Chester Donnally III, MD

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Addison, TX
Chester Donnally III, MD

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.

03/26/2026

🔥 Sciatica is not a diagnosis by itself—it is a symptom, and it often means a nerve is being pinched in the lower back.

Common causes include a disc herniation, spondylolisthesis, or thickened arthritic joints in the back of the spine that narrow the space for the nerve. When that happens, pain can shoot from the low back into the buttock and down the leg, sometimes with numbness, tingling, or weakness ⚡🦵

Understanding the cause of sciatica matters, because treatment depends on what is actually pinching the nerve 🧠

03/22/2026

🦴 Spine Surgery Breakdown: Not all cages are created equal…

From PLIF → TLIF → LLIF → ALIF, each approach reaches the spine differently, but the goals are the same:

✅ Restore lumbar lordosis
✅ Achieve a solid fusion
✅ Open the neural foramen to relieve pressure on the nerves

But the type of spacer and the surgical approach both come with tradeoffs.

An ALIF cage offers major advantages, including better access for restoring lordosis and placing a larger implant, but it often requires an additional access surgeon and brings unique risks from going through the abdomen! These are no joke! But the trade offs can be particularly impressive 🪜

A TLIF cage, on the other hand, keeps the procedure entirely posterior, which can show an advantage in the perfect setting. The TLIF may sacrifice some of the benefits seen with ALIF when it comes to lordosis restoration and, in some cases, fusion potential. L5/1 MIS TLIF 🤮

And a LATERAL (LLIF) is great at L1-L4, harder at 4/5, and very rare/tough at a true L5/S1.

Different path. Different pros and cons. Same mission. 👊

Understanding the approach helps explain why a surgery is chosen—not just what is done.

03/19/2026

Heavy legs when walking? Maybe it’s not just “getting older.” 🚨

Neurogenic claudication happens when arthritis in the lumbar spine compresses the nerves going down to your legs.

Patients often describe it as walking with cinder blocks on their feet… or making it halfway to the mailbox before their legs suddenly stop working.

The key clue? It improves when you sit down or lean forward.

The good news — this is very treatable once properly diagnosed.

03/05/2026

Excited to share a small accomplishment in spine surgery here in Texas 🤠🦴

I recently combined two✌️ advanced technologies — Spineology instrumentation and Joimax endoscopic spine surgery technology — to facilitate a lumbar spinal fusion. This minimally invasive approach allows surgery through very small incisions while still achieving the stability of a fusion.

According to AMAZING reps’ knowledge, this is the first time the combination of and technologies has been performed in the GREAT state of Texas!! ⭐️

I’m incredibly grateful for the mentors who helped shape my training. One of the pioneers of endoscopic spine surgery, Dr. Mike Wang, showed me this technique almost a decade ago during my residency at the University of Miami. 🙏

The goal is simple: smaller incisions, less tissue disruption, and faster recovery for patients. ⚡️

Fun fact: Texas is bigger than France. 🇨🇱🇫🇷

texasdoctor

03/01/2026

2026 Hybrid Spine Surgery: Some insurance carriers are now approving hybrid cervical surgery — combining a fusion at one level and a disc replacement at another.
-
For years, patients were often forced into “all fusion” even when one level was better suited for motion preservation. That’s starting to change due to great leadership in the spine community
-
Hybrid surgery can allow:
• Stability where it’s needed
• Motion where it’s preserved
• More individualized surgical planning
-
It’s 100% not for everyone — proper patient selection matters — but this shift represents real progress in how cervical spine conditions are treated. To be clear, fusions are great when indicated, but let’s use all the tools we have!
-

📍 Dallas, TX
Educational spine content weekly.

SpineSurgeon

02/25/2026

What does the Eiffel Tower have to do with spine surgery? 🗼

In this video, I explain how modern lumbar fusion implants are designed using structural engineering principles — similar to the way the Eiffel Tower distributes force.

Not all interbody cages are built the same.
Some are designed to:

• Improve load distribution
• Increase surface area for bone growth
• Reduce stress shielding
• Enhance long-term fusion potential

As a spine surgeon, I’m always thinking about durability, stability, and biomechanics — not just what looks good on an X-ray.

Understanding how implants are engineered helps patients better understand why certain surgical strategies are chosen.

If you’re researching lumbar fusion, disc collapse, or spondylolisthesis — this breakdown will help you think about spine surgery in a different way.

📍 Dallas, Texas
🌎 Educational spine content weekly

02/20/2026

𝗗𝗜𝗦𝗣𝗢𝗦𝗔𝗕𝗟𝗘 𝗦𝗖𝗥𝗨𝗕$… 𝗪𝗵𝗼 𝗕𝗲𝗻𝗲𝗳𝗶𝘁$?👀💸

Let’s look at the math for just ONE spine surgeon:

🔹 130 operating days per year
🔹 ~4 vendors/reps on an average surgical day

That’s 520 vendor appearances per year.

𝘼𝙣𝙙 𝙩𝙝𝙖𝙩’𝙨 𝙚𝙭𝙩𝙧𝙚𝙢𝙚𝙡𝙮 𝙘𝙤𝙣𝙨𝙚𝙧𝙫𝙖𝙩𝙞𝙫𝙚.

Vendors often come when the surgeon isn’t even there to:
📦 Drop off trays
📤 Pick up equipment
🔎 Check in sets
📅 Prep for next-day cases

Many reps cover multiple hospitals in a single day. So if hospitals are charging per-visit or per-scrub “subscriptions,” the real number of entries can be much higher than just surgery days. 💰

Now let’s talk about what already exists.

Vendors already must:
✅ Complete credentialing
✅ Maintain compliance (vaccines, training, background checks)
✅ Wear visible credential stickers with the exact date displayed

If the date is wrong? It can and should be reported immediately. 🚨

Most hospitals also use:
🔐 RFID badge access
🚪 Secured entry systems
📲 Controlled OR access

So here’s the question…

If we already have credential verification, visible date markers, RFID tracking, and staff oversight — is adding a disposable scrub subscription truly about safety? 🧼

Or is it another revenue stream tied to vendor presence? 💸

𝑰’𝒎 𝒂𝒍𝒍 𝒇𝒐𝒓 𝒔𝒕𝒆𝒓𝒊𝒍𝒊𝒕𝒚. 𝑻𝒉𝒂𝒕’𝒔 𝒏𝒐𝒏-𝒏𝒆𝒈𝒐𝒕𝒊𝒂𝒃𝒍𝒆.
But enforcing existing safeguards may matter more than layering new costs into the system.

Transparency matters. If it improves patient safety, show the data. If it’s financial policy, call it that!

What’s your hospital doing? 👇

02/19/2026

👀 Every so often I’ll see photos circulating in Facebook groups or on Google that make 𝗮𝗻𝘁𝗲𝗿𝗶𝗼𝗿 𝗻𝗲𝗰𝗸 𝘀𝘂𝗿𝗴𝗲𝗿𝘆 look absolutely terrifying 😳📸 — huge incisions, dramatic swelling, very intimidating images.

That is 𝐧𝐨𝐭 the norm. 🚫

For an anterior cervical surgery (what many people call a “neck fusion” or disc replacement) 🦴, 𝘁𝗵𝗶𝘀 𝗶𝘀 𝗮 𝘃𝗲𝗿𝘆 𝘁𝘆𝗽𝗶𝗰𝗮𝗹 𝗶𝗻𝗰𝗶𝘀𝗶𝗼𝗻 𝘀𝗶𝘇𝗲 𝗶𝗻 𝗺𝘆 𝗽𝗿𝗮𝗰𝘁𝗶𝗰𝗲 — small, precise ✂️, and designed with cosmetic outcome in mind.

One of the best pearls I learned from a master cervical surgeon at the ℝ𝕠𝕥𝕙𝕞𝕒𝕟 𝕀𝕟𝕤𝕥𝕚𝕥𝕦𝕥𝕖 🏥 was simple but powerful: before the patient goes to sleep 😴, mark the natural skin crease in the neck. Almost everyone has a subtle fold. If you place the incision in that crease, it essentially hides itself as it heals.

Most of my patients, just a few weeks later 📅, have an incision 𝐭𝐡𝐚𝐭’𝐬 𝐯𝐞𝐫𝐲 𝐝𝐢𝐟𝐟𝐢𝐜𝐮𝐥𝐭 𝐭𝐨 𝐬𝐞𝐞 unless you’re specifically looking for it 👀.

Neck surgery is about relieving nerve compression ⚡️ and stabilizing the spine 🧠 — but it doesn’t have to leave a dramatic cosmetic footprint.

𝗧𝗲𝗰𝗵𝗻𝗶𝗾𝘂𝗲 𝗺𝗮𝘁𝘁𝗲𝗿𝘀. 𝗗𝗲𝘁𝗮𝗶𝗹𝘀 𝗺𝗮𝘁𝘁𝗲𝗿. ✨

— Dr. Chester J. Donnally III

02/13/2026

✌️ Technology Update: Foraminal Stenosis- When bone spurs narrow 🤏 the nerve tunnel (foramen), the nerve root can get compressed — causing pain, numbness, or weakness down the arm or leg ⚡️

This specialized micro-instrument is designed specifically to target that tight space. It allows us to precisely remove arthritic bone overgrowth and decompress the nerve — without unnecessary disruption to surrounding structures.

The goal?
➡️ Relieve pressure
➡️ Protect the nerve
➡️ Restore space

Modern spine surgery is about precision — not brute force.

Sadly, once again- no financial ties to the video. I just like the technology 🥴✔️

02/10/2026

𝗬𝗼𝘂𝗿 𝗹𝗼𝘄𝗲𝗿 𝗯𝗮𝗰𝗸 𝗺𝘂𝘀𝗰𝗹𝗲𝘀 𝗺𝗮𝘆 𝗽𝗿𝗲𝗱𝗶𝗰𝘁 𝘄𝗵𝗲𝘁𝗵𝗲𝗿 𝘆𝗼𝘂 𝗻𝗲𝗲𝗱 𝗮𝗻𝗼𝘁𝗵𝗲𝗿 𝘀𝗽𝗶𝗻𝗲 𝘀𝘂𝗿𝗴𝗲𝗿𝘆🧠🦴

Many studies have shown that spine surgery outcomes are influenced by factors such as disc health, spinal alignment, and surgical hardware. A 2025 Global Spine Journal study adds another important consideration — the 𝐪𝐮𝐚𝐥𝐢𝐭𝐲 𝐨𝐟 𝐭𝐡𝐞 𝐦𝐮𝐥𝐭𝐢𝐟𝐢𝐝𝐮𝐬 𝐦𝐮𝐬𝐜𝐥𝐞 𝐛𝐞𝐟𝐨𝐫𝐞 𝐬𝐮𝐫𝐠𝐞𝐫𝐲.

The multifidus is a deep stabilizing muscle that runs along the spine. On MRI, some patients show fatty infiltration of this muscle long before surgery. In this study, greater 𝗺𝘂𝗹𝘁𝗶𝗳𝗶𝗱𝘂𝘀 𝗱𝗲𝗴𝗲𝗻𝗲𝗿𝗮𝘁𝗶𝗼𝗻 𝗼𝗻 𝗽𝗿𝗲-𝗼𝗽𝗲𝗿𝗮𝘁𝗶𝘃𝗲 𝗠𝗥𝗜 was associated with a higher likelihood of needing revision surgery later on.

🔍 Key finding:
Patients with ≥58% multifidus fatty infiltration had approximately a 2.7× higher risk of revision surgery.

⸻

📊 METHODS

• 216 patients
• Data collected from 2014–2022
• Tertiary academic hospital, New York City
• Open posterior lumbar fusion surgeries
– Single-level and multi-level fusions
• Minimum 2-year follow-up
• Revision defined as subsequent lumbar decompression or fusion

⸻

❗ WHY THIS MATTERS

• Risk may be identified before surgery
• Muscle quality may matter beyond discs and alignment
• Creates opportunity to modify risk
• Improves informed consent and expectation-setting

📚 Burkhard MD et al. Global Spine Journal, 2025

02/05/2026

🚨BREAKING: Peptides are getting a lot of attention right now- but why?! Well one reason is innovation in delivery! (fun fact, yet again I have no financial ties to this video 😖)

😤This is a nasal peptide delivery platform from Drift Peptides, designed to move beyond traditional injections and rethink how peptides are absorbed. As a surgeon, I’m always paying attention to advances in biology, recovery science, and technology that may shape where medicine is heading next.🏆

I’m proud of my good friend John Bains 🍎🍎🍎🍎🍎, the founder, for building something genuinely new and pushing this space forward in a thoughtful way. Always watching the science. Always thinking about what’s next.🧬🧠

futureofmedicine

02/03/2026

📍 𝗜𝗳 𝗜 𝗖𝗼𝘂𝗹𝗱 𝗢𝗻𝗹𝘆 𝗗𝗼 𝗢𝗡𝗘 𝗦𝗽𝗶𝗻𝗲 𝗦𝘂𝗿𝗴𝗲𝗿𝘆…

A medical student asked me in the OR the other day:
🗣️ “𝑰𝒇 𝒚𝒐𝒖 𝒄𝒐𝒖𝒍𝒅 𝒐𝒏𝒍𝒚 𝒅𝒐 𝒐𝒏𝒆 𝒔𝒑𝒊𝒏𝒆 𝒔𝒖𝒓𝒈𝒆𝒓𝒚 𝒇𝒐𝒓 𝒕𝒉𝒆 𝒓𝒆𝒔𝒕 𝒐𝒇 𝒚𝒐𝒖𝒓 𝒄𝒂𝒓𝒆𝒆𝒓, 𝒘𝒉𝒂𝒕 𝒘𝒐𝒖𝒍𝒅 𝒊𝒕 𝒃𝒆?”

My answer surprised them:
👉 𝗨𝗻𝘀𝘁𝗮𝗯𝗹𝗲 𝘀𝗽𝗼𝗻𝗱𝘆𝗹𝗼𝗹𝗶𝘀𝘁𝗵𝗲𝘀𝗶𝘀.

It’s one of the conditions I enjoy treating most because when non-operative care fails, surgery can be powerful, efficient, and highly reproducible 💪

For me, that operation is often an:
🔹 ALIF (anterior lumbar interbody fusion)
🔹 with posterior spinal instrumentation

Now, important context ⚠️ — there is no single “right” way to treat spondylolisthesis.

• Some regions don’t have access surgeons, 𝐦𝐚𝐤𝐢𝐧𝐠 𝐚𝐧𝐭𝐞𝐫𝐢𝐨𝐫 𝐚𝐩𝐩𝐫𝐨𝐚𝐜𝐡𝐞𝐬 𝐢𝐦𝐩𝐫𝐚𝐜𝐭𝐢𝐜𝐚𝐥
• Many surgeons operate primarily in owned surgery centers, 𝐰𝐡𝐞𝐫𝐞 𝐚𝐧 𝐚𝐧𝐭𝐞𝐫𝐢𝐨𝐫 𝐚𝐩𝐩𝐫𝐨𝐚𝐜𝐡 𝐦𝐚𝐲 𝐧𝐨𝐭 𝐛𝐞 𝐟𝐞𝐚𝐬𝐢𝐛𝐥𝐞
• In those settings, a posterior-only approach (TLIF) is often preferred — and it can be an option in the right hands 🤷‍♂️

My preference for ALIF comes from my environment and team 🧠🔧
• High(est?)-volume anterior access surgeons make the exposure efficient and safe
• Posterior instrumentation with 𝐧𝐚𝐯𝐢𝐠𝐚𝐭𝐢𝐨𝐧 adds an extra layer of precision and safety 🧭
• 𝐒𝐭𝐫𝐨𝐧𝐠 𝐚𝐧𝐭𝐞𝐫𝐢𝐨𝐫 𝐜𝐨𝐥𝐮𝐦𝐧 𝐬𝐮𝐩𝐩𝐨𝐫𝐭 𝐡𝐞𝐥𝐩𝐬 𝐫𝐞𝐬𝐭𝐨𝐫𝐞 𝐝𝐢𝐬𝐜 𝐡𝐞𝐢𝐠𝐡𝐭, 𝐦𝐚𝐢𝐧𝐭𝐚𝐢𝐧 𝐥𝐨𝐫𝐝𝐨𝐬𝐢𝐬, 𝐚𝐧𝐝 𝐚𝐥𝐢𝐠𝐧𝐦𝐞𝐧𝐭

There’s also evidence supporting this approach 📊
A 2022 Spine study showed ALIF demonstrated superior segmental and regional radiographic outcomes and broader clinical improvement across patient-reported outcome domains compared to TLIF at L5–S1:

Bottom line:
𝗗𝗶𝗳𝗳𝗲𝗿𝗲𝗻𝘁 𝘀𝘂𝗿𝗴𝗲𝗼𝗻𝘀, 𝗱𝗶𝗳𝗳𝗲𝗿𝗲𝗻𝘁 𝘀𝗲𝘁𝘁𝗶𝗻𝗴𝘀, 𝗱𝗶𝗳𝗳𝗲𝗿𝗲𝗻𝘁 𝘁𝗼𝗼𝗹𝘀 — 𝗮𝗹𝗹 𝘃𝗮𝗹𝗶𝗱.
This just happens to be the operation that, in my Texan hands and environment, delivers consistent, durable results for a condition that can benefit from corrective surgery!

Address

17051 Dallas Pkwy #400
Addison, TX
75001

Telephone

+12143703535

Website

https://www.donnallyspine.com/contact-us-spine-surgeon-dallas-tx.html

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