Refuse to Fuse: Endoscopic Surgery versus Fusion for Cervical Foraminal Stenosis
The Truth About Cervical Foraminal Stenosis
There are many people with pain that radiates into the shoulder or arm who get an MRI and find out that they have cervical foraminal stenosis (narrowing) in the cervical spine that compresses one or more nerves in the foraminal canals.
When this pain is no longer responsive to manipulations, physical therapy, or epidurals, surgery may be the only way to relieve the pain, weakness, or tingling. The pain interferes with sleep, the activities of daily living, as well as limiting or even interrupting recreational activities.
Some foraminal stenosis patients require the use of pain pills, which they don’t want to take. In desperation to get relief, they take a trip to the surgeon, and are told they need a fusion with a plate, screws and a bone graft! Sometimes patients will even hear that if they don’t get operated on immediately, they run a significant risk of paralysis!
Since his early days in practice, Dr. Tony Mork has always wanted patients to retain as much range of motion as possible. The body is meant to move. If surgery is necessary then it should be performed through the smallest possible incision with minimal disturbance of soft tissues.
Surgery should allow the natural motion to continue when possible. Operating directly on a problem, when possible, rather than restructuring the surrounding anatomy, as done with a fusion, is the preferred methodology. By using Endoscopic Spine Surgery, the concept of creating “one problem” to solve another is avoided.
What is Foraminal Stenosis of the Spine
The simplified definition of stenosis is an abnormal narrowing of a structure. In this case, the narrowing occurs in a bony tunnel (and can for a variety of reasons) result in the compression of the nerve traveling in the tunnel. The compression on the nerve results in symptoms of cervical foraminal stenosis causing pain in the shoulder, arm and hand. It seems logical to decompress the nerve by opening the tight portion of the canal. This is the most straightforward approach.
Fusion, unlike Endoscopic Spine Surgery, spreads the disk space apart to make the foraminal canal larger. The endoscopic surgery technique is a small operation to decompress a tight bony canal rather than the entire disc space.
Dr. Tony Mork’s pioneering approach is one of nerve decompression through the smallest incision possible and retention of the maximum range of motion in the process, without a fusion.
Endoscopic spine surgery is mostly about bone removal and decompression Dr. Tony Mork started doing endoscopic spine surgery on the cervical spine over 13 years ago. His practice is devoted exclusively to endoscopic spine surgery and he has never performed a fusion for severe cervical spinal stenosis.
Using his technique, range of motion is preserved or increased and the surgery is directed to the bone pinching the nerve going to the shoulder and arm. Some bone of the facet is removed but not enough to result in any instability.
Writing research papers and evaluating results in the practice of medicine is something Dr. Tony Mork did with his associate, Dr. Scott Haufe, for many years. Their joint research and evaluations were tabulated for the two-year follow up of the cervical spine decompression operations that they performed. Not surprisingly, their research showed good to excellent results, in 85%, of any spine surgery procedure that Dr. Mork performed. As a result, Dr. Mork made a conclusive, informed and positive decision to pursue the endoscopic spinal surgery technique because of the inherent benefits it provides his patients. He presented the research findings at an international meeting in Las Vegas in 2011. The results prove a high rate of success is possible without a fusion. A fusion is not necessary to treat symptomatic foraminal stenosis in the cervical spine.
Treatment of Cervical Foraminal Stenosis
The solution to foraminal stenosis in the cervical spine is a multi-step process. It starts with pain in the shoulder and arm that won’t go away with conservative measures. Chances are a patient has had an MRI and may have read the report noting foraminal stenosis. The next step is to correlate the pain experienced with the nerve being pinched and to confirm they correlate. Sometimes this requires a selective nerve root block to numb the suspected nerve root with Novocain to see if the pain resolves on a temporary basis.
Once the correct nerve root is identified and correlated with a level of foraminal stenosis, then a surgical decompression may be considered. Over the years, Dr. Tony has managed to operate through a tube that has a diameter smaller than a dime, while his patient is under IV sedation, often as an outpatient. Dr. Mork is able to operate directly on the foraminal canal and decompress the pinched nerve passing through the narrow canal by removing the bony overgrowth.
If you suffer symptomatic cervical foraminal stenosis and want to eliminate your crippling pain safely with the least invasive procedure possible, fill out the form and send your MRI to Dr. Mork for a complimentary MRI Evaluation.