Lumbar Spine Procedures

• The Bonati Laser Discectomy of the Lumbar Spine
• The Bonati Laser Lumbar Facet Debridement
• The Bonati Laser Foramenoplasty of the Lumbar Spine
• The Bonati Laser Debridement of the Lumbar Spinous Process

The Bonati Laser Discectomy of the Lumbar Spine

For herniated discs, spinal stenosis, degenerative disc and joint disease, and failed open back surgery.

The procedure is designed as an answer to:

• Severe lower back pain with radiculopathy or radiation of pain into the legs
• Pain that has not responded to conventional treatments such as rest, analgesics, muscle relaxants and physical therapy after 3 months
• Pain from a herniated lumbar disc or discs that have been confirmed by MRI's, CT scans and/or Myelograms
• Pain from previously failed open surgeries

The Bonati Procedures are performed through an incision of less than one inch.

Herniated lumbar discs that produce back and leg pain can be treated. The portion of the disc that is causing nerve compression can effectively be removed through a small incision.

With the patient awake, a needle is placed into the area of the disc that is producing symptoms. A small incision is made on the patient’s back and the endoscopic tube is inserted.

Using specially adapted endoscopic instruments the diseased disc material is removed and then a laser vaporizes the surrounding problem tissue. A laser is then used to shrink and remodel the remaining disc. A small dressing is used to cover the incision.

Often patients feel immediate relief following this procedure. Rehabilitation begins within hours of surgery, and involves gait training, back or neck support, and walking. Post-operative pain management program avoids narcotics in favor of a Transcutaneous Nerve Stimulator that blocks pain messages to the brain.

The benefits of this procedure:

• Fewer risks, local anesthesia, a small incision
• Minimal blood loss
• Short recuperation time
• Minimal damage to tissues
• Surgeries are done in an outpatient setting
• Patient sees a faster return to a normal lifestyle

The Bonati Laser Lumbar Facet Debridement

For degenerative joint disease from Facet Syndrome or facet arthritis.

This procedure is designed as an answer to:

• Severe lower back pain that may radiate into the buttocks
• Pain that has not responded to conventional treatments such as rest, analgesics, anti-inflammatories, muscle relaxants and physical therapy
• Pain from Degenerative Joint Disease confirmed by X-rays
• Pain from previously failed surgeries with persistent back/buttock pain

Facet joints, which connect bones in the spine, facilitate motion. Each vertebra has two sets of facet joints, with one pair facing upward and one downward. The joints, which are located at the back of the spine, are like hinges that link the vertebrae together. Debridement is the surgical removal of torn, inflamed, contaminated, damaged or dead tissue.

This surgical procedure uses specially-designed probes and the Holmium YAG Laser to remove pain-inducing tissue in nerve branches above and below the affected facet joints on the spine

This procedure is performed by numbing the skin with local anesthesia and inserting a small tube down through a small incision. A miniaturized fiber optic television camera is used to visualize the passageway and the exact problem area. Using a laser, the surgeon vaporizes the painful nerves around the diseased area. Most patients experience relief with a short recovery time.

A Bonati Facet Debridement usually takes less than 30 minutes and many patients feel immediate relief following this procedure.

The benefits of this procedure

• Fewer risks, local anesthesia, a small incision
• Minimal blood loss
• Short recuperation time
• Minimal damage to tissues
• Surgeries are done in an outpatient setting
• Patient sees a faster return to a normal lifestyle

The Bonati Laser Foramenoplasty of the Lumbar Spine

A foramen is the window through which a nerve root exits the spine. Bone spurs that form as a result of Degenerative Disc Disease or spinal arthritis may narrow the foramen causing spinal stenosis or foraminal stenosis, conditions that typically cause leg pain. Also, a foramen may be narrowed by a herniated disc or scar tissue from previous surgery. These problems are treated by foramenoplasty.

Foramenoplasty is performed through a small incision in the back, while the patient is conscious under a low-level IV sedation. The narrowed foramen is located with fluoroscopic x-rays, and a guide wire is placed down to the area of disease. Then, a hollow tube is inserted over the wire to the foramen.

The endoscope and surgical instruments are inserted through the tube. The miniaturized television camera on the endoscope provides direct visualization of scar tissue, bone spurs, and diseased disc material. After surgery the patient is prescribed a short course of physical rehabilitation

Benefits of this procedure.

• Fewer risks, local anesthesia, a small incision
• Minimal blood loss
• Short recuperation time
• Minimal damage to tissues
• Surgeries are done in an outpatient setting
• Patient sees a faster return to a normal lifestyle

The Bonati Laser Debridement of the Lumbar Spinous Process

For pain in the vertebrae.

This procedure is designed as an answer to:

• Severe pain along the back of the spine that radiates to other parts of the body
• Severe pain along the back of the spine that is temporarily relieved with Xylocaine
• Pain that has not responded to conventional treatments such as rest, analgesics, anti-inflammatories, muscle relaxants and physical therapy
• Previously failed surgeries with local spinous process pain

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. A Debridement of the Spinous Process removes the pain-inducing medial branch of the problem nerve. Using local and IV anesthesia and X-rays for guidance, specially designed instruments are inserted directly over the affected spinous process. The laser is then used to obliterate the medial branch of the spinal nerve.

Benefits of this procedure.

• Fewer risks, local anesthesia, a small incision
• Minimal blood loss
• Short recuperation time
• Minimal damage to tissues
• Surgeries are done in an outpatient setting
• Many patients see a faster return to a normal lifestyle