Cervical spine X-rays with the neck in full flexion and full extension help evaluate the dynamic positioning of the vertebral bodies in relationship to one another. This ensures that adequate alignment of the bones is maintained during the neck’s normal range of motion. In our opinion, flexion-extension X-rays are advised before any surgery to prevent ligamentous instability. Abnormal movement (translational instability) at an adjacent cervical level can be worsened by surgery and must be recognized earlier to formulate a surgical plan with the best possible outcome.
Intraoperative monitoring refers to electrical stimulation techniques using patches applied to the skin and small needles inserted into the superficial soft tissues to evaluate the spinal cord, nerve, muscle, and brain function in real-time during general anesthesia. These techniques use machines to perform tests using electrical stimulation/detection with human physiology to reduce the risks of intraoperative complications. The tests allow the surgical team to immediately reverse or minimize the occurrence of potentially devastating neurologic deficits. Commonly performed intraoperative monitoring modalities include monitoring the recurrent laryngeal nerve (RLN), motor evoked potentials (MEPs), somatosensory evoked potentials (SSEPs), electromyography (EMGs), triggered EMGs for intraoperative screw stimulation, and electroencephalography (EEG).
Stereotactic radiosurgery refers to the use of precisely focused radiation beams to accurately destroy tumor tissue with minimum damage to surrounding normal tissues. In addition, the procedure eliminates the need for an open surgery and requires no anesthesia. It is completely painless. As there is no incision, there is no blood loss or infection. It is performed as an outpatient and can be repeated if needed. It is useful in treating a variety of benign and malignant primary and secondary tumors of the brain and spine, but requires highly technical equipment to administer. Risks (in <2% of cases) include radiation induced-skin injury; hair loss; swelling of adjacent tissues, tumor swelling resulting in neurologic deficits; direct damage to the spinal cord/nerve roots resulting in pain, weakness, paralysis, loss of sensation, bowel or bladder difficulties, impaired sexual function, and the extremely rare development of secondary radiation-induced malignancies.
Is cervical foraminal stenosis surgery painful?
Before worrying over pain levels, check whether you are eligible for surgery and whether surgery is necessary in your case. Always contact your surgeon or physician for a second opinion. Any recommendation for surgery (as well as whether surgery would be painful or not) also depends on several other factors such as risks versus benefits, pre-existing conditions, prior surgeries, age, etc.