Thoracic Spine Procedures

The Bonati Procedures employ an endoscope to illuminate the surgical area and provide a highly magnified image of the site.

• The Bonati Facet Debridement of the Thoracic Spine
• The Bonati Foramenoplasty of the Thoracic Spine

Thoracic spine pain is often caused by degenerated discs of the thoracic spine and/or degenerated facet joints in the thoracic spine. Also, some patients may suffer from thoracic pain caused by ligament injuries in the mid-back.

The treatment options for thoracic spine pain include Facet Debridement of the Thoracic Spine and Foramenoplasty of the Thoracic Spine.

The Bonati Facet Debridement of the Thoracic Spine

Debridement is the surgical removal of torn, inflamed, contaminated, damaged or dead tissue. This technique is used to treat painful facet joints. Prior to surgery, a diagnostic injection of Lidocaine is used to confirm this condition as the cause of thoracic pain. After the location of the painful joint is confirmed, the surgeon makes a small incision of approximately 1 centimeter in the mid-back. A narrow metal tube, called a cannula, is then inserted into this incision.

The endoscope is then placed down through the metal tube to illuminate the passageway and project a highly magnified television image of the surgical area on a large screen in the operating room. A surgical laser then vaporizes the nerve leading to the particular facet joint. The small incision is closed with a small, absorbable suture and a loose bandage is placed over the incision.

The Bonati Foramenoplasty of the Thoracic Spine

Thoracic foramenoplasty is used to treat both spinal stenosis (narrowing of the canal through which the thoracic nerve roots exit) and thoracic herniated discs. These conditions produce thoracic pain with radiating pain to one side or the other of the mid-back region.

This procedure starts with a small (1 centimeter long) incision to one side or the other of the midline of the thoracic spine. Narrow telescoping metal tubes are then inserted down to the bone over the spinal cord of the thoracic spine. A pin is inserted into the bone as a marker. Soft tissue is cleared off of the lamina and a hole is drilled into the lamina to expose the thoracic spinal cord.

The nerve root that exits can be exposed in this way and any bony encroachment such as bone spurs can be removed. Also the disc can be identified laterally and discal material removed if necessary.