Foraminotomy

Posted by ProfEVL @profevl, Feb 4 3:17am

I'm being informed that the least invasive LHS pain/ache relief I'll obtain is through having a foraminotomy (L5-S1). High doses of pregabalin haven't worked, and neither has a series of epidurals, nerve root blocks and facet joint injections.

For those who have undergone the procedure, what experiences have you had with the success or otherwise of a foraminotomy? Has it worked for you? Is it "minimally invasive" or actually major? Has the pain and referred aching down the glute, leg and foot been alleviated?

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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!

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Profile picture for Leeman25 @leeman25

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!

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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.

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Profile picture for Leeman25 @leeman25

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!

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@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

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Profile picture for annie1 @annie1

@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

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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.

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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

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Profile picture for annie1 @annie1

@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

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@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.

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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?

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