With a dramatic increase in the number of advertisements and social media discussions, the concept of “minimally invasive surgery” – especially spine surgery – has become a hot topic. Experts in back surgery such as Dr. Michael Hisey of Texas Back Institute know that in many cases the hype is more about marketing than about medicine.

What is Minimally Invasive Surgery?

In a recent discussion, Dr. Hisey noted that the trend toward less invasive procedures in surgery has always been a guiding principle of Texas Back Institute for the past 35 years. “However over the past 10 to 15 years, this term – minimally invasive – has gained popularity,” he said.

high_tech_operating_room

Since the first efforts to correct injuries or disease of the spine were made, over 50 years ago, surgery was recognized as potentially destructive to the structures of the spine. However, this was a necessary means to an end.

In order to gain access to the spine to complete procedures such as decompressing nerves, removing herniated discs, thickened ligaments, cysts and bone spurs, back surgeons are required to dissect muscle off the vertebrae.  While this can cause damage to joints and muscles and cause scarring around the nerves, it was necessary to address the patient’s problem.

Other collateral damage resulting from surgery were risks as well, such as  the spine being weakened when ligaments that hold the vertebrae together needed to be removed. Vertebral bones, including parts of joints, were removed in order to allow the surgeon access to the spine. This also weakened the spine and often caused scarring which led to further irritation and compression of the nerves.

Michael S. Hisey, M.D.

Every physician at Texas Back Institute is dedicated to pursuing minimally invasive surgery, in every phase of a patient’s treatment. Why? It’s one of the core philosophies of our practice. While there are many techniques and approaches, along with many high-tech tools used for minimally invasive surgery, all are centered around the core philosophy, to always perform the least invasive procedures possible

In fact, the surgeons at Texas Back Institute have pioneered many of the minimally invasive techniques which are used today. “Our physicians are always looking for avenues to advance minimally invasive spine surgery, ” says Dr. Hisey.

Common Misconceptions about Minimally Invasive Procedures

With all of the marketing noise about this minimally invasive surgery, what challenges do physicians and back surgeons face with patient expectations? Dr. Hisey says, “Many patients believe minimally invasive surgery can fix bigger problems than it really can. Unfortunately, not every back injury or pain from degenerative disease can be corrected with this type of surgery.”

“Patients are also surprised when we discuss the procedure and they learn there may not be a laser involved in the surgery. There are many techniques, but the use of a laser is not always a part of the procedure. Plus, this surgery is not less expensive to perform than traditional surgery. It takes a great deal of training and often specialized equipment for a surgeon to be able to perform minimally invasive surgery. This is often reflected in the expense of the procedure,” Dr. Hisey noted.

What Types of Back Problems Are Best Treated by this Surgery?

There are several conditions that lend themselves to minimally invasive surgery. Dr. Hisey notes, “Patients who have been diagnosed with a herniated disc are good candidates for this type of procedure.”

The American Academy of Orthopedic Surgeons notes that “a high percentage of back pain and leg pain is caused by a herniated disc.” The discs in the spine act as “shock absorbers” for the vertebrae and when wear and tear or injury causes them to herniate, intense pain in the back or legs occur.

“Spondylosis can also be treated effectively with minimally invasive surgery,” Dr. Hisey said. “This condition is the result of degenerative osteoarthritis of the joints between the spinal vertebrae. When it’s severe, it can put pressure on the nerve roots causing pain and muscle weakness.”

Advantages/Disadvantages of Minimally Invasive Procedures

Because there is less damage to muscles, tendons and ligaments around the spine during a minimally invasive procedure, the recovery time for surgery is much quicker. Additionally, there is less blood loss and tissue damage” Dr. Hisey noted.  However, there are also disadvantages to this procedure. “It might not be able to remove or correct all of the damaged tissue.”

Why Choose Texas Back Institute for Back Procedures?

With so much marketing information and often unreasonable claims about minimally invasive surgery, many people with back pain are trying to research every option. Basing a potential life-threatening or, at the very least, life-altering decision such as spine surgery on a Google search should be done with extreme caution.

Dr. Hisey concludes, “For more than 35 years, our practice at Texas Back Institute has been based on doing what is best for our patients, not what currently popular procedure is featured on a TV spot. When it’s appropriate, and based on the expert diagnosis of our spine  specialists, minimally invasive surgery will be advised. However, this decision will never be based on ‘what’s hot’ in the media.”

When searching for a procedure to eliminate chronic neck or back pain, the Latin expression – caveat emptor which translates to “Let the buyer beware” – is appropriate. The spine specialists at Texas Back are constantly researching surgical methods which are minimally invasive. For us, this is not a fad. It’s the foundation of our practice.

Texas Back Institute Best Doctors
Every year physicians from all over Dallas and Collin County vote on their peers to become D Magazine’s Best Docs. Texas Back Institute has a long running history of representing some of the Best Doctors in Dallas and Collin counties. D Magazine has just published the 2013 Collin County Best Doctors list. Congratulations to (photo left to right) Drs. Jack Zigler, Isador Lieberman, Sharon Gibbs, Nayan Patel, Renato Bosita, Scott Blumenthal, and James Cable, also not in the photo Dr. Ralph Rashbaum and Dr. Michael Hisey.
Read the full text of the feature here:
Texas Back Institute (TBI) has served the North Texas area in spine care for more than 35 years. An uncompromising desire to put patients first and give individualized care has helped change the face of treatment options for neck and back pain.Today, TBI is a leader in artificial disc replacement, minimally invasive spine surgery, complex revision surgery, and treatment of spinal deformity. TBI has trained hundreds of surgeons, scientists, and allied health professionals now practicing worldwide. Its research institute employs state-of-the-art technology and is actively involved in many clinical trials throughout the year, including artificial disc replacement, minimally invasive technologies, and spinal cord stimulation.Texas Back Institute has remained one of the most academic private practices in spine care and is one of the largest freestanding multidisciplinary spine centers in the world providing comprehensive care for neck and back pain. With a fully dedicated staff of board-certified orthopedic spine surgeons, physiatrists, and physical therapists, the TBI team work together in support of their mission of helping patients get back to life.

The more than 20 physicians at Texas Back Institute are leaders in the surgical and nonsurgical treatment options for back and neck pain, from the most common outpatient procedures to the most complex cases. Thanks to the unmatched expertise of the medical staff, the advanced diagnostic testing and an unparalleled commitment to patient care, the Texas Back Institute physicians can identify potential cause of your back and neck pain and create a treatment plan specific for your needs.

Texas Back Institute has invested their resources in developing several spine specialty programs. These include Minimally Invasive Spine Surgery, The Center for Disc Replacement, The Scoliosis and Spine Tumor Center, and Failed Back Surgery. These programs give patients access to highly-trained care teams who have specific focus areas in spine care. These specialty centers within Texas Back Institute are now serving patients in the North Texas area.

“At Texas Back Institute, a minimally invasive approach to spine care is our core belief and foundation for all treatment plans.”

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.

Congratulations to Dr. Hochschuler and Dr. Lieberman!

Becker’s Spine Review recently released the “61 Spine Surgeon Inventors to Know,” which includes Dr. Stephen Hochschuler and Dr. Isador Lieberman of Texas Back Institute.  Members of the list were selected for their research and innovation contributing to the development of spine surgical devices and techniques.

The list was created as a result of extensive research. Surgeons included on the list were trained at top medical schools and have worked with some of the biggest device companies to bring their ideas to the market. In many cases, their contributions have made a difference in the quality and cost-effectiveness of spinal procedures. Many of them are also leaders within their practices, hospital departments or professional organizations.

Here is what was written on the Becker’s website.

Stephen Hochschuler, MD (Texas Back Institute, Plano). Dr. Hochschuler is the co-founder of Texas Back Institute and chairman of Texas Back Institute Holdings. He has several patents for spinal stabilization devices and co-founder of Innovative Spinal Technologies. During his career, Dr. Hochschuler has served on the scientific advisory board of physicians for Alphatec Spine and business advisory board for DePuy Spine. He was co-founder of the Spine Arthroplasty Society, now known as the International Society for the Advancement of Spine Surgery, and has participated in several FDA trials. Dr. Hochschuler earned his medical degree at Harvard Medical School in Boston and completed his residency in orthopedic surgery at the University of Texas Southwestern Medical School in Dallas.

Isador Lieberman, MD (Texas Back Institute, Plano). Dr. Lieberman holds multiple patents for his technological innovations, including SpineAssist, a robotic tool he recently co-developed for use during minimally invasive spine surgery. He has held appointments with Cleveland Clinic as staff surgeon and professor of surgery at Cleveland Clinic Lerner College of Medicine. His developments have been recognized with awards from Cleveland Clinic and the Spine Society of Europe. He recently co-founded the Uganda Charitable Spine Surgeon Mission, with which he accompanies a team of surgeons to visit Uganda each year to treat the underprivileged with spine conditions. He earned his medical degree from the University of Toronto in Ontario, Canada, and completed his residency at Mount Sinai Hospital in Toronto. He also completed residency programs in orthopedic surgery at two Toronto hospitals along with a clinical fellowship in spine and trauma surgery at The Toronto Hospital.

Physicians do not pay and cannot pay to be selected for this list.

*Becker’s Spine Review is a Chicago-based publication focusing on spine and pain practice management. The primary contributors and audience for the publication are spine surgeons and industry experts.

Best Doctors in Dallas 2012

September 26, 2012

D Magazine Announces It’s Best Doctors in Dallas 2012 List

D Magazine just published their newest issue and it included the 2012 Best Doctors in Dallas list.  Texas Back Institute is excited to announce several of our physicians made the list.  This year, Drs. Scott Blumenthal, Renato Bosita, Jr., Richard Guyer, Michael Hisey and Jack Zigler were all listed as “Best Doctors in Dallas”, by D Magazine.

At Texas Back Institute, we know we have fantastic physicians, but it is always nice to have a magazine as prestigious as D Magazine say this as well! Check out our profile below.

Photo by: Lisa Means

(Not pictured: Dr. Hisey)

The write up is a little hard to read above, so see below for a close up.

Written by: Jennifer Hayes

TEXAS BACK INSTITUTE

Orthopedic Spine Surgery, Physical Medicine and Rehabilitation

What’s New in Spine Care

Celebrating 35 years of excellence in spine care, Texas Back Institute is known worldwide for providing the latest, state-of-the art treatments and technology for neck and back pain. One example is a new FDA-approved neuro-stimulation system which can help provide instantaneous pain relief for patients with chronic pain. This new spinal implant uses the same “human controller” technology which is found in interactive games, such as Wii and smartphones, and can understand whether a patient is sitting, standing, running, or walking and can adjust the level of stimulation accordingly.

Texas Back is on the leading edge of robotic spine surgery and helped develop the first surgical robot in the world designed specifically to operate on the spine. Accurate to less than half a millimeter, it enables surgeons to plan the optimal surgery using a computed tomography (CT)-based 3D simulation of the patient’s spine. Surgeons can map out the patient’s spinal anatomy and plan the entire procedure before the patient even arrives for surgery. This allows the surgeon to be more efficient and precise and anticipate potential complications before they occur. This technology can be used in biopsies, to treat thoracic-lumbar fusion and vertebral compression fractures, and to correct scoliosis.

The goal for any spine surgery patient is to be able to get back to living an active lifestyle while retaining as much motion as possible. Both of these goals can be achieved through artificial disc replacement. This surgery allows patients to continue their dynamic lifestyle by combining a motion-preserving technology with a minimally invasive approach. Surgeons at the Texas Back Institute were the first in the U.S. to use this technology in a clinical trial in 2000 and have continued to be on the forefront of artificial disc replacement surgical techniques. As we get older, the discs in our spine begin to dehydrate and degenerate which can cause pain and numbness in the arms, legs, shoulders, neck, and sometimes hands. The artificial disc is designed to restore proper spacing between the vertebrae and also preserve the motion of a healthy disc. Texas Back participates in numerous clinical trials involving artificial disc replacement. Many of these trials have an immediate positive impact on patients. Our experience shows faster patient recovery while preserving motion in the spine. Minimally invasive spine surgery has been a philosophy of Texas Back Institute since its inception and continues to be the goal with every patient.

The physicians at Texas Back Institute are leaders in surgical and non-surgical treatment options for back and neck pain, from the most common outpatient procedures to the most complex cases. Thanks to advanced diagnostic testing and an unparalleled commitment to patient care and satisfaction, physicians can identify potential causes of your back and neck pain and create a treatment plan for your specific needs.

Texas Back Institute has locations in Plano, Frisco, Arlington, Dallas, Denton, Flower Mound, Fort Worth, Mansfield, McKinney, Rockwall, Trophy Club, Midland, and Wichita Falls.

Guest Blogger, Jennifer Sanders, Surgery Scheduler and Administrative Assistant for Dr. Lieberman, loves her job!

Not all people can truly say that they love their job. Some people might say that they like their job, but they don’t truly love going into work every day. I happen to love my job and honestly enjoy what every new day brings.

 I’m Jennifer Sanders and I have been working at TBI for a little over a year. My previous employers have all been small companies with no more than 20 employees. I’ll admit it, I was nervous to work for a company so much larger.  Our Plano office seemed so big with so many people and at first I was intimidated.  I soon learned I had nothing to be nervous about; I joined a great company. Although there are close to 100 people working in our Plano office, it still feels like a family environment.  The management makes a point to put on fun events, like pot-luck lunches, casual days and Sonic Boom!- to help with our overall health and wellness. I have never worked in a place where I felt so at home and valued.

 What makes this job different from anywhere else I’ve ever worked is you can literally witness our doctors “getting our patients back to life”.  The majority of Dr. Lieberman’s patients have scoliosis or curvature of the spine and we see a dramatic physical and emotional change in many of our patients after surgery.

 Several months after starting at TBI, I met with a patient who had a severe kyphotic deformity. She was bent forward almost 90 degrees, had to use a walker to move around and had a hard time with day-to-day activities, including laying down.  Dr. Lieberman ended up performing surgery on her and it went very well.

 I didn’t see this patient again for approximately 9 months. One day I was walking through our lobby and I was stopped by this sweet women. “Jennifer?” I paused and looked at the women trying to figure out how I knew her. She said, “You don’t recognize me, do you?” After a couple of seconds, I realized who she was and I was astonished….almost speechless. There standing before me was our patient from 9 months ago who at the time, saw the world completely bent over.  Not only had she changed her hair and lost weight, but she was standing up almost completely straight and without the aid of a walker. It brought tears to my eyes seeing just how good (and tall) she looked. She expressed heartfelt gratitude for what Dr. Lieberman was able to do to help her. I really liked working at TBI before this day, but after seeing that patient I knew I really loved where I was and I was surrounded by people and doctors who were able to improve other people’s lives.

 Since that day, I have witnessed countless other success stories like this patient.

I love my job but I also love my time outside of work. I am a wife, daughter and sister! This is my husband, Trace  and I.

 I am a Texas A&M graduate and I love cheering on the Aggies when I’m not at work.  This is my family and I getting ready to watch the Aggies win!

Seeing the good we are doing with my own two eyes, truly makes me want to come to work everyday. I wake up and say who are we going to help today? Whose life can we change for the better? And what can I do to help our patients get back to life?

I would love to know what you love about your job.  Please feel free to leave your comments here.

Patient of the Month – Felix Gonzales

At 58 years old, Felix Gonzalez, Jr. was a quadriparetic from severe repetitive stress injuries incurred while employed as an aircraft assembly worker. He was confined to a wheelchair and could barely use his arms and legs.

Today, he’s living independently in the Dallas area – thanks to what spine surgeons call a miraculous recovery from modern surgery.

“When I came to TBI, I could not even tie my shoes,” said Gonzalez. “Now I use a walker to walk, have my own apartment, can drive and shop for my groceries. I am slowly gathering my independence.”

Last year, Gonzalez was living with his parents in Washington State, unable to care for himself. Fortunately, his sister-in-law found a place that would treat Gonzalez’s injuries and provide him with relief – Texas Back Institute.

“We knew we could help,” said Dr. Daniel Bradley, a spine surgeon at Texas Back Institute, “but we had no idea how well Felix would recover.”

Gonzalez met with Dr. Bradley and his team to outline a treatment schedule. Dr. Bradley is a pioneer in minimally invasive spine surgery at the Texas Back Institute in Denton, Texas. He performed the cervical fusion first to give Gonzalez relief by alleviating pressure in his spine. Gonzales made what the staff called a miraculous recovery during therapy due to his discipline and diligence.

Next, Dr. Bradley performed the lumbar decompression surgery on Gonzalez. Again, after extraordinary progress in physical therapy, Gonzalez was walking.

Gonzalez does not plan to stop his progress any time soon. He is hoping to be using just a cane in the next month. And he has other plans.

“I want to get back on a Harley and join my friends in Arizona. We used to ride the Four Corners. I will do that again,” said Gonzalez.

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