About Our PracticeAbout Our Practice

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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Lumbar Procedures

Posterior Lumbar Interbody Fusion (PLIF)

Posterior Lumbar Interbody Fusion (PLIF) is currently one of the most frequently used fusion techniques for the relief of persistent lumbar region, or lower back, pain. As its name describes, PLIF is performed from the posterior, or back, of the spine. The posterior is chosen when it is closer to the problem area or there are particular risks to entering through the front of the body. Interbody fusion refers to the removal of an intervertebral disc, which is replaced with a bone spacer, and the adjacent vertebrae are fused together.

PLIF can be used to treat nerve compression, disc space collapse, Spondylolisthesis and other conditions. After obtaining images of the spine with MRI and CT scans, a physician can determine just what type of implant would be best suited to correct the problem.

The PLIF procedure is performed under general anesthesia with the patient lying face down on an operating table. The surgeon makes an incision in the midline of the back near the affected area, then removes the lamina to provide a better view of the nerve roots. The injured disc and any other nearby debris are taken out. A bone graft or bone morphogenetic proteins are then inserted in the open disc space along with any necessary instrumentation to promote stability in the spine.

Bone morphogenetic protein (BMP) is an FDA-approved treatment used in conjunction with spinal fusion surgery to stimulate bone growth within the treated area and achieve more successful results without the need for a bone graft.

Discovered in the 1960s, this group of protein extracts is found naturally in the body and can be created by doctors and then placed in damaged areas of the spine in concentrated quantities in order to fuse the bone ends together at a rate faster than or similar to the use of bone grafts. There are several different types of BMP found within the body, although BMP-2 is most thoroughly evaluated for this treatment.

As a still developing treatment, long-term side effects of BMP remain unknown, and it can be rather costly. It is currently approved for use in posterior lumbar interbody fusion. Most patients who undergo this treatment achieve successful fusion without having to extract a bone graft from another part of the body or using donor bone.

Contact our office to learn more about posterior lumbar interbody fusion (PLIF) or to schedule a consultation.

X-Stop Interspinous Spacer

The X-Stop Interspinous Spacer is a small FDA-approved device that is implanted in the spine to relieve pain caused by pinched nerves or spinal stenosis. These conditions involve a narrowing of the space between vertebrae, causing friction between bone and tissue in the spine. Patients often experience back pain as well as numbness, tingling and pain throughout the legs and feet.

The X-Stop spacer is a titanium implant approved by the FDA in 2005. An oval-shaped device with two extensions to help secure it, the X-Stop is placed in between the spinous processes of the affected vertebrae in the lumbar (lower back) region. The spinous processes are small projections at the ends of the vertebrae attaching the muscles and ligaments to the bone. By indirectly decompressing the nerve roots by limiting the movement of the spine at the site of the pinched nerve, the X-Stop can help to relieve irritation and pain. It stays in place permanently with no need for fusion, screws, plates or other hardware.

The X-Stop spacer is inserted through the back under general anesthesia. The entire procedure is usually completed in less than one hour. In most cases, there is no need to remove any bone from the spine, and patients can usually resume all physical activity after four to six weeks. Physical therapy may be needed after this procedure, but most patients eventually experience effective pain relief while sitting, standing and walking.

As with any surgical procedure, there are rare complications associated with the implantation of the X-Stop spacer. These risks include the possibility that it will fail to relieve the symptoms of spinal stenosis, it can become dislodged from its position, and nerve injuries could occur. The doctor will discuss these potential risks with you prior to surgery.

Contact our office to learn more about X-Stop or to schedule a consultation.

Lumbar Procedures
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