalization, minimal or no blood loss, and a quick recovery. Patients are thrilled that their pinched nerves have been eliminated and they can move around comfortably again.”
Kaixuan Liu, MD, is a board-certified physician who is fellowship-trained in minimally invasive spine surgery at Atlantic Spine Center.