The first Monday of September for many is marked as a day of rest – a rest from work, a rest from school (at least in Texas since school tends to start a little early) and also the time to put summer to rest.  Labor Day is chance for workers to take off from their  jobs and kick back, relax and enjoy themselves. 

In order to enjoy all the holiday has to offer it’s important to keep your back in tip top shape while at work.  In honor of Labor Day here are 5 helpful tips to help you maintain a health back

  1.  Exercise.  Stay fit.  Maintaining strong core muscles can help ease the stress on back muscles.  Also, by gaining weight your back muscles must support the additional load, which can be tiring and painful. 
  2. Drive properly. While commuting, move the seat forward so your knees are level with your hips.  But don’t get so close to the steering while that you can’t turn it easily.    
  3. Move around. Get up and move around during the day.  Moving can keep muscles from getting stiff and fatigued, causing the spine to carry more of the burden.
  4. Maintain proper posture.  Don’t slouch, keep your shoulders back and your back straight. Posture is imperative for maintaining a healthy back.
  5. Lift Properly. Use your legs when lifting objects.  Don’t use your back like it’s a crane.  Keep objects close to your body when lifting and always use the power of your legs to pick objects up. 

 Overall, being physically fit and utilizing proper body mechanics can help protect your back in many situations. I know it sounds easy but sometimes we just need a little reminder that taking care of our spine is important. 

 Have fun, be safe and enjoy the holiday weekend!

Hi Spine Place friends! 

Well Dr. Lieberman is back at work this week in Plano after his two-week spine mission trip to Uganda.  This is the 5th year that Dr. Lieberman has been to Uganda and it’s amazing to see the impact he has out there. 

Here are the first batch of pictures that have been uploaded so far. 

Does that say Fusion Izzy kid’s? 

Dr. Lieberman said that he was walking down the street and this little girl came up to him and was hanging onto his leg.  It wasn’t until she let go that they read her shirt.  We have no idea where the shirt came from but that’s pretty amazing that Dr. Lieberman is being recognized in the streets of Uganda!

Here are some of our favorite pictures!

This amazing bird colony.  How do you think they know which nest is theirs?


This is Kampala. 

When I saw this picture I honestly thought it was fake.  Look how small the moon is.  Amazing!

And last, but certainly not least…..

Doesn’t that make you feel like going on vacation?  It’s just breathtaking!

Have you been on any trips lately?  Tell us about yours!

If you would like to see more pictures you can go to 

Hi Texas Back friends. 

As some of you may know we have been working really hard to get the word out about our new scoliosis and spine tumor program as well as one of only 3 spine surgical  robots. 

This robot has been a long time in the making and truly changes the surgery for scoliosis and spine tumors. 

We wanted to share the following video links with all of our fans, just in case you missed it on the news.

Let us know what you think about them!

August 19th, 1pm

Yesterdays surgery was on a 50+ year young paralyzed female with treated Tuberculosis of the spine with multilevel bone destruction. We treated her with a posterior segmental instrumentation from T4 to T12. We operated at Mulago and two of the local residents scrubbed in with Lori and I…they got to place their first pedicle screws.  The case went well and she did fine overnight and is comfortable this morning.
The young man with the broken neck is finally sitting up in bed, his neck is stable, his chest is still congested and his scalp abscess is still oozing, but at least he now has a chance! The best news is this morning is he has recovered some biceps muscle function!
Yesterday evening we were accompanied by Dr Titus Beyeza to a local Ugandan entertainment center and enjoyed some local folklore and traditional dance. They even had us “Mizungos” dancing and it was clear that some of us had no rhythm.
In total, over 15 patients assessed, 9 operations in 8 patients, congenital scoliosis, idiopathic scoliosis, TB of the spine, and a broken neck, from 2 years to 53 years of age.
Today we are packing, rounding and saying our good byes.
Look to the Uganda Spine Mission website for our final report and pictures! 
Thanks to all for following us along.

Reminder….we will be doing routine phone maintenance on August 20th starting at 12pm. This may cause a disruption in our telephone service.
Thank you in advance for your patience with this matter.

Hi Texas Back Institute friends. 

The employees of Texas Back Institute are in the middle of a donation drive for the victims of domestic violence, and we would like to extend an invitation to you to help with this effort.  This is a great opportunity for us to help the lives of those families affected by domestic violence in our own communities by providing for their back to school needs. We would love for our patients to join with us in donating! Just bring your supplies to the clinic nearest you and we will get it to the right people.

Below is a list of items the shelters are requesting:

  • School Supplies for all ages
    • Colored pencils
    • Folders/Spirals
    • Pencils/Pens
    • Glue
    • Notebook paper
    • Ruler
    • Construction paper
    • Backpacks
    • Etc.
  • Toiletries:
    • Shampoo/Conditioner
    • Toothbrush/Toothpaste
    • Deodorant
    • Etc.
  • Gently used or new clothing
  • Toys for all ages

 The deadline for donations is August 23rd. 

We will be delivering the donated items to the following shelters:

Hope’s Door, Collin County

Friends of the Family, Denton County

The Women’s Center of Tarrant County

Genesis Women’s Shelter, Dallas County

We appreciate your help!

August 17, 6:30 pm
Started with rounds at Case Med Center. Yesterdays case had a fever and as soon as he saw me started screaming, a most natural response from the kids I operate on!
The 14 year old scoliosis patient is liking the pampered life of the hospital. She is a bit lazy so we will push her harder today.
We then went to Mulago and started with a trauma lecture to the residents. I stressed the importance of initial resuscitation, stabilization and prevention of bed sores.
We then got to the spine ward to organize today’s case, an unfortunate 20 yr male with multiple injuries including broken legs broken neck and paralysis. He has been in bed 2 weeks and already has bedsores on his bottom end and his head.  The one on his bottom is already abcessed!
The team was all shocked by his condition, and even more shocked when Anaesthesia tried to cancel his surgery. Go figure this kids only chance is to get his neck stabilized so he can sit up and avoid pneumonia and bedsores. After some less than subtle persuasion the anesthesiologist realized that he and I are the kids only hope.
Considering the theatrics the case went off without any setbacks and I was able to decompress (make more room for the spinal cord) and rebuild his neck, the team performed admirably despite the Mulago conditions.
Unfortunately Mulago’s condition is deteriorating, despite a new OR. There is no infrastructure, the sterilizers do not work, half the light bulbs are either broken or burnt out. As a government funded hospital I can’t help but wonder what is in store for our health care system?  It is a stark difference to the surgeries performed at the Private Case Medical Center.
The team is hungry and thirsty.
We are off to find a pizza place – we are trying to broaden our restaurant portfolio!

Spectacular case! All went well and we achieved a tremendous correction. As I had expected this was not TB but a congenital kyphosis at L1/L2 with a wedge vertebrae. The team was all excited about the case, everyone was involved and learned something new! Lori learned that Gellpie retractors were designed to fit around a 3 year old bottom perfectly. John learned how to throw a double tie in an incision less than 2 inches. Corie realized that she must update her iPod music to the surgeon’s taste. Sherron affirmed that I mumble while operating, and Brian now knows that sublaminar wires are your friend.


Aug 14 & 15, 2010

The weekend, Day 6 & 7

 Saturday we started with a ward round seeing the patients. Thankfully all were doing well. Naturally they were not enthused to see me especially when it came to changing the dressings. There is no way to comfortably take a bandage off a 3 year old child.  This tends to be a good cop, bad cop scenario. I strip the dressing then the team with their smiling faces and lollipops, cleanse and dress the wound. Two of the children were ready to go home on Saturday!

 From the hospital we loaded up the van and went on a “Voyage of Discovery:. The goal for the day was to deliver the goods.  A colleague from Dallas had sent two boxes of supplies for her cousin who lives in Icanga, and  I had been in communication with Rabbi Enosh (who leads a small “orthodox” Jewish community just north of Mbale) who had requested a Bris Milah kit (circumcision kit). After a grueling 3 ½ hour drive we arrived in Icanga to meet with the Winkler family, Mat, Sherrie, 6 children and an assortment of animals. Mat is a Baptist church “planter” whose stated mission is to “ensure that all end up in heaven”. We were welcomed into their home and treated to a wonderful lunch of Mexican style taco’s accompanied by a forthright discussion on the virtues of religion, politics and human nature.

Despite the hospitality we begged our leave to journey on further north to find Rabbi Enosh. On the way I made the executive decision to take a small detour (2 hours) to see the peak of Mt Elgon and the Sipi Falls. On any other trip this would have been the highlight, however with the preceding and forthcoming visits the beauty of the cloud covered peak of Mt Elgon was virtually all but forgotten to us.

We arrived in the presumed area of Rabbi Enosh’s village only to find out that we were in the vicinity but still had to follow a “Boda Boda” (motorbike taxi) over 3-5 miles of muddy trails to get to his site, after a seeming eternity we drove into a compound of huts that were recognizably Jewish. Menorahs and David’s Star painted on the walls or fabricated into the iron work windows seemed entirely appropriate below the grass thatched roofs.

On arrival we were greeted by Shera, the rabbi’s wife, and countless children. Unfortunately the rabbi was summoned away to a funeral and would not be back. We later met with the members of the community including the Chazan and the emeritus rabbi “Abraham” (presumed to be about 60 years), they invited us to stay for the Havdallah ceremony (marking the end of the Sabbath) which we graciously accepted. The ceremony was moving, inspiring and challenging all at once. Here we are in the middle of Africa, listening to a community of individuals struggling to survive as “orthodox jews”, who described to us how they split off from the conservative jews of Abudaguya. Who have absolutely nothing but a paper Torah in a makeshift “aron kodesh” (the Torah ark) and the deep desire to be recognized as jews.

Much to the communities chagrin as they had expected us to stay over, and as it was already late and we faced at least  5 hour drive back to Kampala we once again begged our leave. The irony of it all was that the treacherous drive seemed far more inviting than a night spent in the mud huts. 

The day was tremendous, as diverse as our team is. We all still individually in our own way experienced something new in relation to the extremes of human ideology and dedication to cause. From the Baptist church planter on a mission to lead all on a path to heaven, to the Jewish community struggling to be recognized as orthodox.

 In the wake of Saturday’s experience we set out on yet another mission. We did first go to the hospital to see the patients. N.R. our 14 year old scoli case was doing remarkably well. Her x-rays revealed a tremendous correction of her curve, as stoic as she was while I stripped off her bandages her uncle on the other hand was not that comfortable with me being the bad cop. As the bandage came off her incision he rolled his eyes and promptly hit the ground. The good news is all he suffered was a bruised ego.

The mission of the day was to visit the equator, buy the usual “Afrikan Chachkes”, visit the “crocodile center” and have a relaxing day. At the Equator village we met Tom, a church volunteer in Uganda for a 12 month mission to help restore and maintain orphanages. After a few Tusker Ale’s it was clear that Tom is a newly leaning republican, and after the harrowing drive back to Kampala we all realized the day was not as relaxing as anticipated.

 August 16, 2010

Day 8

Eventful night, despite our best efforts to stick to bottled water 2 team members are down, or is it better termed up and down?  They did get through the night and we will see how the day progresses.

Today’s surgery is on a 3 year old FLK male with presumed TB, treated with antibiotics over 1 year ago and has been left with a hunched spine and difficulty walking. I am suspicious of the diagnosis as the spine x-rays just do not look like old TB. He also has an enlarged head consistent with hydrocephalus. We will know for sure once I am there.

We will be operating with Dr Tendo as our anesthesiologist today as Dr Emmanuel could not get back from Mbrarra on time. I have worked with him in the past and he is every bit as good!

Stage 1 went very well, anterior release of L12 and the L23 discs, the ALL was actually tethered tight, no evidence of TB what so ever, looks like a congenital kyphosis.

Uganda Mission – Update

August 13, 2010

August 13th 10am

The team is just setting up for our first idiopathic scoli case, a 14 year female with about a 60 degree curve. One thing I have noticed with this trip is the pace. I believe I have learnt from past trips and carried through on this trip that the mission is a marathon and not a sprint (except of course the morning runs trying to stay away from the Mizungo Hunting dog). Up to now we have staged the cases in terms of severity and intensity. Today is the most substantial instrumentation case, then monday will be the first anterior posterior case.  JG will be discharged today, he is doing wonderfully well. He now has a 300 mile bus ride home.  I suspect the bus ride will be more risky than the surgery. The other 3 patients are all comfortable and afebrile.

Comments on Kampala:

Over the years I have noticed dramatic changes in the people, city scape and infrastructure. First was the proliferation of cell phones, last year the proliferation of cars, this year the deterioration of the road infrastructure (potholes as big Toledo) and major construction projects (multi story glass and concrete office buildings). One has to wonder what is the economic driver that promotes the construction yet ignores the infrastructure.  I have also noticed a change in the social personality. Individuals are definitely less tolerant of constantly wait in security lines even to get into the local supermarket.  All this I am sure is due to the recent bombing, although today they announced that the terror suspects have been captured and did admit to the crime. 


August 13th 6:30pm  

Just done with a T5 to L2 segmental instrumentation correction and fusion for adolescent scoliosis. The case went as well as expected.  The  correction was tremendous! For 3 of the team members this was their very first instrumented scoli case.  We are off to do evening rounds and then for a fine dinner!

It is time for a Nile Premium lager!


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