Sydney Brain & Spine

Cervical Foraminotomy

This surgery creates more space for a compressed spinal nerve in your neck. The procedure relieves painful pressure caused by a herniated or degenerative disc.


You will be given a general anaesthetic to put you to sleep. A breathing tube (endotracheal tube) will be inserted and you will be given a dose of antibiotics to help prevent infection. You will be placed face down on a special operating table, and your head secured in place with a special clamp. This ensures your neck does not move throughout the procedure. Calf compression devices will be attached to your legs, helping to minimise the risk of developing blood clots in your legs. An X-ray will be taken to identify and mark the level of the spine requiring surgery.

A small incision is made over the area of the spine to be treated, and the muscle is moved aside with a retractor. Microsurgical instruments are used to carefully remove a small amount of bone that serves as the outer wall of the foramen. Once the foramen is opened the nerve root can be seen.  Any bone, ligament, disc or soft tissue that is compressing the nerve will be removed using special instruments. This creates more room for the nerve root to pass through the foramen and relieves the pressure, allowing it to move freely.Once the decompression has been performed, the retractor is withdrawn, and the skin is closed using absorbable sutures that do not need to be removed. A small dressing is applied.


Patients are able to mobilise the same day as the surgery is performed, and stay in hospital for 2-3 days. It is usual to feel some pain after surgery, especially at the incision site, and have some associated neck tightness, but generally this should decrease a little each day. You will be discharged with pain relief medications to manage this, and given a booklet outlining all postoperative instructions.  Once at home you will receive a follow up phone call from the practice nurse. Postoperative appointments will be arranged for you at both the 2 and 6 week mark with the practice nurse and Dr winder respectively.

Once home, frequent short walks are recommended. This will help in your recovery and also reduces the risk of blood clots forming in your legs.  A gradual increase in physical activity is advised.

You must not lift anything heavier than 5kg for the first 6 weeks post-operatively and avoid twisting and bending movements.  Avoid housework such as vacuuming, mowing and hanging washing on the line for the first 6 weeks postoperatively.

Ensure you maintain correct posture when working in front of a computer. You will need to take frequent breaks, assitting for prolonged periods will cause your neck to stiffen and your posture to deteriorate.

You may drive 1 week after surgery if you are comfortable to do so but avoid long distances.

Physiotherapy is recommended 2 to 3 weeks after your surgery. Gentle stretches and postural control exercises will help to strengthen your neck after surgery.

Keep your wound dry, you will be given extra waterproof dressings on discharge. You may shower as normal but if your dressing becomes waterlogged it should be changed.  Dr Winder’s practice nurse will check your wound at your 2 week postoperative appointment.

Dr Winder will discuss resuming sports and other physical activity at your 6 week appointment

Please note that it is common to have localised neck pain for up to 4-6 weeks. This will generally resolve spontaneously and is due to the sensitivity of the cervical musculature.

Depending on the degree of nerve compression, it is also very common to have some degree of arm discomfort, as it will take time for the compressed nerve to recover. Please do not be alarmed if you have some intermittent arm pain, as this is a normal part of the healing process.It is usual to feel some pain after surgery, especially at the incision site.


There are risks associated with any surgery, the most common being:

  • Deep vein thrombosis (DVT)
  • Urinary tract infection (UTI)
  • Chest infection
  • Pulmonary embolism (blood clot in lungs)
  • Myocardial infarction (heart attack)
  • Stroke

A full medical history including allergies, medical conditions and previous surgery is required before your surgery to help reduce the risk of complications occurring.

Some of the possible complications for spine surgery include:

  • CSF leak
  • Bleeding
  • Neurological injury

If you require surgery, Dr Winder will discuss all relevant risks during your consultation.