Transforaminal

Transforaminal is an anatomical term meaning “through the foramen.” In human anatomy, a foramen is an opening through which nerves, vessels, or other structures pass. The term is commonly used to describe pathways that traverse the intervertebral foramina of the spine—the openings between adjacent vertebrae through which the exiting spinal nerves and accompanying vessels leave the spinal canal. It is also used more generally to denote routes that pass through any foramen in the body.

In clinical practice, transforaminal describes procedures or approaches that access the spinal canal or epidural space via the foraminal window rather than through midline structures. This terminology is especially common in spinal pain management and surgery.

Examples of transforaminal procedures include transforaminal injections and nerve blocks. Transforaminal epidural steroid injections (TFESI) deliver medication into the epidural space through the foramen to treat radicular pain from compressed or inflamed nerve roots, typically under imaging guidance. Transforaminal approaches are also described in certain surgical techniques, such as transforaminal lumbar interbody fusion (TLIF), where access to the disc space is obtained through the foraminal region from a posterior-lateral trajectory. Minimally invasive spine procedures may employ transforaminal corridors to minimize tissue disruption while reaching target structures.

Etymology-wise, the term derives from Latin trans- meaning through, across, and foramen meaning an opening or orifice. The precise meaning depends on the anatomical level and the procedure being described, with the foraminal level (for example, L4–L5) specifying the location.