Foraminotomy

I had a procedure last day of October 2025 which was supposed to relieve the aching pain down both legs. I elected to have this done in lieu of expanding my current 2-level fusion (L4-L5) done successfully in 2017. However, the R leg is pain free; the L leg suffers from aching pain front of thigh and down leg. Takes me about 4 hours each day to be able to stand straight, not bent over. Rolling over in bed done very carefully...Now I am getting a third MRI since operation to check to see if there is a problem. Rule it in, or out, so I can go forward with a strategy!

Thanks for this, @leeman25. It sounds to be successfull up to a point. Possible in your case that of the two foraminas targeted at L5, the left exit was given space but the right side wasn't given enough.
Hope you have further success and associated relief.

@leeman25
I was wondering what your pain felt like in your legs. I have a pain that some surgeons say have they haven't seen before. My calf muscles and sometimes my upper hamstrings throb after I walk and it's only a few steps really. I do have foraminal stenosis as well as degenerative disc disease, spondylosis and ridiculopathy. I have been told I need a three level fusion from l3 down to s1. Anyway just curious about this type of pain in the legs and if you don't mind my asking where you're located and where you had your fusion done? Thank you

Ouch, @annie1.
Sounds somewhat similar. I have a deep permanent aching pain in my lower left glute, that further radiates down the lateral side of my left thigh, further into my lateral left calf and then onto the top of my foot. It's not an aching pain that occurs along the full length of the leg, but rather in these four locations. The aching in each location is wide-spread, so not merely a few sq inches, but wider areas than that.
I also have the aching increase during the day, accelerated whenever I stand, walk or run. I wake up with a mild ache, and then that progresses to maximum discomfort over a few hours, and stays at that level until I lie flat in bed. Once lying flat, it takes about an hour to dissipate to nothing more than a mild throb, and the cycle starts again the next day.

I had this procedure done along with open back surgery on C2-C7 After about 2 weeks the pain abated to a reasonable level. I was told that after a year, the way that you are is pretty much the outcome. At that point I was good. I think taking the pressure off the nerves is vital. There is usually a window of time to make sure repair is successful. Good Luck

@annie1
Hello
I have only aching pain; no numbness or other symptoms. I have otherwise decent spinal condition except for the congenital stenosis. I have a feeling this may take a full year to recover. I go to the gym three times a week; elliptical machine for 15 minutes, weight machines, and 30 half sit-ups. I am lucky to live in Seattle where we have outstanding medical care. Had the fusion done here, of course. Surgeon dual trained in Orthopedics and Neurology. He belongs to a specialty surgical practice.

It sounds like you have some complexity to deal with. Might try to locate someone similar to consult with--Good luck.

Had l4&l5 fusion on 2014 and developed foraminal stenosis inl5&s1.Pain mgmt tried epidural but states fusion fixture in the way.Pain in left buttock and lower part of left calf.Have other issues but would like to resolve this one first. Anyone with same experience?

@profevl
This is an old thread but I was hoping you would see my message. Did you end up having surgery ? Did it work out ?

Hi @annie1.
I haven't had surgery...yet. I have a third neuro-surgeon (NS) opinion appointment scheduled for Wednesday 4 March.
My first NS has recommended an ALIF (full titanium cage fusion) at L5-S1.
The second NS (telecall) said that it'd be less intrusive to try a foraminotomy first, and only if that doesn't work, then the full ALIF may be necessary. But my situation suggests a foraminotomy has a high chance of success, according to this NS.
I have a third NS view/opinion on Wed to gauge what's best for me.
I don't think additional facet injections, epidurals, rhizotomies or nerve sleeve injections will do much more as the issue is mechanical - there is insufficient space for the nerve to exit at L5-S1, which shows up clearly on the numerous MRIs, CTs and XRays. There is no disc left at that level and hence no exit space for the nerve root.
Either way, it seems that surgery is staring me in the face (or "back" in this case).
As an update, the aching in the left glute, left lateral quad and left calf has increased and occurs daily. When I wake up and stand vertically, the compression starts, I can last for up to an hour, but by the time I get to work, and get my first cup of coffee, the aching starts. Gradual at first, but it builds during the day to extreme discomfort by evening. Daily. Simultaneously, I have permanent pins-and-needles in my left foot, mostly on the top of my arch, my big and second toes, and under the ball of the foot. Changing posture (bending to the right to unlock the left exit foramina at S1) does not work any more.
So that's where I'm at right now.
The surgery I had previously, 9 years ago when I was paralysed from the waist-down was due to a total rupture of the disc at L3-L4, into my spinal canal. The 1.9cm piece of disc wedged against the spinal cord in the canal and prevented signals reaching my legs. The paralysis took around 4 days to reach a point of zero-signalling, so I was getting weaker in the legs each day until I counldn't walk at all. And the pain was itself paralysing. The spinal cord was being squeezed flat.
Hope this provides further context (notably to Annie1).

@profevl
Wow thanks for that info. That must have been terrifying to not be able to walk at all and the pain. I've been having pain for almost seven years, in my legs and feet, mostly left foot has pins and needles and numb and both calf muscles throb after I walk, painfully. I also have foraminal stenosis, but I was told just treating that wouldn't solve my problem, it probably wouldn't hold up very long. I had hoped to get surgery before the summer because I am an avid swimmer and cyclist, but I was shopping around for a surgeon for almost two years as things got worse over time. It is really not very fun all this spine stuff! Yuck. I wish there was an in person spine support group, but this is very helpful. Where are you located? I've never had a surgeon suggest just a foraminal surgery here in NY.