group getting their fantasy football draftFor anyone who is an avid sports fan, this is a great time of year. The baseball pennant races are full-bore, the college football season has kicked off and the 94th season of the National Football League (NFL) begins on Thursday night, September 5, 2013. Six months later, on February 2, 2014, the NFL season will end with the crowning of a champion team of Super Bowl XLVIII.

Between now and February, a curious addiction will befall many otherwise sane men and women who enjoy following professional football. They will be consumed with the stats of players who most likely don’t even play for their favorite teams. They will spend many hours studying obscure facts such as how well a given running back performs on artificial turf versus real grass. They will struggle to juggle all-star lineups to best take advantage of a scoring system that approaches the complexity of the U.S. Tax Code.

Unlike the treatment delivered by the specialists at Texas Back Institute to patients with back pain, herniated discs or other back problems, there is really no cure for this football sickness. These lost souls are smitten by the phenomenon of playing fantasy football!

Consuming Football Facts

It may not surprise you to learn fantasy football is a very big business. It is estimated by the Fantasy Sports Trade Association that 32 million people, aged twelve and older in the U.S. and Canada, play fantasy sports. The trade group notes that fantasy football players make up 90% of the fantasy sports “industry.” This participation has grown by over 60% the last four years with 19% of males in the U.S. playing fantasy sports.

Because of this high level of participation many consumer products companies such as Sprint, Yahoo, ESPN, Fox and others have invested millions of dollars in fantasy football services and promotions. The two groups who usually disagree about almost everything associated with professional football – NFL properties (composed of the team owners) and NFL Players (the players’ union) – have both created products and services that encourage fans to play fantasy football.

The Texas Back Institute Dream Team 

Most of the fun of playing fantasy football involves choosing a “dream team” from a group of outstanding players. There are no bad football players in the NFL. They’re all good. Therefore, getting to choose the best of the best for one’s own team can be great fun.

In a similar fashion, the spine specialists at Texas Back Institute are the best in their class and as such, there are only great choices. In celebration of the hundreds of thousands of fantasy drafts in full-swing at this moment, we thought we’d introduce you to our dream team.

History of the Team:

Texas Back Institute was formed in 1977 by Stephen Hochschuler, M.D., Ralph Rashbaum, M.D. and Richard Guyer, M.D. The organization is internationally recognized for excellence for spine injuries. In football terms, this team plays offense and defense equally well and the patients are the big winners.

The Texas Back Institute Fantasy Team:

As with NFL teams, the Texas Back Institute team is composed of the best of the best of spine surgery, research and therapy. The game plan for our team has been consistent for more than 35 years. Each patient injury or condition is unique and is best treated with the most minimally invasive approach.

Here’s a brief “draft” report on each of the Texas Back Institute physicians.

arakal0Rajesh G. Arakal, M.D.

Specialties: Orthopedic Spine Surgeon

Add Dr. Arakal and other TBI surgeons to your team if you need thorough evaluation and treatment of cervical, thoracic and lumbar pathology.

Belanger_MD_small

Theodore Belanger, M.D.

Specialties: Orthopedic Spine Surgeon

Add Dr. Belanger and other TBI back experts to your team if you want a spine specialist who evaluates each patient and their situation carefully and makes treatment recommendations based on their goals.

Block_PhD_Small

Andrew R. Block, Ph.D., A.B.P.P.

Specialties: Psychologist

Add Dr. Block to your team if you need to overcome emotional difficulties of surgery, deal with stress and control medications to achieve the best surgical outcomes.

blumenthal

Scott L. Blumenthal, M.D.

Specialties: Orthopedic Spine Surgeon

Add Dr. Blumenthal and other TBI back specialists to your team if you believe the goal of a spine surgeon is to get his patients back to life using the most advanced motion-preserving technologies, including lumbar and cervical artificial discs as well as posterior dynamic stabilization.

bosita

Rey Bosita, M.D., M.B.A.

Specialties: Orthopedic Spine Surgeon

Add Dr. Bosita and other TBI physicians to your team if you want to be treated with respect and have your fears about neck and back pain removed.

bradley

W. Daniel Bradley, M.D.

Specialties: Orthopedic Spine Surgeon

Dr. Bradley along with every other TBI specialist should be on your team if you feel treatment should use the latest in motion preservation and minimally invasive surgical techniques.

cable

James D. Cable, M.D.

Specialties: Occupational & Sports Medicine

Add Dr. Cable to your team for occupational and sports medicine issues. He knows wear and tear eventually affect all of us but most back pain is manageable with proper care.

duff_small

Michael F. Duffy, M.D.

Specialties: Orthopedic Spine Surgeon

Add Dr. Duffy to your team if you agree that we should get busy living! His goal and that of the other spine specialists at TBI is to deliver effective spinal care to patients in order for them to return to doing what it is that makes them happy.

gibbs

Sharon J. Gibbs, M.D.

Specialties: Physiatrist

Add Dr. Gibbs to your team if being in pain affects many aspects of your life. As a physiatrist she works hard to provide patients with the best comprehensive non-surgical care.

guyer

Richard D. Guyer, M.D.

Specialties: Orthopedic Spine Surgeon

As one of the founding physicians of Texas Back Institute, Dr. Guyer is both a player and a coach for new team members. Add him to your team if you agree with his “family test” philosophy – treating patients the way he would want his family members to be treated.

Henry_MD_web_1

Shawn M. Henry, D.O.

Specialties: Orthopedic Spine Surgeon

Dr. Henry and the other spine specialists at TBI should be on your team if you want to be treated with the most advanced technology and treatment available for your condition; holding surgery as a last resort.

hisey

Michael S. Hisey, M.D.

Specialties: Orthopedic Spine Surgeon

Add Dr. Hisey to your team if you feel the goal of neck and back treatment is to return patients to productive and pain-free activity using the most advanced minimally invasive and motion-preserving techniques.

hochschuler

Stephen H. Hochschuler, M.D.

Specialties: Orthopedic Spine Surgeon

Add Dr. Hochschuler and the other spine surgeons at Texas Back Institute to your team if you have lumbar spinal problems or have had a failed spinal procedure.

Jehan_85x85_1

Effat Jehan, M.D.

Specialties: Spine Triage Specialist

Add Dr. Jehan and the other specialists at TBI to your team if you feel the goal should be to help treat not only back and neck issues but also to provide effective coordinated support to help patients get through every day of life without any stresses related to their condition.

lankford

Craig Lankford, M.D.

Specialties: Physiatrist

If you want to be treated with respect, compassion, add Dr. Lankford and every other physician at TBI to your team. He can help you understand how pain affects your everyday life in order to help you get back to life.

lieberman

Isador Lieberman, M.D., M.B.A., FRCSC

Specialties: Orthopedic Spine Surgeon

Add Dr. Lieberman and the other spine surgery experts at TBI to you team if you want to be treated as if you were the only patient we have.

marchetti

Jason Marchetti, M.D.

Specialties: Physiatrist

If you believe in ethical treatment and the importance of educating patients regarding all available treatment options, you should consider adding Dr. Marchetti and the other spine specialists at TBI to your team.

patel

Nayan R. Patel, M.D.

Specialties: Physiatrists

Add Dr. Patel to you team if you think patients should be treated in the same way a physician treats his own family.

rashbaum

Ralph F. Rashbaum, M.D.

Specialties: Orthopedic Spine Surgeon, Pain Management

Add Dr. Rashbaum and the other spine surgery specialists at TBI to your team if you want a timely response to back conditions which leads to predictable outcomes.

shellock

Jessica Shellock, M.D.

Specialties: Orthopedic Spine Surgeon

Add Dr. Shellock to you team if you think it’s time to take your life back, with minimally invasive treatment. Along with the other experts on the TBI team, she is highly trained in the latest procedures.

Tolhurst_MD_web

Stephen R. Tolhurst, M.D.

Specialties: Orthopedic Spine Surgeon

If you want a doctor who sees surgery as a last resort and is dedicated to returning you to the lifestyle you had before the back pain, you want Dr. Tolhurst on your team.

zigler

Jack E. Zigler, M.D.

Specialties: Orthopedic Spine Surgeons

Add Dr. Zigler and the other spine surgeons at TBI to your team if think surgery should be the last resort. However, if it’s required, he’s one of the best spine surgeons in the U.S.

Choosing Your Team

There are literally hundreds of ways to set up your league and arrange for a draft of NFL players. The best advice for those new to this pastime is to understand how the players’ performance will be scored each week. This will help determine the number of running backs, wide receivers, tight ends to choose. For example, in some leagues, the yardage gained by running backs is weighted higher than the passing yardage of quarterbacks.

One should also be aware of the “bye” weeks each team has (when they are not playing) because this will mean a player on the team with the bye, will not play that week and should not be in the lineup.  Here’s a good primer  on choosing your fantasy team.

Fortunately, choosing a spine specialist is much easier than choosing a fantasy football team! With more than 35 years of excellence in spine treatments, management of many FDA trials and a foundation of minimally invasive treatment, the dream team of physicians at Texas Back Institute is championship caliber.

Dr. Andrew Block, a clinical psychologist at Texas Back Institute shares his commentary on the psychology of spine surgery.  This was recently featured in Spinal News International.

Spine surgery is under attack in the popular media. For example, a recent issue of Consumer Reports identified spine surgery as number 1 in their list of “overused medical tests and treatments”.  Indeed, several studies point to the limitations of spine surgery, such as that by Sherman, et al., (2010) who found unfavorable outcomes within 18 months of lumbar discectomy for 28% of patients.  However, other facts strongly contradict a pessimistic view of spine surgery.  Malter and colleagues (1996), for example, found laminectomy/discectomy patients had significantly greater quality of life at 5 years post-operation than did patients provided conservative care alone, with similar results for spinal fusion reported by Fritzell, et al., (2001). Thus, despite the negative press, it is clear that, for many patients spine surgery is an effective means of returning to a normal, healthy and happy lifestyle.

Why, then, does spine surgery go wrong?  A growing body of research suggests that one answer lies in patient selection, for psychosocial factors are increasingly being recognized as critical influences on the outcome of spine surgery.  Early work by Wiltse & Rocchio (1975), and Spengler et al. (1990), for example, demonstrated that patients who have excessive pain sensitivity, as assessed by the Minnesota Multiphasic Personality Inventory (MMPI), tend to have poorer surgical outcomes than patients whose pain perception more accurately reflects their underlying condition. Other emotional factors, such as depression, anxiety and anger can also exert strong adverse influences on surgical outcome.  Financial incentives, too, can militate against improvement, with patients receiving workers compensation or  involved in litigation tending to obtain poorer results.  Further reducing outcome can be issues such as a histories of physical or sexual abuse,  psychiatric treatment, and substance abuse.

Over twenty years of research by our group at Texas Back Institute, as well as research by others, has shown that when patients have a large number of such psychosocial risk factors, the chances of improvement from spine surgery are slim, even when there are clear clinical indications for surgery.  We have developed an algorithm as part of our process for presurgical psychological screening (PPS), which weights psychosocial risk factors and combines them to stratify patients into high, medium and low risk for reduced spine surgery results.  We find about 85% of  those in the high risk category obtain poor surgical results, whereas only about 20% of those in the low risk category are unsuccessful (Block et al, 2001; Block & Sarwer, 2013).

At Texas Back Institute, we now include PPS as part of the surgical work-up, and find that it can improve outcomes in two ways.  First, many psychosocial risk factors, such as depression, anxiety and active substance abuse, can be ameliorated prior to surgery. Thus, the patient is more emotionally stable going into surgery, and the odds of obtaining good results are increased.  Second, for those patients who have overwhelming psychopathology, or situations that would be unresponsive to psychotherapeutic intervention, surgery can be avoided in favor of more conservative treatments, such as multidisciplinary chronic pain programs.  By avoiding surgery for such psychologically recalcitrant patients, the surgeon’s overall success rate improves, and the true effectiveness of spine surgery is revealed.

The popular media attacks on spine surgery are based on research demonstrating both limitations in its effectiveness and reports that some patients go on to further surgeries or other aggressive treatments.  When surgeons recognize the value PPS brings to the diagnostic process, they can provide the most-effective, individualized treatment for the patient, and improve spine surgery outcomes.  Spine surgery, then, will again be recognized as a powerful tool for healing rather than a treatment to be avoided.

References:

Sherman, et al., (2010). The Spine Journal 2010; 10: 108-116.

Malter et al.,  Journal of Spine 1996; 21:1048-1054.

Fritzell et al., Spine 2001; 26:2521-2532.

Wiltse & Rocchio. J Bone Joint Surg (Am) 1975;75:478–483.

Spengler et al. J Bone Joint Surg (Am) 1990;12: 230-237.

Block et al., The Spine Journal, 2001;1:274-282.

Block & Sarwer (Eds.) Presurgical Psychological Screening, 2013, APA Books

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