Lo que sigue describe algunas condiciones en que los Procedimientos Bonati pueden ayudar. Para más información, haga clic el nombre de la condición..
Advanced Spine Surgery
Dr. Alfred Bonati ℠ pioneered the application of endoscopic and laser surgery to problems of the cervical, thoracic, and lumbar spine, such as spinal stenosis, spondylosis, degenerative disc disease, herniated discs, and previous failed open back surgery.
The instrumentation for his world-famous Bonati Procedures℠ has been awarded six patents by the U.S. Patent Office. The Bonati Procedures have been performed successfully more than 20,000 times on patients suffering with pain from back and neck conditions.
Unlike old-fashioned "open" back surgery, these advanced outpatient spine surgeries usually can avoid dissection of the muscle and removal of the bone. Because these surgeries are minimally-invasive, patients with cervical, thoracic, or lumbar disc problems experience far less trauma.
Our surgery patients can return to work and resume normal daily activities much sooner than patients who have had "open" back surgery.
Conditions and diseases of the spinal column usually affect more than one disc. "Open" back surgery usually employs a single wide incision to address problems in more than one disc. This procedure can produce considerable pain, bleeding, and a lengthy recovery period.
The advanced procedures employed at The Bonati Institute℠ address problems such as herniated discs, bulging discs, or ruptured discs with minimally-invasive outpatient procedures that minimize discomfort, reduce bleeding considerably, and greatly shorten recovery. Administering these procedures in stages also allows the body time to adjust to each correction of a back or disc problem through intermittent physical therapy.
The Bonati Procedures
Dr. Bonati developed these spine surgery procedures and designed specific instruments to correct several cervical and lumbar spinal conditions. He introduced the use of a laser to remove intervertebral disc tissue during back surgery and assist in neural decompression.
Through continuous evolution, The Bonati Procedures have been perfected to meet the needs of the patients in terms of their specific pathological conditions in the cervical, thoracic and lumbar areas of the spine. This includes discectomies, annulorrhapies, foramenostomies, arthroscopic laser arthrodesis, partial facetectomy, ligamentum flavum resection and SI joint laser debridement.
The Bonati Procedures allow for entry through a small portal in the back or neck measuring only 3mm to 5mm in diameter. Only local anesthesia is required, thus eliminating the need for regional or general anesthesia and its inherent risks. The patient is awake and alert throughout the procedure, which allows him / her to communicate directly with the surgeon. This is extremely valuable in guiding the surgeon to the location of the pain while providing immediate feedback when pain is experienced or relieved.
Depending upon the procedure, a central or lateral approach can be utilized. This provides passage for the instrumentation to the necessary level of pathology in the spine, allowing access not only to discs, but also the vertebral body, intervertebral foramen, hypertrophic degenerative facet joint, posterior lamina, ligamentum flavum and spinous processes in order to treat multiple ligamentous problems, as well as primary joint disease. These tools are guided to their site of pathology by the use of image intensifiers. This allows the surgeon to precisely approach the site of maximum pathology.
Once the instrument has reached the site, it is then docked on the site and direct visualization can take place through a series of graduated cannules. This procedure allows for direct visualization of the site and direct instrumentation in the site. Once the site has been verified, a number of surgical techniques can be employed to affect the site. This includes application of a laser, the use of mechanical hand tools, the use of mechanical high-powered burrs and rasps.
The laser that is employed is a 2.1 Holmium YAG Laser which remains today the most effective laser in orthopaedic surgery.
The use of The Bonati Procedures enables the surgeon to remove pathologic discs, bone spurs, reduce impingement upon nerve roots by bony pathology of the posterior facet joints and allows for re-channeling the intervertebral foramen, thereby reducing nerve root impingement. It also allows for reduction or excision of hypertropic ligamentum mucosum and also the removal of impinging facet joints within the spinal canal, as well as the release and/or removal of inflamed ligamentous tissue at the sites of spinous processes of the spine and posterior joints.
The Bonati Procedures are best defined as advanced spine surgery, although these procedures are also very often defined as laser surgery, endoscopic spine surgery, outpatient back surgery, microscopic spinal surgery, microscopic spine surgery, laser spinal surgery, spinal stenosis surgery, alternative spinal surgery, microsurgery, arthroscopic back surgery, and endoscopic back surgery.
The Bonati Procedures encompass an array of specific surgical techniques, including microdiscectomy, cervical discectomy, lumbar discectomy, thoracic discectomy, pinched nerve, microdiscectomy, laser spine surgery, laser discectomy, laminotomy, foraminoplasty, hemilaminotomy, endoscopic laminoforaminoplasty, facet debridement, endoscopic laminoforaminoplasty discectomy of the lumbar spine , lumbar facet debridement, laser foramenoplasty of the lumbar spine, laser debridement of the lumbar spinous process, arthroscopic laser cervical discectomy-anterior approach, laser cervical decompression-posterior approach, and arthroscopic laser spinous process release.
These procedures have shown to be effective in treating pain from sciatica, spinal fusion, headache, pinched nerve, back pain, neck pain, degenerative disc disease, sciatica, spinal instability, lumbar arthritis, degenerative disc disease, spondylosis, spondylolisthesis, failed back surgery syndrome, chronic back pain, radiculopathy, fibrosis, nerve pain, lumbar pain, cervical pain, facet syndrome, bone spurs, bulging discs, cervical disc problems, degenerative arthritis, foraminal narrowing, failed fusion, radiculitis, scar tissue, scoliosis and spinal cord compression.
The Bonati Arthroscopic Laser Discectomy of the Lumbar Spine
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.The benefits of this procedure:
The Bonati Arthroscopic Laser Lumbar Facet Debridement
For degenerative joint disease from Facet Syndrome or facet arthritis. This procedure is designed as an answer to:
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.The benefits of this procedure:
Arthroscopic 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 rehabilitationThe benefits of this procedure:
Arthroscopic Laser Debridement of the Lumbar Spinous Process
For Pain in the VertebraeThis procedure is designed as an answer to:
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.The benefits of this procedure:
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
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.
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Medical Development Corporation of Pasco County d/b/a The Bonati Institute.