The Bonati Institute Glossary: Foraminal Stenosis

The mission of The Bonati Institute is to provide hope to people suffering with chronic pain from a back or neck condition. We believe that a well-informed patient is vital to restoring hope and finding answers to pain. We developed this web site primarily to help educate pain sufferers and their families. We’ve found that the more individuals in pain learn about their anatomy, their condition and the options available to them the more likely they will be to choose the advanced arthroscopic procedures offered by The Bonati Institute.

Foraminal Stenosis

Foraminal narrowing or stenosis may arise without any disc herniation. The majority of symptoms are usually caused by one nerve root on one side. Typically, the condition is characterized by the following:

The pain develops slowly

The pain may develop over many years

The pain is not continuous

The pain is related to an activity or position

Unlike many other back or neck conditions, most conservative treatments for foraminal stenosis, such as pain medication, are unlikely to be of much benefit. Most often, patients choose either restricting activity or back surgery to relieve pressure in the nerve root from foraminal stenosis.

Foraminal stenosis is similar to spinal stenosis but primarily affects one or more vertebral foramen. The vertebral foramen is the small canal through which the nerve roots exit the spinal cord. In a normal spine the nerve roots have ample space through which they exit the spine. However, condition of age, injury or disease may constrict the available space within the foraminal canal and cause compression of the nerve root. Compression of the nerve root within the foraminal canal may be the result of bone spurs, a herniated or bulging disc, scar tissue or arthritis.

Symptoms

Foraminal stenosis can produce radicular pain which is pain that travels to an extremity along the path of the nerve. For example, foraminall stenosis may cause the radicular pain of sciatica, or pain that radiates along the sciatic nerve down the back of the thigh and calf into the rear of the foot. Symptoms of foraminal stenosis may also include numbness, weakness and burning or tingling sensations. If ignored, foraminal stenosis may result in loss of sensory and/or motor functions.

Probable Treatment

The Bonati Arthroscopic Laser Foramenoplasty

Foramenoplasty is performed through a small incision in the back, while the patient is conscious under a low-level IV sedation. The narrowed foramen is located with fluoroscopic x-rays, and a guide wire is placed down to the area of disease. Then, a hollow tube is inserted over the wire to the foramen.

The endoscope and surgical instruments are inserted through the tube. The miniaturized television camera on the endoscope provides direct visualization of scar tissue, bone spurs, and diseased disc material. After surgery the patient is prescribed a short course of physical rehabilitation

The benefits of this procedure:

• Fewer risks, local anesthesia, a small incision
• Minimal blood loss
• Short recuperation time
• Minimal damage to tissues
• Surgeries are done in an outpatient setting
• Patient sees a faster return to a normal lifestyle