spine

Foraminotomy

The cervical disc acts as a shock absorber between the bones in the neck. Typically soft disc herniations are seen in people in their 20's and 30's. The normal gelatin-like shock absorbing center of the disc dehydrates gradually, and as this happens the space between the vertebral bodies collapses. As the disc space narrows, added stress is applied to the facet joints of the spine. This causes neck pain as a result of further wear, arthritis, and degenerative disease. The cervical disc can also protrude and put pressure on the spinal cord or nerve roots when the rim of the disc weakens. This is known as a herniated cervical disc/disc bulge.

When people say they have a "slipped" or "ruptured" disc in their neck what they are actually describing is a herniated disc, which is a common source of pain or weakness in the neck and arms. The combination of this Neck and radiating arm pain is called Cervical Radiculopathy.

cervical_radiculopathy

Surgical Treatment

Surgery may be necessary for patients with progressive neurologic symptoms or severe pain that does not improve with other treatments. Surgery may be required if a disc fragment lodges in the spinal canal and presses on a nerve, causing significant loss of function. Surgical options in the neck are varied and depend entirely on the patient, the symptoms and the pathology. For some patients, a smaller surgery may be performed on the back of the neck that does not require fusing the bones together. These posterior approach options can include a microdiscectomy or posterior procedure like a minimally invasive microscopic Foraminotomy (click the graphic below), depending on the size and position of the disc herniation.

cervical_posterior

Here you can see how a disc herniation can cause pressure on a nearby nerve root. In order to remove this pressure you can see how Dr. Pablo Pazmino can access the offending disc herniation through a posterior approach by removing a tiny window in the bone, represented here by the highlighted orange area.

disc_herniation

bony_window

Here is a view from the back of the neck. With the bony window now removed Dr. Pablo Pazmino can completely decompress the nerve removing all pressure on the exiting nerve root.

When Should You Seek Medical Care?

If severe pain occurs following an injury (motor vehicle accident, diving accident, or fall), a trained professional, such as a paramedic, should immobilize you to avoid the risk of further injury and possible paralysis. Emergent medical care should be sought immediately.

Immediate medical care should also be sought when an injury causes pain in the neck that radiates down the arms and legs.

Radiating pain, or numbness in your arms or legs which causes weakness in the arms or legs without significant neck pain should also be evaluated.

If there has not been an injury, you should seek a Spinal Evaluation with Dr. Pablo Pazmino when pain is:

  • Continuous and persistent
  • Severe
  • Accompanied by pain that radiates down the arms or legs
  • Accompanied by headaches
  • Accompanied by numbness, or tingling
  • Accompanied by weakness!

Many patients seek care for Foraminotomy pain by Dr. Pablo Pazmino because as an Orthopaedic surgeon he is specifically trained to diagnose, treat, and help prevent problems involving the muscles, bones, joints, ligaments, and tendons. Although Dr. Pablo Pazmino confines his practices to Spinal pathology he also treats a wide variety of diseases, injuries, and other conditions, including Herniated Disc.

 

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