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Anterolateral foraminotomy is a procedure that treats nerve pain in the arm
This type of surgery is most commonly used when your spinal canal (a tunnel that runs up your back, through which your spinal nerves travel) becomes reduced in size, which leads to one or more of your nerves being compressed against one of your vertebrae (the bones that form your spinal canal).
Often, cervical nerve compression causes a burning pain or numb sensation in your arm. Anterolateral foraminotomy involves making a small keyhole incision into your neck and enlarging the space around your spinal canal, enabling your spinal nerves to pass through freely without becoming compressed.
Private foraminotomy is an effective and safe procedure that directly addresses pain in your shoulder and arm, allowing you to move without pain or reduced movement. We recommend this surgery when other treatment options such as pain medication and arm nerve pain exercises have not helped resolve the issue.
The treatment is one of many types of spinal surgery delivered in specialist spinal units at Circle Health Group hospitals across the UK. Our experienced consultant neurosurgeons use advanced diagnostic equipment and the latest surgical techniques to deliver fast, tailored treatment that can eliminate your spinal issue and vastly improve your overall quality of life.
This page explores what happens during and after anterolateral cervical foraminotomy for nerve pain, along with its causes, cost, and symptoms of the condition.
The cost of anterolateral foraminotomy with Circle Health Group depends on a variety of factors, including is the reasons you are having surgery, and which hospital you choose. Your healthcare team will ensure you know the cost of your treatment at every stage of your journey with them, including information on how and when to pay it.
Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment fee are charged separately.
Our flexible payment options help you spread the cost of your payment across a time period that suits you. We offer fixed-term monthly payment plans over 10 months to five years with no deposit required. If you decide to pay over 10 months, you will pay interest-free. If you are paying for a longer period, you will pay 14.9% APR.
If you have private health insurance, your treatment will usually be covered by your provider. Speak to your insurer directly to find out more information on this.
If you have any questions about our fixed-price packages and flexible payment options, you can speak to a friendly member of our advisory team on 0141 300 5009
We recommend anterolateral foraminotomy when you have severe symptoms that interfere with your daily life and haven't improved with more conservative treatment methods, such as medication or physiotherapy. These symptoms could include:
Anterolateral foraminotomy is one treatment option used when a nerve root becomes compressed in your cervical spine. Your cervical spine is found in your neck area. It comprises seven bones that are separated by intervertebral discs.
These discs are like cushions that sit between the bones in your spinal canal and absorb pressure put on your spine. When the spinal canal diminishes in size, it is possible for a spinal nerve to press against one of these discs, which can lead to nerve pain in your arm or shoulder.
While anterolateral cervical foraminotomy targets trapped nerves in your neck area (or cervical spine), nerve compression can happen along any part of your spinal column. The foraminotomy procedure is essentially a process of enlarging the area around one of the bones in your spinal column, thereby relieving pressure on compressed (or trapped) nerves. 'Anterolateral' refers to the method of surgery, specifically to the way that a surgeon accesses a spine to operate on it.
The kind of spinal compression you have is determined by where the affected nerve sits. Some issues that can cause spinal compression include:
Anterolateral foraminotomy is not suitable for all cervical spine problems. Your consultant will be able to confirm whether this type of surgery could help you.
Generally, as a starting point, your consultant will prescribe a combination of pain relief medication and arm nerve pain exercises. You might be recommended physiotherapy and/or massage therapy. They may also give you a nerve sheath injection - a local anaesthetic injected through the skin of your neck that targets the compressed nerve, which can make a significant difference, sometimes to the point where surgery is unnecessary.
If the above non-surgical methods don't work, or you have a history of arm pain due to a trapped nerve, your consultant may decide surgery is the best option for you. In order to see whether anterolateral foraminotomy is right for you, they might run tests including:
This test measures the electrical signals in your muscles and can tell whether your nerves are working as they should be.
This shows whether there's any damage to soft tissues that may be causing a trapped nerve and pain in your arm, or whether there's damage to your spinal cord.
This uncovers whether there's any narrowing or changing alignment of your spinal cord, along with any fractures that might be present.
By running these tests, your consultant will be able to tell whether you have a compressed nerve in your neck and confirm whether we should move forward with the surgery.
As is usually the case, you will need to avoid eating or drinking anything after midnight on the day of your anterolateral foraminotomy.
Your consultant will encourage you to refrain from drinking alcohol 48 hours before the procedure.
If you are a smoker, you need to stop before the surgery. It could cause problems with the anaesthesia and negatively affect your breathing after surgery. Your recovery may be slower and possibly not as effective if you continue to smoke following the procedure.
If you are taking any blood-thinning medications, such as aspirin, you will need to stop taking these at least two weeks before the surgery to prevent any unwanted bleeding during and/or after the surgery.
Rest is incredibly important for the first week after surgery, so make sure you have all the supplies you need at home beforehand. Should you want any additional bits and pieces following the operation, ask a member of your support network to grab them for you, for example a friend or relative.
During the procedure, you'll be lying on your stomach, with your head resting in a special fixation device. Your surgeon will begin by making a small keyhole incision at the part of your neck where the compressed nerve sits against your vertebra. Using X-rays, a special microscope, and other tools, they will push away muscles to expose the spinal canal. They will then be able to access the part of the disc that is causing compression against the nerves and remove it using small tools. Where possible, only the area of your disc causing you problems will be removed, and the functioning portion of your disc will be left alone.
After making sure the nerves are completely free, your surgeon will remove the tools, put the muscles back into place, irrigate the small incision with antibiotic solution, and then close it up.
When you first wake up after the operation, you may feel a bit groggy. This is completely normal as the general anaesthetic wears off. There might be some pain from where we made the incision, but we'll make sure you have as much pain relief as you need to feel comfortable.
You should be able to sit up two hours after the surgery, and we'll encourage you to move your neck carefully. You'll have to wear a soft neck collar for a while afterwards. We'll most likely be able to discharge you from the hospital the day after your foraminotomy.
After getting home from hospital, you'll need to take it easy. There might be some remaining pain, for which we'll provide medication, and there's a good chance you'll feel quite tired. If possible, have some help nearby for this first week, as even simple tasks will feel like a challenge. You'll need to avoid certain movements, such as bending your neck.
The wound, at first, will be covered with a dressing that you'll need to keep dry. If your surgeon used non-dissolvable stitches or staples to close the wound, these will be removed five to 10 days after surgery. We'll make an appointment for you to get this done.
For the first four weeks after anterolateral foraminotomy, you will still need to avoid certain movements, such as bending, lifting, or twisting. We will provide a physical rehabilitation programme - small exercises that support you on your journey back to full strength, such as taking short walks throughout the day - as well as guidance around activities that you can and can't do. Driving, for example, might not be possible for about four weeks.
If your job doesn't involve any physical exertion (i.e. a desk job), you should be able to return to light work in two to four weeks. When it comes to jobs that require strenuous activities like driving or heavy lifting, on the other hand, you will need more time off – possibly a few months. Please speak to your consultant about this to learn more about your recovery timeframe.
Every individual recovery timeline is different and influenced by a range of factors, such as your age and the severity of the problem, so you might be back to 100% sooner than these averages, or the process may take a little longer than expected.
Do not hesitate to ask your consultant any questions about your recovery period during your appointments with them. They will understand your personal circumstances better and be able to offer you a more personalised timeline based on your situation and recovery goals. No question is a silly question - we're here to help you feel safe and informed before and after surgery.
Complications can sometimes occur, as is the case with any surgery, but these are extremely rare.
There is also a small risk that the surgery won't relieve your pain. This could be down to factors such as your age, location of the compressed nerve in the spinal canal, or any other medical conditions you have.
Prior to the surgery, your consultant will explain everything to you, taking care to address any questions or concerns you might have, so that you can make a completely informed decision.
To learn more about anterolateral foraminotomy, book your appointment online today or call a member of our team directly on 0141 300 5009.
Content reviewed by Circle in-house team in January 2023. Next review due January 2026.