What Is a Foraminotomy?

The foramen is the opening between adjacent vertebrae through which a nerve root exits the spinal canal. Foraminal stenosis, the narrowing of this opening due to disc degeneration, bone spur formation, or joint hypertrophy, compresses the exiting nerve and produces radicular symptoms in the arm or leg depending on the spinal level affected. A foraminotomy removes the bone and soft tissue encroaching on the foramen to restore adequate space for the nerve. It is a targeted, nerve-preserving procedure that addresses the mechanical cause of compression without requiring the broader exposure of a laminectomy or the permanence of a fusion. At the cervical level, foraminotomy is performed through a posterior approach and is particularly well-suited for patients with foraminal stenosis and arm symptoms where the disc height is preserved and fusion is not necessary. At the lumbar level, foraminotomy is often performed as part of a laminectomy but can be performed in isolation when compression is limited to the foramen at a single level.

Foraminal Stenosis and the Atlantic County Patient

Foraminal narrowing is a gradual process that typically begins in the fourth and fifth decades and progresses with cumulative disc degeneration and joint wear. Atlantic County patients who have been active in physically demanding work or recreational activities throughout their adult lives often present with multi-level foraminal changes, though symptoms may be concentrated at one level with a single entrapped nerve root producing the majority of functional limitation. The POA Linwood team takes a targeted evaluation approach: identify the level that is actually generating the symptoms and address that level specifically rather than treating every imaging abnormality.

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Is Foraminotomy an Outpatient Procedure?

Posterior cervical foraminotomy is frequently performed on an outpatient basis, with patients going home the same day as surgery. Lumbar foraminotomy performed in isolation is also often done as an outpatient or one-night stay. Outpatient surgical options within the AtlantiCare system and at Jersey Shore Ambulatory Center are available for appropriate Linwood patients, depending on the procedure and the patient's health status.

Foraminotomy at POA Linwood: What to Expect

  • Consultation: imaging review correlated with symptom distribution to confirm foraminal stenosis as the primary nerve compression source
  • Conservative trial: most patients have already completed a therapy and injection trial before surgical evaluation; those who have not are offered that pathway first
  • Surgery: performed at AtlantiCare Regional Medical Center or Jersey Shore Ambulatory Center based on procedure and patient factors 
  • Recovery: cervical foraminotomy typically requires two to four weeks before return to most activities; lumbar timing varies by approach
  • Follow-up: scheduled at POA Linwood
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Your Surgical Team at POA Linwood

Rahul V. Shah

Dr. Rahul V. Shah, MD, FAAOS

Board-Certified Orthopaedic Spine Surgeon  |  Fellowship-Trained, UCSF  |  Chief Resident, Yale

Dr. Shah's expertise in both cervical and lumbar spine surgery includes foraminotomy as a core component of his decompressive technique repertoire. His UCSF training and research in minimally invasive cervical approaches are directly applicable to the evaluation of foraminal stenosis in Atlantic County patients presenting at POA Linwood with arm symptoms that have not resolved with conservative care.

  • FAAOS — Fellow, American Academy of Orthopaedic Surgeons
  • Spine Surgery Fellowship — University of California, San Francisco
  • Chief Resident — Yale University Orthopaedic Surgery
  • Faculty — Rowan University Medical School

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Joseph R. Zerbo male in white lab coat

Dr. Joseph R. Zerbo, DO

Board-Certified Orthopaedic Spine Surgeon  |  NASS Member  |  35+ Years in Southern NJ

Dr. Zerbo's NASS membership and ongoing engagement with current evidence on foraminal decompression inform how he evaluates each patient presenting with radicular symptoms at Linwood. His Atlantic County surgical network, including Jersey Shore Ambulatory Center, provides outpatient surgical options for patients whose procedures do not require an inpatient hospital environment.

  • AOBOS Board-Certified — American Osteopathic Board of Orthopaedic Surgeons
  • NASS Member — North American Spine Society (since 1999)
  • Chief Resident — Kennedy Memorial Hospital / UMDNJ
  • Surgical Privileges - AtlantiCare Regional Medical Center, Shore Medical Center, Jersey Shore Ambulatory Center
  • Founder — Zerbo Spine, PA

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Foraminotomy FAQs

How is foraminotomy different from a laminectomy?

Do I need a fusion with a foraminotomy?

Can foraminotomy be performed at an ambulatory surgery center in Atlantic County?

How is foraminotomy different from a laminectomy?

A laminectomy removes a portion of the lamina to open the central spinal canal, addressing stenosis across the canal broadly. A foraminotomy targets the specific lateral opening through which a nerve root exits, removing bone or tissue compressing that particular nerve. The two procedures can be performed together when both central and foraminal stenosis are present, or a foraminotomy can be performed alone when the compression is limited to the foraminal zone.

Do I need a fusion with a foraminotomy?

In most cases, foraminotomy alone does not require fusion, because the procedure removes a limited amount of bone and does not destabilize the segment. When foraminal stenosis occurs alongside significant disc degeneration with loss of height, segmental instability, or spondylolisthesis, fusion may be recommended alongside decompression. Your surgeon will explain specifically whether your anatomy warrants stabilization alongside decompression.

Can foraminotomy be performed at an ambulatory surgery center in Atlantic County?

Yes, in appropriate cases. Dr. Zerbo holds privileges at Jersey Shore Ambulatory Center, and outpatient foraminotomy is appropriate for healthy patients with isolated foraminal stenosis at one or two levels. Patients with significant comorbidities or more complex decompression needs are better served in a full hospital environment.

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