Alfred Bonati, MD is an orthopaedic surgeon and founder of The Bonati Spine Institute, a comprehensive care spine surgery center located in Hudson, Fla. He began to focus on arthroscopic, or minimally invasive, spine surgery in 1986. He researched and developed advanced arthroscopic techniques and instruments for spine surgery and obtained patents from the United States Patent and Trademark Office for his methods and instruments, including the use of a laser on the spine. Dr. Bonati was the first to obtain FDA approval for the use of the Holmium YAG laser on the spine. These methods and instruments are known as The Bonati Spine Procedures.
In 2005, he obtained a patent from the U.S. Patent and Trademark Office on his method and his instruments for removing orthopedic hardware. In 2006, he obtained a patent for additional surgical instruments he designed for use in removing orthopedic hardware.
He discusses the reason that many patients experience Failed Back Surgery Syndrome (FBSS) and how his laser spine procedures can help them.
Q: What causes Failed Back Surgery Syndrome?
Dr. Alfred Bonati: First, let's define Failed Back Surgery Syndrome (FBSS). FBSS refers to chronic back and/or leg pain that occurs after spinal surgery. It is characterized as a chronic pain syndrome. Following open spine surgery, whether it is a fusion, a discectomy, or a laminectomy, patients can continue to experience chronic pain in the back, arms or legs. Despite maximum efforts of surgical intervention and, often ancillary treatment, the back pain is not alleviated. In the majority of cases, we find that there is need for additional intervention to relieve the pain.
As to the causes of FBSS, there are many reasons that traditional open back surgery can fail. Contributing factors include massive surgery resulting in extensive scar tissue, loss of flexibility at the level of the fusion, recurrent disc herniation and postoperative pressure on a nerve. We usually find that the area that needs attention has not been adequately decompressed.
Adequate decompression is sometimes difficult to achieve in open spine surgery. Our concept is based on looking for the specific nerve that is being compressed and causing pain. This compression can be caused by bone, disc, tissue or a combination of these. Our procedure frees the nerve that is causing pain by going above, below and on each side of the nerve and removing the material that is compressing it.
As a tertiary spine surgery facility, physicians often refer patients to us if the initial open spine surgery doesn't correct the problem. In fact, over 40 percent of our patients suffer from failed back surgery that has been performed at another medical facility. They are often taking medication for pain and depression, taking muscle relaxers and going to a pain management specialist.
Q: How are The Bonati Spine Procedures a different option for these patients?
AB: Early on, I recognized that too many complex back surgeries were being done and people were suffering unnecessarily. The numbers have only continued to increase. Fortunately, with modern technology in the form of minimally invasive endoscopic laser spine procedures, patients no longer have to undergo traditional open back surgery.
The Bonati Spine Procedures are a proven technique for the treatment of spinal disorders and provide significant advantages for our patients. The sequentially performed procedures use the smallest incision possible to correct problems of the lumbar, cervical and thoracic spine. The procedures are outpatient and utilize MAC (monitored anesthesia care). Sedation and local anesthesia are used, leaving the patient able to communicate with our surgeons throughout the procedure to accurately target the source of the pain.
As a surgeon, success results in good patient outcomes. I am proud of our success rate of over 90 percent.
Q: What do you tell a patient who comes to you and they are still in pain after open spine surgery?
AB: I tell them that we can help and further decompress the nerve that is causing the pain, but that they have to be willing to also follow our recommendations in terms of exercise and lifestyle changes in order to achieve optimum results. They deserve to live their life without back pain.
Learn more about The Bonati Spine Institute.
In 2005, he obtained a patent from the U.S. Patent and Trademark Office on his method and his instruments for removing orthopedic hardware. In 2006, he obtained a patent for additional surgical instruments he designed for use in removing orthopedic hardware.
He discusses the reason that many patients experience Failed Back Surgery Syndrome (FBSS) and how his laser spine procedures can help them.
Q: What causes Failed Back Surgery Syndrome?
Dr. Alfred Bonati: First, let's define Failed Back Surgery Syndrome (FBSS). FBSS refers to chronic back and/or leg pain that occurs after spinal surgery. It is characterized as a chronic pain syndrome. Following open spine surgery, whether it is a fusion, a discectomy, or a laminectomy, patients can continue to experience chronic pain in the back, arms or legs. Despite maximum efforts of surgical intervention and, often ancillary treatment, the back pain is not alleviated. In the majority of cases, we find that there is need for additional intervention to relieve the pain.
As to the causes of FBSS, there are many reasons that traditional open back surgery can fail. Contributing factors include massive surgery resulting in extensive scar tissue, loss of flexibility at the level of the fusion, recurrent disc herniation and postoperative pressure on a nerve. We usually find that the area that needs attention has not been adequately decompressed.
Adequate decompression is sometimes difficult to achieve in open spine surgery. Our concept is based on looking for the specific nerve that is being compressed and causing pain. This compression can be caused by bone, disc, tissue or a combination of these. Our procedure frees the nerve that is causing pain by going above, below and on each side of the nerve and removing the material that is compressing it.
As a tertiary spine surgery facility, physicians often refer patients to us if the initial open spine surgery doesn't correct the problem. In fact, over 40 percent of our patients suffer from failed back surgery that has been performed at another medical facility. They are often taking medication for pain and depression, taking muscle relaxers and going to a pain management specialist.
Q: How are The Bonati Spine Procedures a different option for these patients?
AB: Early on, I recognized that too many complex back surgeries were being done and people were suffering unnecessarily. The numbers have only continued to increase. Fortunately, with modern technology in the form of minimally invasive endoscopic laser spine procedures, patients no longer have to undergo traditional open back surgery.
The Bonati Spine Procedures are a proven technique for the treatment of spinal disorders and provide significant advantages for our patients. The sequentially performed procedures use the smallest incision possible to correct problems of the lumbar, cervical and thoracic spine. The procedures are outpatient and utilize MAC (monitored anesthesia care). Sedation and local anesthesia are used, leaving the patient able to communicate with our surgeons throughout the procedure to accurately target the source of the pain.
As a surgeon, success results in good patient outcomes. I am proud of our success rate of over 90 percent.
Q: What do you tell a patient who comes to you and they are still in pain after open spine surgery?
AB: I tell them that we can help and further decompress the nerve that is causing the pain, but that they have to be willing to also follow our recommendations in terms of exercise and lifestyle changes in order to achieve optimum results. They deserve to live their life without back pain.
Learn more about The Bonati Spine Institute.