Dr. Scott Blumenthal was the first Orthopedic Spine Surgeon in the US to perform an Artificial Disc Replacement (ADR) surgery. This life changing surgery has now helped over 1,400 Texas Back Institute patients. Recently SpineUniverse.com featured the blog post below about the choosing the right spine surgeon for you.

Choosing the Spine Surgeon Who Is Right for You

Patients often wonder how to choose a spine surgeon to perform their total disc replacement.

The easy answer to this question is simple:  carefully.

The longer answer to this question is:  do your research, both on your surgeon and on the procedure.

Tips for Choosing a Spine Surgeon for Disc Replacement
While thousands of surgeons have been trained in disc replacement techniques, very few have adopted it into their clinical practice with any regularity.

Certainly, the bare minimum requirements for choosing a surgeon would be to ensure he/she is a board certified or board eligible orthopedic or neurosurgical spine surgeon.  “Board certified” means that the doctor has gone through a rigorous testing and peer evaluation process by a specialized medical board.

You can ask your doctor if he/she is board certified, or you can research it online.

Some tips to get a better feel for the expertise of the surgeon are:

  • Ask how long he/she has been performing disc replacement surgery and with what frequency they do this procedure.
  • Make sure your surgeon performs many types of surgery and can tailor your treatment to be most appropriate for your condition. Not every patient is best served with a spinal fusion, nor is every patient best served with disc replacement.
  • Make sure you have open communication with your physician.
  • Make sure you trust and have confidence in your surgeon’s abilities.
  • Look at the surgeon’s academic credentials or published papers.  Find out what they have written on disc replacement and if they are leaders in this specialized area of spine care.

A warning to patients:  Don’t depend on fancy advertising or marketing when choosing a surgeon.  Use all your resources when making a decision this critical. The Internet, medical directories and societies, as well as your regular physician can all be great resources in helping you decide which surgeon to go to.

There are also additional resources such as patient chat rooms and blogs where you can read about other patients’ experiences with surgeons.

Choosing a spine surgeon is a very important decision, and the more facts you can get, the better. Luckily, there are many resources to help you find a spine surgeon who is right for you.

Mistakes Men Make Concerning their Back Health

Men taking charge is nothing new in most situations.  At work, at the gym, on the sports field or even when a little spider invades the kitchen.  When it comes to their back health and safety men can be known for being a little lackadaisical.

Dr. Ted Belanger, an orthopedic spine surgeon at Texas Back Institute in Rockwall shares 5 mistakes men can make when it comes to their spine health.

 

1)       They don’t exercise their back.  Guys go to the gym and exercise their “glamour muscles” to get strong and look trim, but they only rarely do any exercises to strengthen their back.  Your back is made of the same tissues as your arms and legs, and responds to exercise in much the same way.  The old adage that it’s dangerous to exercise or use your back for strenuous activity is a myth.  You can strengthen it just the same as you strengthen your biceps—with repetitive range of motion against resistance until you reach muscle fatigue.

2)       They don’t do enough research.  Very often evaluation of back problems is sought without any careful research to determine who might be the best person to see.  There are big differences in the training, background, certification and experience of the various practitioners available to assess a patient with a complaint about their back or spine.  The list includes chiropractors, primary care physicians, physiatrists, pain management doctors, orthopaedic surgeons, neurosurgeons and orthopaedic spine surgeons.  Among these, no specialist has more training and experience assessing and treating musculoskeletal conditions than an orthopaedic surgeon.  Most of the others on the list either have very little musculoskeletal training (neurosurgeon) or have no experience at all in the surgical treatment of spine conditions (all the rest).  An orthopaedic spine surgeon is in the best position to diagnose and treat a patient with a back/spine problem, whether or not they need surgery.

3)       They don’t ask enough questions.  Patients often present for a second opinion to our clinic.  A common element of their frustration and sometimes confusion is a lack of understanding of their problem.  This can be avoided by insisting your questions be answered the first time around.  Bringing a list of standard questions is a great way to make sure you are communicating well with your doctor.  Good questions are:  What is my diagnosis?  What will happen if I don’t do anything about it?  What are my options to treat it and what can I expect from the treatment?  How does the treatment work, exactly?

4)       They don’t recognize the difference between amateur and expert advice.  People often put as much weight on their neighbor or friend’s back advice as they do their doctor. While good-intentioned, the patient should at least recognize that their doctor, particularly if they are an orthopaedic spine surgeon or neurosurgeon, has much more insight and understanding about the diagnosis and treatment options.  A common comment made by patients and their friends and family is “back surgery doesn’t work”.  But that’s a drastic generalization that simply isn’t true.  There are many different kinds of back surgery (discectomy, fusion, disc replacement, decompression, etc.) and many different reasons to undergo back surgery (degenerative conditions, fractures, trauma, scoliosis, deformity, tumor, infection).  Whether or not surgery is successful depends largely on the diagnosis you are treating, the details of the workup, the execution of the surgery, the choice of surgical technique, and the alignment of the expectations of the patient with what the surgery can accomplish.  Orthopaedic Spine Surgeons know this better than anyone else.

5)       They too often think their back problem is hopeless and they just need to “live with it”.  Patients are often afraid to seek advice about surgery because they are afraid.  They should think of the office visit the way the doctor does: a consultation to answer questions and provide information.  The decision about what treatment to participate in always rests with the patient.  If you are still not sure after visiting with a doctor, feel free to do more research, ask more questions, and seek more advice from experts.  Sometimes second or even third opinions are necessary to come to a decision about how to proceed.

If you or someone you know has fallen victim to one of these mistakes, it’s not too late.  Give us a call today and we will talk to you about your situation and help you figure out what the best treatments are for you!

Now that the school year is off to a good start and football season is in full swing many may think the safest place for athletes is on the sidelines, however, studies show this isn’t necessarily the safest place for athletes anymore.  In the 29th Annual CATASTROPHIC SPORTS INJURY RESEARCH report high school cheerleading is accounted for 64.8% of injuries to female athletes and 70.6% at the college level.  Many attribute this high injury rate with an increase in gymnastic type stunts.  Though injuries may never be completely preventable, there are some tips cheerleaders can follow-up help decrease the likelihood of injury.

According to The University of North Caroline National Center for Catastrophic Sport Injury Research the following are a list of sample guidelines that may help prevent cheerleading injuries:

1. Cheerleaders should have medical examinations before they are allowed to participate.  This would include a complete medical history.

2. Cheerleaders should be trained by a qualified coach with training in gymnastics and partner stunting. This person should also be trained in the proper methods for spotting and other safety factors.

3. Cheerleaders should be exposed to proper conditioning programs and trained in proper spotting techniques.

4. Cheerleaders should receive proper training before attempting gymnastic and partner type stunts and should not attempt stunts they are not capable of completing.  A qualification system demonstrating mastery of stunts is recommended.

5. Coaches should supervise all practice sessions in a safe facility.

6. Mini-trampolines and flips or falls off of pyramids and shoulders should be prohibited.

7. Pyramids over two high should not be performed.  Two high pyramids should not be performed without mats and other safety precautions.

8. If it is not possible to have a physician or certified athletic trainer at games and practice sessions, emergency procedures must be provided.  The emergency procedure should be in writing and available to all staff and athletes.

9. There should be continued research concerning safety in cheerleading.

10. Cheerleading coaches should follow the concussion policy and guidelines published by the NFHS (National Federation of State High School Associations).

11. Cheerleading coaches should have some type of safety certification.

12. The NFHS should make cheerleading a sport, which will place cheerleading under the same restrictions and safety rules as all other high school sports (physical exams, qualified coaches, safe facility, athletic trainers, practice limits, and starting and ending dates for practice and games or competitions). The NCAA should follow this same recommendation.

A cheerleader has been defined as someone who calls for and directs organized cheering, but more recently cheerleading involves much more than this.  It’s important everyone involved in cheerleading is taking an active approach to keeping our cheerleaders safe.

Do you love cheerleading?  Tell us what’s your favorite thing about cheerleading below!

1st US Service Member to Receive Artificial Disc Celebrates 8 Years Pain-Free

He was a U.S. Marine on Active Duty, planning a career as a Naval Aviator, when a herniated disc stopped everything. Alex Fender saw all his plans postponed, then stopped indefinitely, as physicians repeatedly told him that he would be ‘medically retired’ from the Corps at the age of 21. It was a prediction he refused to accept.

In 2004, Fender met Dr. Scott Blumenthal, a spine surgeon at Texas Back Institute in Plano. After the initial exam, Dr. Blumenthal suggested an artificial disc, which was a new procedure at the time.

Artificial Disc Replacement had just recently been FDA approved back then,” says Dr. Blumenthal, “I had exceptional outcomes since performing the first disc replacement in the US and I knew Alex would be a good candidate for this procedure.”

Fender was up and walking pain-free hours after his surgery. He had no complications, served four more years on Active Duty, and was honorably discharged in 2008.

Today, Fender is a successful entrepreneur in Dallas. He now serves as CEO of Funnel Science, an internet marketing and SEO agency.

“Staying healthy is objective number one,” says Fender. “You can’t get on with your life if you’re not able to get up and go to work. Texas Back Institute gave me that opportunity, and I’m glad to be an example of how well this surgery works.”

Day 10 – Ebola?

Today we only had one case booked at Mulago hospital. We all woke up in the morning a little bit unsettled because we had all heard conflicting stories as to what the state of Mulago was in regard to the Ebola situation. Although most of the stories involved New Mulago, which is a part of the greater Mulago hospital, but located a short distance away, we were still not completely clear what was true and what was hearsay  As it stood, only half of the team was meant to go to Mulago to work on the case. There definitely seemed to be some tension within the team because it seemed like people were unhappy about this situation, but no one was speaking up. Thankfully, before we headed out, there was a team meeting called where we were told what was shared with Dr. Lieberman from the acting director of Mulago Hospital, and from his perspective it was safe for us to go in and perform the operation.

Off we went in the van, the group of us scheduled to do the case at Mulago. This case was an idiopathic scoliosis instrumentation, reduction and fusion on a 21-year-old female. Despite being slightly nervous about the Ebola situation, we all pulled together as a team and supported each other, mostly with lighthearted humor about the situation, and got through the case very successfully.

Day 11 – Last Day of Surgery at Mulago

Today there were two cases planned, one at each of the hospitals. At Case Hospital, we had planned to perform a difficult procedure on a 3-year-old female with a mass in the cervical region of her spinal cord. Knowing the delicate nature of this procedure, Dr. Holman had organized late last week to have some of his more specialized neurosurgery equipment shipped from the United States to help perform this procedure. Unfortunately, although it appeared that the shipment had arrived in Uganda, it was being held up by customs, and thus we were unable to obtain it. Consequently, this case had to be cancelled. This was such a frustrating outcome, after having planned to perform this procedure, and hopefully make a real difference for this little’s girl life, but instead the Ugandan government prevented this from happening.

While the Case half of the team were dealing with their setbacks, the other half of the team was working on a case at Mulago on a 50-year-old female with a suspected infection in her spine. This group at Mulago also faced their own set of obstacles in trying to undertake this case. When we arrived in the morning we found that the instruments we needed for the procedure had not yet been sterilized, and furthermore, the truck that was supposed to come and pick it all up to take it to where it can be sterilized, was out of gas. As we waited around for the necessary equipment, we rounded on patients, caught up on writing operative reports, grabbed a quick power nap, and Dr. Ughwanogho cracked the whip to ensure our patients were getting their post-operative x-rays after being told that they couldn’t get them because they had to pay for them themselves. Dr. Ughwanogho’s persistence paid off and sure enough, before we knew it we had all of the post-operative x-rays.

Finally, at around 1 pm, we had our instruments sterilized and returned, the patient was ready, and we began the case under the very competent leadership of Dr. Ughwanogho, with assistance from two Ugandan orthopedic residents. There was some uncertainty going into this case because this particular patient had been investigated for an infected process in her spine, but we did not know exactly what we would find. What we did find was a very inflamed spine, with cavitating lesions. Due to the precarious state of this patient’s bones, likely due to underlying  osteoporosis, this case took longer than we had anticipated; plus, we had had a considerable late start. Bottom line, it was a late night at Mulago, and when we finally had finished it was around 8 pm.

The rest of the team had gone to an evening reception, hosted by the Mulago administration, but as we had had a long and frustrating day, exhausted and starving, we headed home and went out to grab a late dinner. We eventually met up with the rest of the team at the apartments and discussed the trials and tribulations of the day, but encouraged by the positive outcome for the patient. Moreover, I think this was an important day for Dr. Ughwanogho, as he was able to reaffirm to himself just how talented and competent he is as a young orthopedic surgeon, even in the most adverse conditions.

Day 12 – Last Day in Uganda

Today, our last day in Uganda, was spent operating on a 5-year-old male with congenital scoliosis at Case Hospital. While half of the team was at Case operating, the other half of the team went to Mulago to wrap up any loose ends, check in on post-operative patients, and clean up our equipment. Once we had finished up at Mulago, we bid a bittersweet farewell to this place that had quickly become a home away from home for several of us. Although we had only been there for two weeks it became very apparent to us that we had established very strong and special relationships with the health care staff we had been working alongside; not to mention the relationships we had formed with the patients we had operated on and were now on their way to recovery. To me there was definitely a sentiment of this trip not being long enough. It seemed like just when we were starting to get into the swing of things, and starting to really mesh with the Mulago staff, it was time to go. Afterall, there is always more we could do.

Once we had finished up at Mulago, those of us who were not part of the operating team at Case went home to work on outstanding reports, sorting of the thousands of pictures that will be necessary to supplement the trip report, and catching up on other odds and ends. However, our ability to do work was interrupted by a building-wide power outage. Thankfully a generator was brought in, but only lasted as long as a full tank of gas, and then we were once again powerless. This made for more of relaxing afternoon that we had anticipated, but we were not too upset about that!

The operating team finished up the case successfully and without any complications. Upon their arrival home, we all packed up, sorted out the equipment that would be getting shipped back to the United States, and cleaned up the apartments, as we had an early morning departure on Friday morning. After all of our dirty work was completed, we gathered for our final team dinner at a restaurant called The Lawn. It was a lovely evening, with great food, drink, company and lasting stories and memories shared among us all. As usual we shared our personal lessons, but this time it was the lesson of the trip. Although we all shared very profound and meaningful lessons, it became obvious to me that this trip could never be summed up in a single lesson. Each of us has learned invaluable lessons from our patients, colleagues, from the Ugandan way of life as a whole; and more importantly learned more about ourselves than we probably even know. It is my hope that these lessons and memories remain strong and fresh in my mind for years to come.

Uganda Mission

November 6, 2012

Day 9 – Second Week Begins

Contributed by Erin Sadler

                Today marked the beginning of the second week of surgery. We had procedures taking place at both Mulago and Case Hospitals. At Case Hospital, Dr. Lieberman was performing a revision of hardware. At Mulago, Dr. Ughwanogho, one of Dr. Lieberman’s fellows, completed his first case on his own. He did a fantastic job operating on a 20 year old male with a cervical burst fracture. It was not only his surgical competency that I was so impressed by, but earlier in the day while he was rounding, Dr. Ughwanogho blew me away. It was during his interaction with a young man who had been in a motorcycle accident and had an odontoid fracture in his neck. After discussing with him the potential surgery that may be necessary for him, Dr. Ughwanogho proceeded to get to know more about the patient, and in doing so learned that he was in school training to be a pilot. Furthermore, learning the operation he had been suggesting, could potentially compromise this young man’s future career. Immediately, Dr. Ughwanogho realized these implications and quickly adapted his plan to accommodate an outcome that is more in favor of this young man’s future profession. Dr. Ughwanogho’s display of compassion and patient-focused care makes him a very strong role model that any surgeon-hopeful can, and should, look up to.

                After a long day, we arrived back home and turned on the television to watch some Olympics, but were quickly distracted by the CNN headlines of the Ebola outbreak in Uganda. After a few seconds of watching we were even more surprised to see a screen shot of the Mulago hospital, the hospital we had just operated at all last week, and all day today. Although we had been aware that Ebola was present in the Kibaale district, we were not informed of its presence at Mulago until now. This made most of us quite uneasy, and in no time family members were sending emails and texts sharing their concerns for our safety. We were later told that Mulago had not yet confirmed cases of Ebola, but there were several health care professionals being quarantined. We were more reassured when we heard that the airports were still open, there had been no travel restrictions placed on Uganda, and the belief from health officials that if there was any suspicious virus, it had been contained at Mulago.

                In an attempt to take our minds off of our worry about the current situation, we went for an absolutely incredible dinner at the Kampala Serena Hotel. This buffet dinner had the most delicious fresh avocado  smoked tilapia, beef kebabs, and a smorgasbord of desserts. After filling ourselves to the brim, we headed home. Before going to bed, much to the delight of our Polish anesthesiologists, we watched the Poland Men’s Beach Volleyball team (or as Jason astutely puts it, “sand” volleyball since they are not playing on a beach during this Olympics) defeat the USA team.  We then retired to bed, some us quite nervous as to what tomorrow would hold with respect to going to Mulago to operate, and furthermore, the implications of our travelling home with this health threat brewing.

Uganda Mission Day 8

November 5, 2012

Uganda Mission

We finally have the final blog posts from Dr. Lieberman’s Uganda trip!

Day 8 – Seeing More of Kampala

Contributed by Erin Sadler

The day started with some of the team heading off to round on post-operative patients at the respective hospitals. The others who remained at the apartments spent the morning doing laundry, finishing up some work, catching up on other odds and ends, plugged into the Olympics, and in Dr. Holman’s case: fighting a suspected case of food poisoning. In the early hours of the morning, it came to Ngozi’s and my attention that Dr. Holman was feeling under the weather. By the time the morning arrived he was feeling worse and we were all concerned that he had eaten something bad that was taking a toll on his system. It was no surprise that Liz took on the nurturing role of nurse to keep a close eye on him.

Once everyone had returned from rounding, we decided to spend the afternoon going to the art market and gain a more inside look at Kampala by visiting the city market. We had initially thought we would visit the Bujagali Falls, but the previous day, during our return from Putti, we had sat in traffic for over an hour, and thus we were hesitant to take this same route, and spend the afternoon baking in a vehicle stuck in bumper to bumper traffic. Instead, we settled on the local markets. After getting a grocery list from Liz with remedies for Dr. Holman, including salted crackers, ginger ale, and Lucozade, we headed off in the bus to exercise our bargaining skills at the market.

The art market is an area in the center of town where various vendors have set up booths and sell their goods. There is everything from jewelry to art, to authentic Ugandan clothing, pottery, and other trinkets. Going from booth to booth we began to appreciate not only the art of the vendors, but the art of bargaining the price down. This was best demonstrated when we were looking at the section of the market with paintings. It was quite entertaining to see Brian attempt to exercise his negotiating prowess to try and get a painting from 150000 shillings to 80000. Although he claims he “won” since he did not end up paying more than he wanted, he also walked away empty-handed because the artist wouldn’t budge below 90000. Others were more successful, and came away with treasures that they had negotiated to a reasonable price.

From the art market, we courageously ventured to the real Kampala city market where goods are bought, sold, and traded. This was an absolutely incredible experience, to gain an insider’s look at the local commerce of Uganda. We also gained important knowledge regarding appropriate attire to wear in Ugandan public: women should not wear shorts. Unbeknownst to me, wearing shorts is the closest thing to being naked, as in Ugandan culture, a women’s thighs should only be exposed to her husband. I guess I had to learn this lesson the hard way, as many of the locals were taking pictures and quite interested in the “Muzungu” who was “naked.” Needless to say, the group of us was quite a spectacle to see wandering through the maze of alley-ways filled with mountains of clothing, shoes, electronics, and various food products and other provisions. This visit did serve a greater purpose; upon seeing the glorious local produce, we were inspired to buy ingredients to make guacamole. Under the keen eye of Chef Brian, we selected and bought the finest avocados, garlic, onions, hot peppers and limes. After making our way safely back to the vans, with our purchases in tow, and the new knowledge of what not to wear, we headed home. After a quick stop at the Nakumatt (the 24 hour grocery store) to buy a few more key ingredients including cilantro, salt and chips, we arrived home, all of us anticipating Brian’s creation. I have to admit I was skeptical, but Brian proved to be quite the chef, and concocted some of the most delicious guacamole I have ever tasted.

After our delicious appetizer, we decided to have our second dinner at Khyper Pass, the delicious Indian restaurant we had gone to on the first evening. Unfortunately, Dr. Holman was still feeling sick, and after giving him a few litres of intravenous saline and reminding him what it is like to be on the patient side of health care, he was still not up for taking solid food, so we headed off without him, promising white rice upon our return.

With our bellies full and white rice for Dr. Holman, we returned home to play a lively game of “Things.” Hopefully you have played this game, because in my opinion it might be the most fun game ever created. Needless to say, the rest of the evening was filled with hysterical laughter, learning a lot about each other, perhaps even things we may not have wanted to know, and most importantly, the complexities of Brian’s relationship with his cat, Max.

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