Microforaminotomy (Spinal Decompression Surgery)

Microforaminotomy surgery is also known as spinal nerve decompression surgery. It widens the openings in your spine where your nerves exit your spinal canal.

Injury or other health issues can shrink the openings in your vertebrae (spinal bones) where your spinal nerves exit. This shrinking can compress (pinch) your spinal nerves. This compression may cause pain and discomfort.

During a microforaminotomy procedure, your surgeon widens the openings. They may use a microscope, exoscope, or endoscope and small surgical instruments to access the spine in a minimally invasive way. This procedure can relieve symptoms and improve your quality of life.

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What Is Microforaminotomy?

Microforaminotomy surgery is a type of spinal nerve decompression surgery. It is a minimally invasive procedure. It widens the openings between the vertebrae where spinal nerves exit your spinal canal.

The openings between your spinal bones where your spinal nerves exit can become smaller due to injury or other health issues. This can compress (pinch) your spinal nerves. This compression may cause pain and discomfort.

Microforaminotomy involves smaller incisions. The surgeon uses small surgical instruments and a microscope, exoscope, or endoscope. They carefully widen these openings to reduce compression of your spinal nerves to help relieve symptoms.

Is microforaminotomy a major surgery?

A microforaminotomy procedure is a minimally invasive surgery. It is essential to follow all your surgeon's instructions. It is a common spine procedure that may help to reduce pain and other symptoms while restoring your quality of life.

Types of Microforaminotomy

Microforaminotomy helps relieve symptoms of compressed spinal nerves. This compression can happen in different parts of your spine. Microforaminotomy procedures have names based on the areas of the spine that have compressed nerves.

Procedures include:

Cervical microforaminotomy — Treats compressed nerves in your neck.
Coccygeal microforaminotomy — Treats compressed nerves in your tailbone.
Lumbar microforaminotomy — Treats compressed nerves in your lower back.
Sacral microforaminotomy — Treats compressed nerves near your pelvis in the bottom of your spine.
Thoracic microforaminotomy — Treats compressed nerves in your middle and upper back.

Conditions we treat with microforaminotomy

Many spinal health issues can cause compressed nerves. Some shrink the space through which the nerves exit the vertebrae. People with these health issues are potential candidates for microforaminotomy.

These conditions include:

Foraminal stenosis.
Spinal nerve compression.
Spinal stenosis.

Why Would I Need Microforaminotomy?

You may need a microforaminotomy procedure if you are having pain or other symptoms caused by compressed spinal nerves.

Who is a candidate for microforaminotomy?

You may be a candidate for microforaminotomy if you have spinal nerve compression due to injury or other health issues.

Spinal nerve compression can cause symptoms like:

Difficulty controlling your bowels or bladder (incontinence).
Difficulty performing everyday activities, such as walking, sitting, standing, or grasping objects.
Numbness, tingling, or weakness in your arms or legs.
Pain that does not improve with nonsurgical treatment.

You may need microforaminotomy if your health issue doesn't improve with nonsurgical care.

Alternatives to microforaminotomy

Instead of a microforaminotomy, your surgeon may suggest a traditional open foraminotomy procedure. This procedure causes more damage to the back muscles and tissues, leading to longer recovery times.

Other alternatives to microforaminotomy include nonsurgical care to manage symptoms, such as:

Heat or ice.
Over-the-counter pain medicine.
Physical therapy.
Steroid injections.

What Are the Risks and Complications of Microforaminotomy?

As with any surgery, microforaminotomy surgery comes with some risks.

Possible complications include:

Bleeding or infection at your incision site.
Blood clots.
Instability in your spine.
Nerve damage.
No improvement or a return of symptoms.
Problems with anesthesia.
Reduced range of motion in your neck or back.

What Should I Expect From Microforaminotomy?

Before: How to prepare for microforaminotomy

Before surgery, you will meet with your surgical team and have a physical exam. Your surgical team may order tests.

These may include:

Blood or urine tests — Your doctor may order blood work and urine studies to ensure you are healthy enough for surgery and check for signs of illness or infection.
Computed tomography (CT) scan — An imaging procedure that uses a combination of x-rays and computer technology to create detailed cross-sectional images of the body.
CT Myelogram — A diagnostic imaging test that uses contrast dye and computed tomography (CT) to visualize the spinal cord and surrounding structures.
Electrocardiogram (ECG or EKG) — This test records the electrical activity of your heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and can sometimes detect heart muscle damage. EKGs are often performed before surgery to ensure your heart is healthy and identify potential problems.
Electromyogram (EMG) —This test checks how healthy your muscles are by examining the electrical signals your muscles make, both when you’re using them and resting them.
MRI — A diagnostic procedure that combines large magnets, radio frequencies, and a computer. It produces detailed images of organs and structures within your body.
Nerve conduction study — Similar to an EMG, this test looks at how well the electrical signals travel from your nerves to your muscles.
X-ray — Your doctor may order an x-ray to learn more about the condition of the bones and tissues in your spine.

Your doctor will explain the procedure to you and answer your questions. To prepare for the procedure, you should:

Fast for a certain period before the procedure. Your doctor will tell you how long to fast (usually overnight).
Have any tests that your doctor requires. For example, your doctor may request a blood test before the procedure to determine how long it takes your blood to clot.

Make sure to tell your doctor:

If you are sensitive or allergic to medicines, iodine, latex, tape, or anesthetic agents (local and general).
About all medicines you're taking, either prescription or over-the-counter, and any herbal or other supplements, as well.
About any other health issues. Your care team may need to take certain precautions during surgery for your safety.
If you have a history of bleeding disorders or if you are taking any blood-thinning medicines, like aspirin, or those that affect blood clotting. You may need to stop some of the medicines before the procedure.

On the day of your procedure, bring your photo ID and health insurance card(s). Leave valuables such as cash and jewelry at home.

After your procedure, you will stay in the hospital for one or more nights. You should bring toiletries, a robe, slippers, a cell phone and charger, medicines, and a change of clothes. You should also arrange for someone to drive you home from the hospital after the care team discharges you.

How long does microforaminotomy take?

Microforaminotomy procedures take about two hours. However, procedure times may vary depending on your needs. You may also have additional procedures done during surgery.

During your microforaminotomy

When you arrive at the hospital, you will meet with your care team for final preparations.

You will receive an IV and general anesthesia so that you will sleep through the procedure. Your anesthesiologist will make sure that you are comfortable and do not feel any pain.

After you are asleep, your surgeon will:

Make an incision in your back to access your spine.
Insert a surgical microscope that provides an up-close view of your spine.
Use small surgical instruments to carefully widen the openings in your spinal bones to reduce pressure on your nerves.

After your procedure, your surgeon will close your incision and make sure your health is stable.

Recovery after microforaminotomy

After your procedure, the care team will monitor you in the recovery area as you wake up. Depending on your doctor's assessment, you will spend one or more nights in the hospital. After your care team discharges you, you will need someone to drive you home from the hospital.

You should not drive for one to two weeks after your procedure. You may need to limit the movement of your spine. You will also need to care for your incision to prevent infection.

Before you go home, your doctor will tell you:

How and when to wear a neck or back brace, if needed.
How to care for your incision and watch for signs of infection or complications.
What medicines you need to take.
When or if you should begin physical therapy.
When to call your doctor or 911 if you have certain symptoms.
When you can return to your normal activities.
Which movements are safe and which movements to avoid.

What is the recovery time for a microforaminotomy?

Most patients can resume normal activities within a few weeks. Your doctor will give you more information about your recovery time.

When to call your doctor about post-op problems

You should let your surgeon know if you have:

A fever of more than 100.0°F.
Difficulty breathing.
Difficulty walking or keeping your balance.
New or increasing shortness of breath.
Numbness, tingling, pain, or weakness in your arms or legs.
Pain, redness, bleeding, drainage, or increased swelling at your incision site.
Severe pain that does not respond to medicines.

What is the prognosis after microforaminotomy?

Most people can live full and active lives after microforaminotomy surgery. However, your doctor may tell you to avoid certain strenuous activities.

What is the success rate of microforaminotomy?

Microforaminotomy is a common, safe procedure that helps to eliminate or reduce spinal nerve pain in more than 85% of people after surgery.

Why Choose UPMC for Microforaminotomy?

At UPMC, our surgeons use the least invasive and most effective approach to treat spinal nerve disorders. Our team has pioneered some of the latest approaches to microforaminotomy surgery. They use advanced devices and techniques — promoting safer surgeries, improved outcomes, and enhanced quality of life.

By UPMC Editorial Staff. Last reviewed on 2025-06-26.