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Our doctors are all highly experienced and renowned in the field of orthopaedic medicine and surgery.

We offer:

  • Board Certification in Orthopaedic Surgery
  • Board Certification in Anesthesiology
  • Board Certification in Pain Medicine
  • Decades in practice helping patients

In the News!

A Second Chance by Dr. Lospinuso

Freedom To Move by Dr. Bhatnager


The following doctors have been named Jersey Choice Top Doctors 2014 by New Jersey Monthly


  • Dr. Ramil Bhatnagar, MD FAAOS
  • Michael F. Lospinuso, MD FACS
NJ Monthly Top Doctor 2014
About Our Practice
Dr. Bhatnagar's Congratulations Letter
Dr. Lospinuso's Congratulations Letter
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Cervical Procedures

Foraminotomy

Foraminotomy is a minimally invasive surgical procedure performed to expand the opening in the spinal column where the nerve roots exit the spinal canal. Its purpose is to relieve the pressure resulting from foraminal stenosis. This is a painful condition caused by a narrowing of the foramen, the opening within each of the spinal bones that allows nerve roots to pass through.

As a result of aging or other musculoskeletal conditions such as arthritis, the foramen may gradually become tightened and develop bone spurs that press on the nerves and cause pain, numbness, stiffness and weakness, and may also develop into spinal stenosis. Herniated discs and thickened ligaments and joints may also be the cause of the narrowing of the foramen.

When foraminal stenosis does not respond to conservative treatments, it may require a foraminotomy. The procedure, which frees the nerve from pressure and allows it to move again within the spinal column, can be performed on any part of the spine but is most common on the cervical (neck) or lumbar (lower back) regions.

The patient is given general anesthesia and lies face down on the operating table. The surgery typically takes about two hours. An incision is made on the back to access the spine. A portion of bone is cut or shaved down to open up the passageway of the foramen. If any disk fragments are present, they are removed. Bone at the back of the vertebrae may also be taken out if that is necessary to provide more space. Foraminotomy may be combined with spinal fusion surgery to provide greater stability to the affected area of the spine.

After the surgery, you will most likely be admitted to the hospital. If the foraminotomy was in the cervical region, you will probably be required to wear a soft neck collar to limit your head and neck movement. Physical therapy may be recommended for the first several weeks after surgery. The full recovery time is typically between two and three months.

Foraminotomy has a very good success rate for relieving the symptoms of foraminal stenosis. Complications are rare, but can occur during any surgical procedure. The risks for any surgery include reactions to anesthesia, bleeding, infection, damage to a spinal nerve, pain after surgery, blood clots and the potential return of symptoms. These risks can be minimized by choosing an experienced surgeon to perform your procedure, and by adhering to your surgeon's instructions before and after your procedure.

Contact our office to learn more about foraminotomy or to schedule a consultation.

Laminectomy

A laminectomy is a surgical procedure designed to relieve the pressure and pain caused by spinal stenosis. Spinal stenosis is a narrowing of the spinal canal that puts pressure on the nerves and causes pain throughout the spine and extremities. It can develop as a result of bone spurs, osteoarthritis or even just from aging. In this procedure, a small section of bone that covers the back of the spinal cord, called the lamina, is removed to relieve the compression. It is most commonly performed on the vertebrae in either the neck or the lower back.

A laminectomy of the cervical spine is performed through the back of the spine under general anesthesia. Part or all of the lamina bones may be removed on both sides of the spine, along with the spinous process, which are projections from the back of the vertebrae. The removal of the lamina, thickened ligament, and any bone spurs relieves the pressure on the spinal cord and nerves.

If one of the vertebrae has moved over another or if there is curvature of the spine, spinal fusion may be needed for stability along with the laminectomy. The remaining spine bones can be connected by fusing vertebrae together using bone grafts or titanium metal rods with screws attached to bones on each side. The procedure can also be done without fusion.

After a laminectomy, you will most likely remain in the hospital for a short stay. Soon afterward, most patients begin a regimen of physical therapy. You will be restricted from activities that require bending and lifting for several weeks after the procedure. Generally, most people can return to work in four to eight weeks after surgery.

Contact our office to learn more about laminectomy or to schedule a consultation.

Laminectomy with Foraminotomy

At times, spinal stenosis is accompanied by foraminal stenosis. This condition is caused by a narrowing of the foramen, the opening within each of the spinal bones that allows nerve roots to pass through. When that is the case, a foraminotomy will be performed along with the laminectomy. Foraminotomy is a surgical procedure used to expand the opening in the spinal column where the nerve roots exit the spinal canal, with the goal of relieving the pressure that results from foraminal stenosis. Both of the procedures may be combined with spinal fusion surgery to provide greater stability to the affected area of the spine. Due to aging or other musculoskeletal conditions such as arthritis, the foramen may gradually become clogged and develop bone spurs that press on the nerves and cause pain, numbness, stiffness and weakness. Herniated discs and thickened ligaments and joints may also be the cause of the narrowing of the foramen.

After a laminectomy with foraminotomy, you will most likely remain in the hospital for a short stay. Soon afterward, most patients begin a regimen of physical therapy. You will be restricted from activities that require bending and lifting for several weeks after the procedure. Generally, most people can return to work in four to eight weeks after surgery. The full recovery time is typically between two and three months.

Contact our office to learn more about laminectomy with foraminotomy or to schedule a consultation.

Cervical Procedures
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