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The foramen (latin for “window”) is the hole through which a spinal nerve exits the spinal column to travel down the arm. Foraminal stenosis is narrowing of the hole causing compression of the spinal nerve. Foraminal stenosis can be due to a disc herniation/degeneration or degeneration of the facet joint. A cervical foraminotomy entails a minimally invasive microscopic procedure that enlarges the foramen by removing a small amount of bone, ligament, and joint capsule. In the right patient, the foraminotomy is a good alternative to a fusion operation.