To understand foraminal stenosis, also called neural foraminal stenosis, first let’s define a foramin. The nerves in the spinal canal will exit at each disc space level through a small tunnel on each side of the spine called a foramin. The borders of the foramin are the disc in the front and the facet joint in the back. Problems to either of these structures, such as bone spurs, disc bulges and disc degeneration or herniation, can form debris and lead to narrowing of this space called foraminal stenosis.
What causes Foraminal Stenosis?
Quite similar to spinal stenosis, foraminal stenosis can affect one or more areas of your spine. In addition to the causes listed above, other common causes of neural foraminal stenosis include spondylolisthesis, synovial cyst and scoliosis. The narrowing of the foramin can cause compression on the nerve that is exiting through it, giving symptoms of a pinched nerve.
Symptoms of Foraminal Stenosis
- Pain in the affected nerve distribution area
- Sensations of burning, tingling, and pins and needles in the affected arms or legs
- Numbness in the affected extremity
- Weakness in a specific muscle or muscles of the affected arms or legs
The MISI Approach to Treating Foraminal Stenosis
Although not all foraminal stenosis cases must be treated, when patients have symptoms affecting their quality of life, there are several options available.
- Anti-inflammatory (NSAID) medication
- Pain Medication
- Chiropractic Treatment
- Physical Therapies
- Massage Therapy
- Injection Treatment
For patients who fail to respond to conservative treatment, surgery may be an option. Also, in some cases the stenosis is critical and if ignored, loss of function may occur and nerves can become irreversibly damaged. The surgical treatment of foraminal stenosis is dependent on the cause of the stenosis. The goal of treatment is to increase the opening space for the nerve exiting through the foramin. For mild to moderate foraminal stenosis, a simple outpatient decompressive procedure performed through an incision less than one-inch may be effective. In some lumbar cases, this can be done endoscopically. For cases of severe foraminal stenosis, or those with structural abnormalities such as scoliosis and spondylolisthesis, a stabilization procedure is usually performed in addition to the decompression. These foraminal stenosis treatments can also be performed through an incision less than one-inch in length, allowing for a faster recovery in an outpatient surgery center. These techniques minimize the damage to surrounding tissues, including muscle, so our foraminal stenosis treatment allows you to get back to life as quickly as possible.