Chester Donnally III, MD

Chester Donnally III, MD Spine Surgeon🔬 | Dallas Native⭐️ | Father🏡 | Spine Expert📚 | Technology Expert🤖 | Researcher🧐
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As a third generation Texan, Dr. Donnally is compassionate to the needs of his community and the patients he serves in his native city of Dallas. He prides himself on performing the least invasive amount of surgery to alleviate a patient’s spinal pathology while concurrently accelerating their post-operative rehabilitation. Additionally, he stresses surgical techniques that minimize post-operative

pain and medication use. While Dr. Donnally is passionate about minimally invasive surgery he is also committed to complex corrective procedures for adult spinal deformities. Early in his career Dr. Donnally placed an emphasis on medical research. His contribution of more than 70 peer reviewed publications and a dozen book chapters has allowed him to be invited to many speaking engagements across the country to present his findings. He is dedicated to advancing the spinal community’s knowledge base through research and education. He continues to work with various scientific and product teams to identify modern techniques that will better diagnosis spinal conditions and manage these pathologies. A true local, Dr. Donnally graduated from Highland Park High School in Dallas and then earned Magna Cum Laude honors while at Southern Methodist University. While attending medical school at Texas Tech Health Science Center he graduated top of his class with a Distinction in Research. Dr. Donnally completed his Orthopedic Surgery training at University of Miami Hospital/Jackson Memorial Hospital. He continued his Spine Surgery training as a fellow at the world-renowned Rothman Institute in Philadelphia. He is a member of the Phi Beta Kappa and Alpha Omega Alpha honor societies. Additionally he earned the distinction of Eagle Scout with local Dallas Troop 82.

05/23/2026

Three RADIOGRAPHIC Factors I Evaluate When Considering a Disc Replacement 👇

Cervical disc replacement can be an amazing motion-preserving option for the right patient, but patient selection matters.

When I’m evaluating someone for disc replacement, three things I pay close attention to are:

1️⃣ Severe disc height loss
If the disc space has collapsed by more than 50%, high impact studies have shown outcomes can become less predictable.

2️⃣ Instability or spondylolisthesis
This can suggest more significant arthritis or dysfunction in the posterior joints of the spine. A disc replacement ONLY treats the disc space in the front/middle part of the spine — it does not directly fix the facet joints in the back. Instability inherently implies facet dysfunction

3️⃣ Significant kyphosis
If the cervical spine is hunched too far forward, restoring motion with a disc replacement may not be the best option for every patient. Newer studies, have a challenged this notion, buuuut I’m OK being a traditionalist when it comes to CDAs.

There are definitely excellent surgeons who push the limits in select/many cases, and innovation is an important part of spine surgery. For my own patients, I tend to follow textbook IDE (Investigational Device Exemption) criteria and evidence-based guidelines closely. Practicing in the same city myself and my family were all born and raised in means -I’m not going anywhere, so for me- long-term outcomes are extraordinarily important!!

The goal is not just to do a newer surgery — the goal is to choose the surgery most likely to help that specific patient.

05/20/2026

🤷‍♂️Where Pinched Nerves in Your Spine Radiate To…

Different nerves in your lower back can create very different pain patterns.

Pain into the upper thigh may point more toward an L2 or L3 nerve issue, while an L5-S1 problem can irritate the S1 nerve root and cause pain that shoots from the buttock down the back of the thigh and leg.

That is why diagnosing spine problems is not just about looking at X-rays or MRI images. The patient’s symptoms have to match the imaging. Listening to the patient and correlating their pain pattern with the MRI is one of the most important parts of making the right diagnosis and helping them get better.

05/17/2026

🚨Spinal Stenosis Patient Testimonial 📰

Spinal stenosis from an L4–L5 spondylolisthesis can be treated several different ways, and the “right” operation depends on the full picture 🧠🦴

In this case, the patient had nerve compression, instability on flexion-extension X-rays, gapping facets, and a facet cyst. A laminectomy alone could take pressure off the nerves, but it would not fully address the underlying instability or permanently restore the foraminal height where the nerves exit ⚡️

That is where a fusion can be a powerful tool 🔩

The goal was to stabilize the unstable segment, reduce the spondylolisthesis, restore height, and open the neural foramen in a more durable way. The surgery was performed efficiently, which helped minimize anesthesia time, reduce narcotic needs, and allowed the patient to be up walking the halls later that same night 🚶‍♂️🙌

Every patient and every spine is different, but this is a great example of matching the surgery to the pathology — not just treating the MRI picture, but treating the actual mechanical problem ✅

Shared with patient gratitude and permission.

05/09/2026

Definitely feeling like an older spine surgeon these days… the interns keep looking younger and younger. 😑

Today the whole family came in to round on a VIP patient! 😇 Safe to say the excitement level was high, the hallway discipline was questionable, and everyone took their job very seriously. ❤️

This week in my online , I’m focusing on a pretty cool that I’ve adopted over the last year—and one I’ve been extreme...
05/07/2026

This week in my online , I’m focusing on a pretty cool that I’ve adopted over the last year—and one I’ve been extremely satisfied with. 🧠🦴

A recent multicenter randomized trial further supports what I’ve been seeing clinically, so let’s evaluate this together 👇

Sounds obvious—but if I’m doing a fusion, it needs to fuse. In multi-level cervical spine surgery, that doesn’t always happen.

This study compared:
➡️ 3-level
vs.
➡️ 3-level ACDF + percutaneous posterior cervical stabilization

At 24 months:
• 67% of ACDF-alone patients had a nonunion ❌
• 23% required another surgery 🔁
• Most revisions were due to nonunion

With added percutaneous posterior support:
• Nonunion dropped to 25% 📉
• Reoperations dropped to 2% 📉

Importantly, the study showed:
• No increase in complications ⚠️
• No increase in hospital length of stay 🏥

Tradeoff:
• ~47 minutes of additional operative time for 3-level surgery ⏱️

Here’s the nuance 👇

Not every is a disaster.
Some are stable and patients do well 👍

But when I take someone to surgery—especially across multiple levels—I’m thinking about long-term durability 🧱

Because revision spine surgery is:
• More complex ⚙️
• Less predictable 🎯
• Harder on the patient 😣

The goal isn’t the smallest surgery.
It’s the one that works the first time. 💯

—

For patients reading this: while the word “nonunion” sounds terrible, many stable nonunions actually have very good clinical outcomes. In many cases, neither the patient nor the surgeon would even realize a nonunion is present without advanced imaging. This study used extremely strict criteria to define “fusion,” including both specialized motion X-rays and CT scans reviewed by independent radiologists. That level of scrutiny is probably beyond what most patients would ever clinically require—but for an investigational study, it represents a true gold standard approach. A stable nonunion is not the end of the world, and many patients live completely happy, functional lives with one. That said, if a little more work upfront can create a more robust long-term fusion construct, it’s something worth considering.

04/28/2026

PATIENT TESTIMONIAL: BONE SPURS PREVENTING SWALLOWING

I’m incredibly grateful to Stephen for allowing me to share his story 🙏

He came to me after seeing more than 10 other physicians, and by his account, was told his case was too complex to operate on 😳 His symptoms were severe—large anterior cervical bone spurs that were physically blocking his ability to swallow 🍽️❌

For cases like this, the front of the neck is one of the most delicate areas we operate in ⚠️ You’re working around the esophagus, trachea, carotid artery, thyroid, and critical nerves—structures that don’t tolerate mistakes 🧠

In Stephen’s surgery, I used an ultrasonic bone-cutting tool (the “diamond burr shaver” from Bioventus) 🔬 Instead of a traditional high-speed rotating burr, this technology uses high-frequency oscillation to precisely break down bone while preserving surrounding soft tissues

Why that matters:
– Less blood loss 🩸⬇️
– Continuous irrigation for better visibility 💧👀
– No spinning blade that can catch soft tissue ❌🔄
– Increased control in extremely tight, high-risk anatomy 🎯

In simple terms, the tool targets bone while pushing softer structures away rather than injuring them 🦴➡️ This isn’t about being flashy—it’s about being safer in a very unforgiving space

This was a challenging operation, no question 😬 But using this technology allowed for a safer, more controlled approach where the margin for error is essentially zero

Stephen did exceptionally well after surgery 🙌 and was kind enough to share his experience so others in similar situations know that there may still be an option—even when they’ve been told otherwise

Stories like this are why I do what I do ❤️

04/25/2026

PATIENT TESTIMONIAL: TWO LEVEL DISC REPLACEMENT

I’m extremely fortunate that patients trust me to share their stories 🙏 — it helps others who are fearful of spine surgery realize there is real hope ✨

This was a wonderful patient of mine who had a significant problem with a relatively straightforward solution 💡 She’s now doing fantastic 🙌

Cases like this remind me that while spine surgery can be complex and stressful 🧠, the outcomes can truly be life-changing ❤️‍🩹 when done for the right reasons

Treating my locally home community in Dallas, Texas 📍(sadly… no financial ties to any disc replacement companies! Also not biased 👀🤣)

04/21/2026

𝑼𝒍𝒕𝒓𝒂𝒔𝒐𝒏𝒊𝒄 𝑺𝒖𝒓𝒈𝒆𝒓𝒚 𝑴𝒆𝒏𝒕𝒂𝒍𝒊𝒕𝒚. 🦴⚡
-
As a spine surgeon in hometown🏡 (Dallas), I use this tool to help open up nerve tunnels and take pressure off pinched nerves in patients dealing with spinal stenosis and other forms of nerve compression- Yes, I still use ultrasonic technology in certain fusion cases, including scoliosis correction. 🐍
But the mindset I bring into surgery is bigger than that: when possible, I want to use precise tools to reconstruct the spine, relieve pressure on the nerves, and potentially avoid a fusion. ✅🕵️‍♀️

Fusions are absolutely the right operation when they are indicated. But having a tool that helps safely and precisely remove bone around delicate neural structures is a huge advantage—and in my opinion, it is useful in almost every spine practice.📚

⭐ Sadly, no financial ties to this video. ☹️😢😢😢

SpineSurgeon Dallas Orthopedics MedicalEducation

04/15/2026

🚬Smoking and spine surgery do not mix. 🚭

Ni****ne can hurt blood flow, slow healing, increase complications, and lower the chance of a solid fusion after surgery. If a patient wants the best possible outcome, quitting smoking is one of the smartest moves they can make.

In this video, I explain why smoking matters so much before and after spine surgery!!

neckpain spinesurgeon donnallyspineconsult

04/11/2026

🚫Not all spondylolisthesis is the same — and the type you have SHOULD determine how it’s treated. 📚
There are 6 types. Today I’m breaking down two of the most common: degenerative and isthmic.
Degenerative spondylolisthesis tends to be more stable. That means in many cases, fusion isn’t necessary — and we can manage it without surgery or with a less aggressive approach.
Isthmic spondylolisthesis is a different pathology entirely!!! It’s often unstable, and unstable spondylolisthesis has better outcomes with stabilization and fusion. Pubmed.gov
Same-sounding diagnosis. Completely different treatment path. This is why getting the right diagnosis matters.

04/05/2026

A true game changer in spine surgery. 🦴⚡

This technology allows surgeons to cut bone with impressive precision while helping protect nearby soft tissue structures. In the right setting, that can make decompressions more controlled, more efficient, and technically easier when working around delicate anatomy.

Tools like this are one of the reasons spine surgery continues to evolve—better visualization, better precision, and better ways to safely treat pressure on the nerves and spinal cord.

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