The procedure involves a posterior approach to the cervical spine. After a midline incision and muscular dissection, the spinal surgeon focuses on the affected foramen, the bony opening through which the nerve root exits the spinal column. Using microsurgical techniques, the surgeon carefully removes any bone spurs, portions of the lamina, or disc material compressing the nerve root.

Unlike anterior approaches, a Cervical Foraminotomy does not typically involve manipulation or removal of the disc itself unless a herniated disc contributes to the foraminal narrowing. The goal is to decompress the nerve root while maintaining the integrity and stability of the cervical spine.

The use of a surgical microscope is crucial for precise visualization and minimization of trauma to the nerve root and surrounding structures. Intraoperative neurophysiological monitoring can also be employed to ensure the integrity of the nerve roots during surgery.

One of the primary advantages of Cervical Foraminotomy is its motion-sparing nature. Unlike fusion procedures, foraminotomy preserves the motion at the operated segment. This aspect is particularly beneficial in younger or more active patients where preserving cervical spine mobility is a priority.