What are the Treatment Options for Foraminal Stenosis?
Depending on the severity of your symptoms, managing foraminal stenosis through a non-surgical treatment plan is quite common. Treatment usually includes anti-inflammatory medications, commonly referred to as NSAIDS (Non steroidal anti-inflammatory drugs) cortisone injections, activity modification, physical therapy, and exercises.
Since some movements, such as bending over, can relieve pain, activity modification can help manage symptoms and is an essential foundation in treating foraminal stenosis. Epidural steroid injections can provide temporary pain relief to help ensure a successful recovery.
Physical Therapy for Foraminal Stenosis
Neural foraminal narrowing treatment including physical therapy will often show promising results within the first few weeks of treatment. Your therapy program will be designed to help restore the flexibility and strength in your neck or back. By improving your strength and flexibility and correcting your posture, it should help to reduce your symptoms. It is important to note that a proper diagnosis should be attained before beginning a therapy program, as an improper diagnosis could lead to an incorrect treatment plan. If there is nerve compression with radiating pain leading into the extremities it should be investigated before proceeding further.
Foraminal Stenosis Surgery
The decision to proceed with surgery should never be taken lightly. Foraminal stenosis surgery should not be attempted until months of conservative treatment methods have been exhausted. The exception to this rule would be if the stenosis is so great that it is causing nerve death.
Even once conservative measures have been exhausted, some patients may choose to live with their symptoms if they are not affecting their quality of life. Once a patient complains about the inability to walk for lengths of time without sitting to relieve pain, they are usually at a stage where surgical intervention would likely benefit them.
Approaching Foraminal Stenosis Surgery
Surgery is traditionally performed as an open procedure, meaning the surgeon makes a large incision in the skin and cuts away muscle to gain access to the narrowing. Thanks to the advancement of technology, today's surgery can be performed through an endoscope, meaning only a very small incision is needed for the surgeon to perform the surgery. The surgeon uses a tiny camera to see inside the spine so the surgery can be performed with greater precision.
New - Endoscopic Foraminotomy Treatment
The Endoscopic Foraminotomy begins with the patient being brought to the operating room and administered intravenous sedation. A local anesthesia is given to the patient and a small metal tube, about the size of a pencil, is gently inserted into the neuroforamen. The surgeon will be able to use this tube to insert the surgical tools that will be needed to remove the debris causing the narrowing. Once the problem is located and isolated with the use of a camera, under direct vision the bone spurs, scars, or ligament overgrowth is removed. The tube is then removed and the incision is closed with one or two stitches.
Upon completion, the patient is encouraged to walk around and is free to leave the surgical center, with a companion, the same day. After a follow-up visit with the surgeon the next day, the patient can go home for a quick recovery.
Overall, the endoscopic procedure for decompression is among one of the most rewarding spine surgery options. After an endoscopic foraminal procedure, most of our patients can easily get back to their old self and enjoy the many pleasures a life free of back pain brings them.