Microscopic Posterior Foraminotomy/Laminotomy for Nerve Root Decompression

In the absence of any indication for decompression, dynamic stabilization through a minimally invasive paraspinal approach is the method of choice. This chapter discusses the indications, contraindications, preoperative planning, including physical examination and radiological studies, a brief description of the open surgical technique, complications, and outcomes of the laminoforaminotomy. In 1943, RE Semmes and F Murphy described a unilateral rupture of the sixth cervical disc resulting in compression of the seventh cervical root in the neural foramen. The surgical literature supports the posterior froaminotomy/laminotomy approach for several cervical and cervicothoracic disorders. Preoperative planning should include a detailed history and physical exam, as well as a thorough neurological exam, with affected nerve roots identified by sensory, motor, and reflex abnormality. Posterior laminotomy/foraminotomy is historically a very successful surgery with few complications when used to treat appropriately selected patients.