Decompressive surgery for foraminal stenosis includes procedures such as laminectomy, laminotomy, foraminotomy, or partial facetectomy, all aimed at creating more space for compressed spinal nerves. It is generally considered when symptoms such as radiating pain, numbness, tingling, or weakness continue despite conservative treatment such as physical therapy, exercise, and medications. Surgery is usually supported when MRI or CT findings match the patient’s symptoms and there is ongoing significant pain or functional limitation after at least 4–6 weeks of appropriate nonoperative care. Earlier surgical evaluation may be needed if there are progressive neurologic deficits. Symptoms of cauda equina syndrome, such as bowel or bladder incontinence or saddle anesthesia, require urgent evaluation.