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 an endoscopic tube is inserted. Using specially adapted 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.

• 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

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. Joints with severe arthritis may be fused. The patient experiences relief with a short recovery time.

A Bonati Facet Debridement usually takes less than 10 minutes and many patients feel immediate relief following 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

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

• 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

For Pain in the Vertebrae

• 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.

• 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

Laser Arthroscopy of the Shoulder allows direct examination and repair of the joint without large incisions and trauma to the surrounding tissues. This greatly reduces the time required for recuperation. The procedure is performed under local and general IV anesthesia or general anesthesia, at the discretion of the surgeon. The patient lies on the unaffected side with the affected shoulder up and the arm elevated to open the joint space as much as possible. After anesthesia is administered a small probe is placed into the shoulder joint.

The surgeon confirms the diagnosis with an Arthroscope. Specialized instruments then debride any rough edges or tears, smooth the joint surfaces, remove spurs and inflamed tissue, increase the space inside the joint to allow for greater range of motion. The site is irrigated with a saline solution and the area is checked for any loose material. After the instruments are removed, the openings are closed with a suture and a bulky dressing is placed over the area. The procedure generally takes one and a half to two hours.

Laser Arthroscopy of the Hand and Wrist allows for direct examination and repair of the joints without large “open” incisions and the trauma to surrounding tissues they cause. Minimally invasive arthroscopic surgery greatly reduces the time required for recuperation.

The procedure is performed under local and IV anesthesia as well as general anesthesia at the discretion of the surgeon. The patient lies face up with the affected hand or wrist propped in position. After anesthesia is administered, a small probe is introduced. The Arthroscope is introduced and the diagnosis confirmed. Specialized instruments are used to repair tears, remove loose bodies or release any pinched nerves. The area is irrigated and checked. The small incisions where the Arthroscope was introduced are closed with sutures and a bulky dressing is applied.

Laser Arthroscopy of the Knee is employed in the management of chronic, traumatic synovitis, meniscus tears, fractures of the joint and loose bodies within the joint, as well as repair of tears of the ligaments, abnormalities of the patella such as chondromalacia, fractures and spurs, and rheumatoid arthritis or synovitis. A diagnostic Arthroscopy may be done prior to, or on the day of, surgery to confirm the diagnosis.

Laser Arthroscopy of the Knee is performed under local and IV anesthesia as well and general anesthesia at the discretion of the surgeon. The patient lies face up with the affected knee propped up and bent to open the joint space as much as possible. Anesthesia is administered and a small probe is placed into the joint. The surgeon examines the area with an Arthroscope. Specialized instruments debride the joint surfaces, repair tears and remove spurs as well as inflamed tissue. Debridement is the surgical removal of torn, inflamed, contaminated, damaged or dead tissue.

The area is then irrigated and checked to confirm that all loose material has been removed. Usually three small incisions remain where the Arthroscope was introduced. After the instruments are removed, the incisions are closed with a suture. A bulky dressing and elastic bandage are applied to the area. Laser Arthroscopy of the Knee procedure usually takes one and a half to two hours.

Laser Arthroscopy of the Ankle is performed under local and IV anesthesia as well as general anesthesia at the discretion of the surgeon. The patient lies face up with the affected ankle propped in position. After anesthesia is administered, a small probe is introduced. The Arthroscope is introduced and the diagnosis confirmed. Specialized instruments are used to release any pinched nerves. The area is then irrigated and checked. Small incisions where the Arthroscope was introduced are closed with sutures and a bulky dressing is applied.

The Bonati Arthroscopic 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 Arthroscopic 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, postoperative recovery is shortened, and the patient confirms the pain relief at the time of surgery.