Cervical Spine Procedures

• The Bonati Laser Cervical Discectomy-Anterior Approach
• The Bonati Laser Cervical Decompression-Posterior Approach
• The Bonati Laser Spinous Process Release

The Bonati Procedures are outpatient procedures that do not require hospital stay.

Disorders of the neck or cervical spine can cause neck pain, arm pain, headaches, or any combination of these symptoms. The most common cervical spine disorders are related to herniated or bulging cervical discs and bone spurs affecting nerve roots to the arm. At The Bonati Institute, endoscopic spinal surgeries have been developed to treat these conditions. All surgeries are performed on an outpatient basis.

The Bonati Laser Cervical Discectomy-Anterior Approach

If the cervical condition is a herniated or bulging cervical disc, endoscopically-assisted laser discectomy can be performed from the front of the neck. The patient undergoing this procedure is awake during the surgery and is given a combination of intravenous sedation to promote relaxation and local anesthetic to numb the skin in the front of the neck.

The Bonati Laser Cervical Decompression-Posterior Approach

The Bonati Laser Cervical Decompression-Posterior Approach is done from the back of the patient's neck to remove bone spurs and enlarged ligaments that are compressing the spinal cord and nerves leading to the arms. This procedure is usually employed to treat Degenerative Disc Disease and/or facet joint arthritis. However, patients who have had previous cervical fusions with residual pain can also benefit from a Laser Cervical Decompression-Posterior Approach.

The patient is positioned on his / her stomach with the back of the neck facing up. Intravenous sedation and local anesthesia are applied. A guide pin is placed through the skin and down to the area of pathology around the nerves using x-ray guidance.

A hollow metal tube is then placed over the guide wire to the bone. The endoscope and specially- designed instruments are directed down the tube and a decompression of the abnormal ligaments and bone spurs is done until the spinal cord and nerves are visualized as completely cleaned. The operation is complete when the patient's pain in the neck and arms is gone. Because the patient is awake during surgery, anesthesia risk is minimal, and post-operative recovery is shortened.

The Bonati Laser Spinous Process Release

The spinous process is the portion of the vertebrae that protrudes from the back of the spinal column. Spinous processes create the "bumps" on the midline of the back and neck. Pain in the midline in the neck often arises from abnormal nerve endings called neuromas that are located in the posterior neck ligaments. These may develop after trauma to the neck such as whiplash, after surgery to the neck, or in conjunction with previously mentioned neck conditions.

To treat these painful neuromas on the spinous processes, an endoscopic laser technique is used.