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Neck pain and arm pain are very common complaints.  These symptoms can be caused by nerve root compression, commonly termed a “pinched nerve.”  A MRI scan may reveal a herniated disc or bone spur.  Most episodes of neck and arm pain are self-limiting and can be managed with rest, soft cervical collar, and antiinflammatory medications.  Sometimes, physical therapy or steroid injections may be used. 

Surgery may be considered if patients have more prolonged symptoms and do not respond to conservative measures.   For certain selected patients with nerve root compression, a minimally-invasive posterior cervical foraminotomy may be an option.  A MRI and/or CT scan can be helpful in determining the appropriate surgical candidates for this approach.  One of the chief advantages of the posterior cervical foraminotomy approach is that it does not require a bone graft, fusion, or metal plate.  Dr. Elowitz is now performing these surgeries in a minimally-invasive fashion compared to the prior open approach.

The minimally-invasive posterior cervical foraminotomy can be performed on an ambulatory basis, although many patients may stay in the hospital overnight.  An approximately 1-inch incision is performed in the back of the neck, and under x-ray guidance, a METRx tubular retractor is then placed.  Using a microscope, the bony neural foramen is then drilled and the bone spur and/or disc herniation are removed.  One of the chief advantages of a minimally-invasive approach is a much smaller incision as well as far less muscle retraction than in the standard, open surgery.  Patients have a faster recovery and can return to work and activities on an earlier basis.