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Transforaminal Micro Decompression & Disectomy

Within three months, I was back to my regular active schedule–walking four miles a day, playing tennis, weight training, swimming, and most amazingly, zip lining in Costa Rica.

Jo Ann Medalie
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At A Glance

  • Transforaminal micro decompression enlarges the bony foraminal canal to take the pressure off the exiting nerve.
  • The procedure is also known as endoscopic decompression foraminotomy with or without laser.
  • Informally, many people informally refer to the surgery as a Roto-Rooter-ing of spinal canals.
  • Transforaminal microdecompression treats Foraminal Stenosis.
  • Transforaminal micro discectomy is more effective in removing certain types of herniated discs that otherwise would be difficult to reach from inside the central spinal canal.
  • Transforaminal micro discectomy treats Herniated Intervertebral Disc.


Foraminal stenosis is a narrowing of the spinal openings where nerve roots exit, usually caused by a combination of bone spurs, bulging disc material, collapse of the disc space, and thickening of some ligament structures.

In treating this condition, transforaminal decompression can be safely performed using either a microscope or an endoscope, a long, lighted tube that can be inserted into the body. The key is for the surgeon to accurately see the exiting nerve in order to avoid damage to this critical structure.

Various instruments may be used, including a type of laser known as the holmium laser. The advantage of this kind of laser is that at low power levels, it will not harm bone. However, higher power settings do pose a risk of excessive heat. Therefore, other instruments such as micro drills, small punch cutters, and micro dissection tools are options.

Transforaminal Micro Discectomy

In some cases, a disc herniates within or to the outside of the foraminal canal. Here, a surgeon must be extraordinarily careful not to injure or inflame the exiting nerve root, or a condition called reflex sympathetic dystrophy may occur. This is a condition creating chronic, burning pain in an arm or leg, typically worsening over time.

To minimize risks, the surgeon may perform a micro discectomy (removal of a portion of the herniated disc) in the foraminal canal with the use of operating magnifying glasses (loops), a surgical microscope or an endoscope, along with specialized retractors and micro surgical instruments.


Frequently Asked Questions

What condition is treated with a transforaminal micro decompression?
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