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Foraminotomy: Anyone have any experience with this procedure?

Posted by rayreich3 @rayreich3, Apr 22, 2020

Hi my Surgeron is recommendations are for a foraminotomy has any one had experience positive or negative to this procedure?
Raymond

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berniec | @berniec | Jul 14, 2025
In reply to @annie1 "I have lumbar foraminal stenosis not in the neck. So the nerves coming out of the..." + (show)
Profile picture for annie1 @annie1

I have lumbar foraminal stenosis not in the neck. So the nerves coming out of the foramen are being pinched, worse on the left side. The test confirmed nerve damage in the S 5 area I think. So tired right now due to pain keeping me awake.
I want to find out from others on here if anyone had lumbar foraminotomy without fusion.
Thanks for your help !

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Yes I just had a left L1 and L2 Foraminotmies done two weeks ago no fusion. I am completely pain free and doing very light rehabilitation for 4 weeks. There is an odd sensation especially in the morning on mobilizing which resolves. Otherwise all good.

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halhawkins | @halhawkins | Jan 15 9:15pm
In reply to @gently "I hadn't heard of Discseel. I appreciate the information. Annulogram seems like an advancement over the..." + (show)
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I hadn't heard of Discseel. I appreciate the information.
Annulogram seems like an advancement over the older discogram and microdiscectomy.
The older procedure would inject enough die in the center of the disc to create pressure on the disc. They would use floroscopy to see how far the die/disc fluid would flow. It was quite painful as in if you didn't scream it wasn't the disc causing your pain.
An annulogram is said to be painless. But the next part of the discseel procedure also seems preferrable. Instead of using heat (thermomodulation) to seal the disc, discseel uses fibrin.
Microdisectomy removes the extruded portion of the disc with minimally invasive surgery. It is usually covered by insurance.
Discseel is covered by Medicare and may now be covered by your insurance.

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@gently Please be very careful in your research of Discseel and ensure you've gotten all the information on it not just from their office

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gently | @gently | Jan 15 9:59pm
In reply to @annie1 "Hi All, Does anyone know of non cortisone injections for foraminal stenosis ? Also can a..." + (show)
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Hi All,
Does anyone know of non cortisone injections for foraminal stenosis ? Also can a foraminotomy be done without having fusion ?

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halhawkins, thank you so much for the kindness of your warning.

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annie1 | @annie1 | Jan 16 12:47am
In reply to @gently "I hadn't heard of Discseel. I appreciate the information. Annulogram seems like an advancement over the..." + (show)
Profile picture for gently @gently

I hadn't heard of Discseel. I appreciate the information.
Annulogram seems like an advancement over the older discogram and microdiscectomy.
The older procedure would inject enough die in the center of the disc to create pressure on the disc. They would use floroscopy to see how far the die/disc fluid would flow. It was quite painful as in if you didn't scream it wasn't the disc causing your pain.
An annulogram is said to be painless. But the next part of the discseel procedure also seems preferrable. Instead of using heat (thermomodulation) to seal the disc, discseel uses fibrin.
Microdisectomy removes the extruded portion of the disc with minimally invasive surgery. It is usually covered by insurance.
Discseel is covered by Medicare and may now be covered by your insurance.

Jump to this post

@gently
Last time I checked this disc seel was not covered by Medicare. Also I just saw a YouTube by someone who had a horrible problem after getting discs healed with the inventor whose name I'm forgetting now. Look it up.

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annie1 | @annie1 | Jan 16 12:49am
In reply to @ga29 "I have had two fusions, the first at L4-5, then 2 years later a revision removing..." + (show)
Profile picture for ga29 @ga29

I have had two fusions, the first at L4-5, then 2 years later a revision removing those screws then an L5-S1 fusion. I had osteoporosis in my spine and osteopenia in hips and neck. After my first dexa bone scan the doctor suggested taking 2 D3+K vitamins along with magnesium, coQ10, turmeric and other supplements, two years later, my dexa bone scan showed my spine number had improved to severe osteopenia. I did improve my diet as well, did some walking.
I am not able to walk much now, as my neck needs help, my stenosis and other issues are really hurting.
But don’t think you can’t get help! I had my surgery at Mayo, and specifically asked if osteoporosis would prevent me from having surgery. They said no. But everyone needs to get a professional opinion as we are all different.
I was nervous about having a fusion too.
I wish you the best!

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@ga29
So did the fusion help your pain? I don't have many options I have pain after I walk even a few steps but I can ride a bike so I do that wherever I can instead of walking. In any rate I'm considering fusion very seriously now I've interviewed many surgeons and some of them are saying they're not sure if it could really help with my leg pain anyway. What was the pain that you had was it in your legs or just in your back?

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annie1 | @annie1 | Jan 16 10:31pm
In reply to @gently "@annie1 have you received second opinions. You might send your MRI to https://www.bonati.com/free-mri-review-help-diagnose-back-pain/ I'm not recommending..." + (show)
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@annie1
have you received second opinions. You might send your MRI to https://www.bonati.com/free-mri-review-help-diagnose-back-pain/ I'm not recommending Bonati, just the free evaluation to understand if you have better options than fusion.

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@gently I recently had an appointment with a prominent neurosurgeon at the Cleveland clinic who recommended the tops procedure which is a non-fusion procedure however I have been looking it up and it's not supposed to be used with people with osteoporosis which I have. I am very confused that he would then suggest it and insist that it's good for people with osteoporosis. My osteoporosis has improved being on Evenity but I still do have it. Has anyone here had the tops procedure and with osteoporosis?

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gently | @gently | Jan 17 7:35am
In reply to @annie1 "Hi All, Does anyone know of non cortisone injections for foraminal stenosis ? Also can a..." + (show)
Profile picture for annie1 @annie1

Hi All,
Does anyone know of non cortisone injections for foraminal stenosis ? Also can a foraminotomy be done without having fusion ?

Jump to this post

Annie1. you are right to have concern. Your bones have to be strong enough to hold the screws.
What are and what were your T scores L2 through L5. How long have you been on Evenity. What will you take following Evenity.
Your bones may be strong enough for a single segment Tops.
You might contact the manufacturer. https://premiaspine.com/find-a-doctor/
Have you looked at this surgeon's reviews. It can be good to know his success rate and how many of these surgeries he has done. Some doctors don't like those questions since it questions their skills.
The surgical guidelines don't mention osteoporosis in patient selection.
I haven't had the procedure, but hope someone who has had success responds. The potential with Tops is exciting.

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annie1 | @annie1 | Jan 17 9:03am
In reply to @annie1 "Hi All, Does anyone know of non cortisone injections for foraminal stenosis ? Also can a..." + (show)
Profile picture for annie1 @annie1

Hi All,
Does anyone know of non cortisone injections for foraminal stenosis ? Also can a foraminotomy be done without having fusion ?

Jump to this post

The surgeon who recommended it is actually the head of neurosurgery at the Cleveland clinic a very impressive position. He said he's only done about a hundred of those tops procedures which isn't that many but he said they're mostly people over 65 which also contradicts other things I've heard and read. I don't understand how someone in his position could be lying so it's very confusing. I have a very degenerated spine many places are collapsing but I think you would only put the device in one place. They also said he couldn't guarantee that it would get rid of my main symptoms but they all say that because my symptoms apparently are unusual. My legs throb painfully after I walk.

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