Concierge spinal surgery · UK
Foraminotomy — spinal decompression, by a consultant spinal surgeon.
A keyhole decompression that enlarges the bony tunnel around a trapped nerve — cervical or lumbar, open, MIS tubular or endoscopic. Motion-preserving where possible, honest about when it is not the right operation.
Why patients choose us
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A consultant spinal surgeon, in theatre
Not a general orthopaedic list and not a training case. A named spinal surgeon — neurosurgical or orthopaedic — with a fellowship in decompression, and a proper theatre.
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Motion-preserving where possible
For a one-level unilateral radiculopathy a foraminotomy can spare you a fusion. We say so before you agree to bigger surgery.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private foraminotomy costs in the UK.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A one-level foraminotomy in our network: £6,000–£12,000, home same day or after one night.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Posterior cervical foraminotomy (one level) | £7,000–£11,000 | 60–90 min | 1-night stay |
| Open lumbar foraminotomy (one level) | £6,000–£9,500 | 60–90 min | Day-case or 1 night |
| MIS tubular lumbar foraminotomy | £7,500–£11,000 | 75–110 min | Day-case or 1 night |
| Endoscopic lumbar foraminotomy | £8,500–£12,000 | 60–100 min | Day-case |
| Foraminotomy + microdiscectomy (same level) | £8,000–£12,000 | 90–120 min | Day-case or 1 night |
| Consultation and MRI review | £250–£450 | 30–45 min | Same visit |
Prices vary by clinic, by which surgeon does the case, by the approach chosen (open, tubular or endoscopic), and by whether a discectomy is added at the same sitting. Most cases are insurance-funded; NHS pathways run in parallel. We come back with a firm quote within one working day.
The problem
The right operation, at the right level, at the right time.
Spinal decompression is quietly one of the most over- and under-done procedures in the UK. Booked too early it fails to help; booked too late a weak muscle does not recover. The judgement call is what you are paying for.
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Not sure it is needed?
Physio, NSAIDs and a nerve root injection deserve six to twelve weeks first. We say so before you agree to surgery.
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Worried it is too big?
Foraminotomy is a keyhole, motion-preserving operation. It is not a fusion — and often the reason you do not need one.
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Want it done properly?
A named consultant spinal surgeon — neurosurgical or orthopaedic — in a proper theatre, with a physio plan on day one.
The journey
From enquiry to recovery — what happens, in order.
One coordinator from first message to review — including MRI correlation and the physio ramp.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A few hours at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. The arm or leg pain, the dermatome, how long, and what has already been tried.
- 02
Before
MRI and clinical correlation
We review your MRI against the symptoms. A foraminotomy only works when the imaging matches the nerve you feel.
- 03
Before
We come back with a recommendation
Within one working day: the right approach — cervical or lumbar, open, MIS tubular or endoscopic — the right anaesthetic, and an indicative price.
- 04
Before
We arrange the appointment
Usually within one to three weeks. Blood-thinning medication is reviewed with the team and you are told exactly how to prepare.
- 05
On the day
Arrival at the clinic
Arrival, consent and a chat with the surgeon and anaesthetist. General anaesthetic in most cases; LA plus sedation is possible for endoscopic lumbar work.
- 06
On the day
The procedure itself
60 to 120 minutes in theatre, prone. A small incision, high-speed burr, and enlargement of the foramen — with less than half the facet removed to protect stability.
- 07
After
Recovery and review
Mobilise the same day, home the same day or after one night. Desk work at 2–4 weeks, heavy lifting at 6–8, sport at 6–12. Physio guided throughout.
Typical end-to-end: 2–3 weeks from enquiry to surgery. Return to sport: 6–12 weeks.
When it helps
When a foraminotomy is the right step.
The situations we see most, plus the red flags that mean an emergency rather than an appointment.
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Cervical radiculopathy (C5, C6, C7)
Arm pain, tingling or weakness in a nerve root pattern from foraminal narrowing in the neck.
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Lumbar radiculopathy (L4, L5, S1)
Leg pain, numbness or weakness in a dermatome from foraminal or lateral recess stenosis.
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Failed 6–12 weeks conservative care
Physio, NSAIDs and a nerve root injection tried without lasting relief — the point at which surgery earns its place.
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MRI foraminal or lateral recess stenosis
Imaging that matches the clinical dermatome. Without correlation, decompression will not help.
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Overhanging facet or osteophyte
Bony narrowing of the foramen from arthritic facet joints or spurs — the classic foraminotomy target.
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Lateral or foraminal disc herniation
A disc fragment pushing on the exiting nerve root — often addressed with foraminotomy plus a small discectomy.
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Motor weakness or progressive deficit
New or worsening weakness accelerates the timeline. Not something to sit on for months.
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Red flag: cauda equina or myelopathy
Saddle numbness, bladder or bowel changes, hand clumsiness or gait imbalance are emergencies — same-day A&E, not a clinic booking.
Procedure options
One label, several ways of doing it.
What each approach on the table actually involves — and which fits which pathology.
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Posterior cervical foraminotomy
Frykholm / Scoville approach. Small midline incision, laminoforaminotomy with a high-speed burr, less than half the facet removed. Motion-preserving alternative to ACDF for lateral disc or foraminal osteophyte.
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Open lumbar foraminotomy
Microscope-assisted, familiar to every spinal surgeon. Removes the overhanging facet, osteophyte and ligamentum flavum to widen the foramen.
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MIS tubular foraminotomy
METRx, Quadrant or similar tubular retractor. Same decompression through a smaller corridor, less muscle stripping, faster mobilisation.
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Endoscopic foraminotomy
Transforaminal or interlaminar endoscopic approach. Suits selected foraminal pathology; often possible under LA plus sedation.
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Foraminotomy + microdiscectomy
When a disc fragment is also compressing the exiting root, the two are combined at the same sitting through the same incision.
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Not suitable: central disc or myelopathy
A central cervical disc, cord compression or myelopathy is treated with ACDF or laminectomy, not foraminotomy. We say so upfront.
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Not suitable: multi-level or instability
Bilateral, multi-level or unstable disease usually needs a bigger decompression or a fusion — not the right patient for a keyhole foraminotomy.
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Consultation only
An honest MRI-plus-symptoms review and an opinion on whether decompression is needed at all — no obligation.
Our vetted UK network
A small panel of spinal surgeons, we picked them.
Consultant spinal surgeons across London and the major UK centres. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every spinal surgeon in our network.
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Consultant spinal surgeons — neurosurgical or orthopaedic — with a decompression fellowship
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MIS tubular and endoscopic capability where the pathology suits it
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NICE NG59 and SBNS/BASS-aligned decision-making, not surgeon preference alone
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Motion-preserving options discussed before a fusion is offered
Safety and recovery
What to expect afterwards — honestly.
Foraminotomy is a common, safe spinal operation with an 80–90% good/excellent pain-relief rate for well-selected patients. The risks are real but small — and worth naming.
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General anaesthetic, prone, 60–120 min
GA in most cases. Endoscopic lumbar work can be done under LA plus sedation for the right patient.
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Dural tear (1–4%)
A small tear in the nerve sac is the commonest intra-operative event. Usually repaired at the time; occasionally needs a short period of bed rest.
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Nerve root injury or dysaesthesia (~5%)
A brief patch of new numbness or altered sensation in the dermatome. Usually settles over weeks; permanent injury is uncommon.
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Incomplete decompression
If the wrong level is targeted or the disease is broader than the foramen, symptoms can persist. Careful pre-op correlation matters.
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Instability requiring fusion (rare)
Keeping at least half the facet protects segmental stability. Aggressive removal is the main driver of later instability.
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Recurrent disc herniation
A small ongoing risk when a discectomy is added, especially in the first year. Not usually a reason to redo surgery.
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Epidural haematoma, infection, DVT
Standard spinal-surgery risks. Mechanical prophylaxis in theatre and early mobilisation keep the numbers low.
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Cervical-specific risks
C5 palsy is a recognised transient shoulder weakness after cervical decompression. Vertebral artery injury is very rare with a posterior approach.
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Long-term: adjacent segment disease
Any spinal surgery mildly increases wear on neighbouring levels over years. Foraminotomy, being motion-preserving, is kinder than fusion here.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever approach was used, the note the surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Level, side and pathology treated
The exact level (e.g. right C6/7, left L5/S1), the side, and whether it was foraminal stenosis, osteophyte, disc, or a combination.
- 02 Technique
Approach and extent of bone removed
Open, tubular or endoscopic; how much of the facet was taken (less than 50% preserves stability); any dural tear and how it was managed.
- 03 Findings
Nerve root free at end of decompression
The surgeon confirms the exiting root moves freely by the end of the case. This is the intra-op endpoint of a good foraminotomy.
- 04 Impression
Recovery, restrictions, physio plan
Read this first: mobilisation, driving, work, lifting, sport, and when physio starts. Ask us to translate anything that is not clear.
Recognised by major UK insurers
Cover for foraminotomy is standard across major UK insurers when the imaging and clinical picture correlate. We confirm cover in writing before booking.
Frequently asked
Everything we get asked about foraminotomy.
Quick answers on whether you need surgery, which approach, cost, recovery and risk.
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What is a foraminotomy?
A spinal decompression that enlarges the intervertebral foramen — the bony tunnel a nerve root exits through — to take pressure off the nerve. It is done in the neck (cervical) or lower back (lumbar), through a small incision, and preserves the joint by removing less than half of it.
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Do I need a fusion instead?
Often, no. For one-level unilateral radicular pain from a lateral disc or foraminal osteophyte, a foraminotomy usually keeps the segment moving and avoids a fusion. Central disease, myelopathy, instability or multi-level involvement changes the answer — we say so honestly.
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When is surgery the right step?
When you have arm or leg pain in a clear dermatome (C5, C6 or C7 in the neck; L4, L5 or S1 in the leg), MRI foraminal or lateral recess stenosis that matches, and 6–12 weeks of physio, NSAIDs and a nerve root injection have not settled it. New or progressive weakness moves it up the queue.
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Open, MIS tubular or endoscopic — which is better?
All three are legitimate. Open is versatile and time-tested. MIS tubular gives the same decompression with less muscle stripping. Endoscopic can be done under LA plus sedation for selected foraminal disease. Pathology and surgeon experience matter more than the label.
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How much does a private foraminotomy cost in the UK?
Roughly £6,000–£9,500 for an open lumbar case, £7,500–£11,000 for MIS tubular, £8,500–£12,000 endoscopic, and £7,000–£11,000 for posterior cervical. Adding a discectomy adds a little. Insurance funds most cases; NHS pathways run in parallel.
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How long is recovery?
You mobilise the same day. Driving 1–2 weeks. Desk work 2–4 weeks. Heavy lifting 6–8 weeks. Return to sport 6–12 weeks depending on the sport and the level. Physio guides the ramp.
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What are the results?
80–90% of well-selected patients get good or excellent pain relief. Numbness and weakness recover more slowly than pain and are less predictable — long-standing motor loss may not fully return.
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What are the main risks?
Dural tear (1–4%), nerve root dysaesthesia (~5%), epidural haematoma, incomplete decompression, later instability (rare when the facet is preserved), recurrent disc herniation, infection and DVT. Cervical cases carry a small risk of transient C5 palsy; vertebral artery injury is very rare with a posterior approach.
Related tests
Looking for something else?
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Endoscopic discectomy
Keyhole disc surgery, often under LA plus sedation.
Learn more -
Discectomy
Microdiscectomy for a herniated lumbar or cervical disc.
Learn more -
Epidural steroid injection
A targeted injection often tried before surgery.
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All tests
Every test and procedure we arrange.
Learn more