Degenerative Disc Disease Surgery

Everyone’s discs degenerate as they age. In some cases, patients may see signs of degenerative disc disease as early as the late teenage years due to surgery, trauma, or genetics. Often, patients try to manage their chronic back pain and acute lower back pain episodes or flare-ups with conservative or non-surgical care. Sooner or later, they may need to consider degenerative disc disease surgery to relieve their pain and return their lives to normal.

Why Is Degenerative Disc Disease Surgery Done

For patients with ongoing intense, disabling pain and other degenerative disc disease symptoms such as numbness, tingling, difficulty sitting, a surgical procedure may be warranted. A physical examination and MRI review are used to confirm a diagnosis of degenerative disc disease. These findings may confirm the disc space collapse, which may lead to the narrowing of the space between the vertebrae that can cause nerve impingement.

Reasons why a patient might consider degenerative disc disease surgery, include:

Lack of Pain Relief

Patients who have tried different non-surgical degenerative disc disease treatment options without success may need surgery. Non-surgical methods may include:

  • Physical therapy
  • Over-the-Counter pain relievers
  • Prescription pain relievers
  • Oral steroids or epidurals
  • Herbal remedies either taken orally or applied to the skin

Severe Back Pain

Patients who have pain that is still significant, both in terms of intensity and inability to be reduced with medication and other treatment.

Significant pain is characterized as:

  • Pain related to activity that becomes acute (flares up) but then returns to a low-grade pain level
  • Chronic pain that ranges from nagging to severe and disabling
  • Episodes of pain that last from a few days to a few months
  • Lower back muscle spasms
  • Reflex changes such as those controlled by the tendons under your kneecap or ankle

Limited Everyday Functionality

Patients who have poor quality of life or are unable to work due to limited functionality. Some examples of day-to-day limitations may include:

  • Picking up or holding a child
  • Folding laundry
  • Driving a car
  • Sitting down for dinner
  • Participating in a meeting at work

The Bonati Spine Surgery For Degenerative Disc Disease

The Bonati Spine Procedures utilize patented instruments and methods that were developed by Orthopaedic Surgeon and Bonati Spine Institute founder, Alfred O. Bonati. These procedures do not require general anesthesia. Using conscious IV sedation and local anesthesia, the patient is comfortable, responsive, and maintains the ability to provide feedback to the doctors throughout the procedure.

The Bonati Spine Procedures offer an array of surgical techniques to treat degenerative disc disease. These procedures may include:


A discectomy is performed to remove part of a bulging disc or herniated disc that is putting pressure on the spinal cord and/or spinal nerve roots, causing pain, radiculitis (pain that radiates to the extremities), numbness, tingling or weakness.


The Bonati foraminotomy/foraminectomy are performed to relieve pressure on the nerve endings that are being compressed at the site of the intervertebral foramina or neural foramina. A small portion of the bone is removed to create some space and relieve pressure on the nerve roots. Any bone spurs (osteophytes,) tissue, disc material or excessive ligament are also removed.


A facetectomy is performed to relieve pressure on the nerve roots. A facetectomy may be recommended for conditions such as facet joint syndrome, degenerative facet joints, facet arthritis, facet disease, facet hypertrophy, and osteoarthritis.


The Bonati laminectomy/laminotomy are outpatient decompression surgeries that relieve pressure on spinal nerves caused by narrowing of the spinal canal, a condition known as spinal stenosis. This condition may also result in enlargement of the facet joints, stiffening of the ligaments, and bony overgrowth (bone spurs or osteophytes). The lamina is accessed through a small incision and small portions are removed until the patient reports that the nerve pressure is relieved.

Facet Thermal Ablation

The Bonati Facet Thermal Ablation (Rhizolysis) uses a laser to deaden sensory nerves that are irritating the facet joints, causing pain. Facet joints are the joints in your spine that make your back flexible and enable you to bend and twist. Nerves exit the spinal cord through these joints.

Healthy facet joints have cartilage that allows your vertebrae to move smoothly against each other without grinding. Facet disease occurs when the cartilage in the joints deteriorates, as a result of wear and tear, aging, injury, or misuse. This may cause the joints to become misaligned, causing pain. Also, when facet joints become inflamed, stiffness and/or pain can occur.

Before Surgery

Do not eat or drink after midnight the day prior to your surgery. Try to stop smoking if you smoke and exercise regularly to improve your recovery rate. Certain medications can increase your risk of bleeding and other complications during any surgical procedure. Although your physician will give you specific instructions, the following medication should be withheld for seven days before surgery:

  • Aspirin, Plavix, and other blood thinners
  • Anti-coagulants
  • NSAIDs such as Ibuprofen, Naproxen, Aleve, and Advil
  • Arthritis medications
  • Vitamins and herbal medicines as they may interact with the anesthesia

Discuss with your surgeon and physician your condition and all of your prescriptions medications for exact instructions on how to manage them before and after surgery. Do not drink alcohol the night before and the day of your procedure.

During Surgery

All Bonati Spine Procedures are performed with conscious IV sedation and local anesthesia. This allows direct communication with the surgeon during the procedure to pinpoint the pain and facilitate its alleviation. Often patients are asked to complete a series of mobility exercises to verify that the pain has been successfully treated.

After Surgery

Your surgeon will give you a specific exercise/recovery plan to help you return to normal activities as soon as possible. Patients are often able to start walking therapy immediately after their procedure and return to work and other daily activities within days.

Recovery Time from Degenerative Disc Disease Surgery

Because The Bonati Spine Procedures do not involve a large incision, they avoid significant damage to the muscles and tendons surrounding the spine. This generally results in less pain after surgery and a faster recovery. The length of recovery time may vary and depends on your individual procedure and condition.

For more than 30 years, the physicians at the Bonati Spine Institute have been regarded as the leaders in spine surgery. Under the guidance of Dr. Alfred Bonati, more than 75,000 of our patented spine treatments have been performed with a greater than 98.75% patient satisfaction rating.