Preparation for spine surgery begins with a patient history, a physical exam, and imaging to confirm the spinal disease diagnosis, to determine the affected level, and to decide on the type of surgery. A cervical foraminotomy is a minimally invasive decompressive procedure used to treat refractory spine disease symptoms in the cervical region.

The cervical foraminotomy is performed with the patient lying face down. An intraoperative x-ray machine is used throughout the procedure to confirm that the correct vertebra/vertebrae are being operated on. After locating the proper vertebra, the skin is marked, cleaned, and draped for sterility. A small incision, less than one inch, is made on the midline of the neck and the muscles on the back of the neck are gently dissected.

Once the spine is exposed specialized retractors keep the incision open for the duration of the procedure, allowing the surgeon to see and operate. A small portion of the laminae, the backside of the vertebrae, is removed to reach the foramen, vertebral spaces through which nerves branch off of the spinal cord and into the body. The surgeons removes any pieces of disc material or bone spurs that may be compressing nerves using specialized biting instruments and then begins the closing process. The retractors are removed from the incision and bleeding is controlled. Each layer of tissue is closed with sutures and the final layer of skin may be closed with either sutures or staples, which are strong enough to hold together the thick muscles in the neck.

After surgery the patient recovers in a post-operative room to make sure that their pain is under control, that they are able to eat and tolerate food and beverage, and that they can walk and urinate properly. They are able to go home within 23 hours of the procedure, but a friend or family member should be available to drive the patient home and to monitor the patient for at least 24 hours after the procedure.