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.


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.


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.


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.


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.


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.


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.


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.


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.


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.


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.


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.


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.


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.


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.


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.


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.


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.


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.


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.


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.


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.


With just one lap to go in the NASCAR Sprint Cup Series Auto Club 400, driver Denny Hamlin’s day, took a sudden and violent turn for the worst. As a result of a collision with another driver, Joey Logano, Hamlin’s back was broken and he will likely be sidelined for the next six weeks. Was this accident caused by competition spiraling out of control? Will this crash end the career of one of NASCAR’s top drivers?

The spine experts at Texas Back Institute see the type of injury Hamlin sustained – an L1 compression fracture – with some regularity, but most patients don’t sustain this injury while driving in excess of 200 miles per hour! NASCAR fans want to know the nature of Hamlin’s injury, what’s involved in the surgical treatment for this lumbar region of the spine, possible long-term damage Hamlin might expect and what type of rehab he will likely undergo.  So, we asked a specialist.

As a spine surgeon at Texas Back Institute, Dr. Michael Duffy is an expert at dealing with this type of injury and this makes him a great source for explaining the ramifications of Hamlin’s injury. His practice is focused on helping patients overcome chronic back pain, spinal disc damage, Scoliosis and, in the case of an accident like Hamlin’s, spinal surgery. Before getting Dr. Duffy’s thoughts, a brief review of this NASCAR accident is in order.

A Recap of the Race

Hamlin must have been feeling great when the cars lined up to start the race at Auto Club Speedway in California. He had good reason. His qualifying time of 187.5 miles per hour secured the coveted pole position for his #11 car for the race and as such, he was the favorite to win. This early optimism would be shattered a few of hours later.

From the earliest days of stock car racing, NASCAR drivers have had reputations for highly competitive spirits. As the news wire services noted, “In the waning laps of Sunday’s race, the two were battling for the lead when they again made contact. Logano’s Penske Racing Ford slid across the nose of Hamlin’s Toyota before striking the wall. Hamlin’s car spun, then drove straight into the inside wall near the entrance to pit road. The impact lifted the car completely off the ground.”

Although, additional safety equipment has been added to the track as a result of Sunday’s crash. Unfortunately, this new safety equipment will not help Hamlin.

Medical Insights from Texas Back Institute

Twitter seems to be the social media of choice for NASCAR drivers, even those who are in pain. Hamlin’s tweet on March 26 had no good news for his fans. “I wish I got good news today… I didn’t. If me getting back in a car was based on pain tolerance then I would be in the car next week. There’s just more to it that I can’t control.”

Wire reports note that Hamlin was examined Tuesday by Charlotte-area neurologist and spinal specialist Dr. Jerry Petty, who determined that the driver would not need surgery but would have to be out of the car for at least six weeks. NASCAR takes this weekend off, and the Sprint Cup Series returns to action May 7 on the short track at Martinsville. If Hamlin keeps to his recovery timetable, he would miss five races and return May 11 at Darlington.

Duffy Headshot Square

We asked Texas Back Institute surgeon Dr. Michael Duffy to explain the importance of the L1 vertebra. He said, “There are 5 lumbar vertebras including the L1 and they give the spine stability. The usual patient for this type of compression injury is an elderly female whose L1 vertebra has deteriorated from osteoporosis. In the case of this driver, the force from this collision went up the spine and apparently the L1 took the brunt of the force and failed.”

Since there will apparently be no need for surgery, Dr. Duffy notes that a brace and non-activity are the appropriate treatment for this type of injury. Had this injury been more extensive, the patient could have undergone a more extensive range of procedures, ranging from a corpectomy – removing the damaged bone and replacing it with a fusion cage – to adding screws and rods to increase stability of the spine.

Wire reports noted that Hamlin had a history of back problems – torn and bulging discs. Will these previous problems affect his recovery from this fracture? Dr. Duffy says, “It’s definitely a possibility. Some spine injuries can result in osteoarthritis occurring in the part of the spine. This could result in back pain in the future.”

Does having a repaired vertebra make someone more likely to have other back problems later? For example, can this lead to osteoarthritis? Duffy notes, “Any time there is a compression fracture such as this, it changes the stress on spine and eventually arthritic changes could occur. This might take 10 to 20 years, but Denny could have back pain from this injury in the future.”

Drive Fast!

It’s been said that the sport of race car driving is simple – you just drive fast and turn left. However, when that speed is combined with even a tiny miscalculation in steering or bump from another driver, the ramifications can be serious.

However, Dr. Michael Duffy is optimistic about Hamlin’s prognosis. “It appears that the spine is stabilized and with the use of the brace and rest, a patient with this injury should recover. Hamlin should be able to climb back in the racecar in 6 to 8 weeks.”

This is good news for NASCAR fans and especially Denny Hamlin.

Photo of Denny Hamlin from

Patient of the Month

Robbin Hallford went from unable to stand to increasing the number of yoga classes she teaches thanks to the miracle of 360 fusion.

Baby Boomer Robbin Hallford is a teacher and yoga instructor who can proudly state she is more active now than in her 20’s thanks to the miracle of modern surgery. Hallford, a 48-year old mother of three, underwent a 360 fusion around her L4 and L5 vertebrae in March of 2011. Since that time, she has proven daily that she can stay active and continue teaching yoga. In fact, she is planning to increase the number of classes she is teaching this summer, only a year after surgery.

Surgery was not Hallford’s first choice. After several days of pain and the inability to move her left leg, she attempted to manage the pain with chiropractic treatments. It was during these treatments that x-rays showed the lumbar area to be foggy. The chiropractor suggested an MRI, which Hallford took to a physician who recommended Dr. Michael Duffy of the Texas Back Institute.

Dr. Duffy made every effort to help me control the pain, including steroid shots, pain control and anti-inflammatory drugs. Unfortunately, I had reactions to the medications, particularly the anti-inflammatory,” said Hallford.

Hallford collapsed in her class, which was the final straw. She decided to move forward with back surgery at Texas Back Institute. Dr. Duffy assembled a team of experts to ensure that Hallford’s surgery went smoothly. In March of 2011, they performed a 360 fusion on L4 and L5, giving Hallford much needed relief.

“We knew that Robbin’s condition would be considerably improved by a 360 degree fusion,” said Dr. Duffy. “Having a patient who was so dedicated to post-operative physical therapy certainly expedited her recovery.”

Hallford’sbackground is in physical therapy and kinesiology, so she was well aware of the effort it would take to recover from surgery.

“I was in devastating pain, thinking of giving up my yoga practice and going on disability,” said Hallford. “Thanks to Dr. Duffy and his great team, I am 100% better. I got the life back that I wanted. For me, surgery was the answer.”

Like many baby boomers, Hallford wants to continue an active life on her own terms and not let injuries or aging slow her down.

“My 48 does not look like my mother’s 48 or my grandmother’s. I do more now than I did when I was 20 years old. I’m stronger now. The surgery helped me to be able to keep that,” said Hallford.

Hallford is not a proponent of choosing surgery first. In fact, she chose to use her own knowledge and skills in yoga to postpone surgery as long as possible. In the end, it was the miracle of back surgery that gave her the life she wanted.

“If there is any way, do it without surgery. But it you cannot avoid it – go to TBI. I highly recommend Michael Duffy. To take me from where I was to where I am now, he’s a very skilled physician. The team they put together was top-notch. If you are facing [spine] surgery, I can tell you with all confidence you will get the best treatment and honestly I believe the best outcome.”

Ken McGinty…back to ranching!

Ranching is hard and physically demanding work every day, all the time.  So when Ken McGinty’s back pain knocked him out of the saddle, he went to Texas Back Institute for help.

Dr. Michael Duffy diagnosed Ken with lumbar spinal stenosis and, in his case, recommended surgery.

“I couldn’t walk. I couldn’t stand. I had a MRI, came here, scheduled the surgery and got on with it,” said Ken, who tends his ranch in Ranger, Texas.

“Degenerative spinal stenosis occurs in virtually the entire adult population as a result of the natural process of aging,” said Dr. Duffy. “Spinal stenosis a very common indication for spine surgery for adults over the age of 60, and Mr. McGinty was right there in that age group.”

Ken underwent a laminectomy procedure and, two months later, was at Texas Back Institute for his last post-surgical visit with Dr. Duffy who determined it was time to lift the physical restrictions required during the healing process.

Receiving the doctor’s blessing to return to the physical rigors of running a ranch and other activities he enjoys, Ken was a happy man.

“After two months since surgery, I’m back to ranching just working cows, making sure fences are up, driving tractors and routine ranch stuff,” said Ken.  “I’m right back at it, so I can play golf, I can ride horses, I can bail hay and I can work. I’m happy. I can get back to life as normal.”


 Dr. Michael Duffy, our orthopedic spine surgeon in Mansfield, took some time out of his practice on Tuesday to talk with Chris Flanagan from Good Morning Texas about how to avoid injuring your back pain when golf. Dr. Duffy actually played golf in college so this type of segment was right up his alley! 

Dr. Duffy and Chris Flanagan.

Dr. Duffy and Chris having a good time!



Thanks so much to Mansfield Methodist for inviting us on the show. 


If you have questions about back/neck pain, please come out to the BACK TALK event Saturday August 6th at 10am. 


Super Doctors!!!!

March 23, 2011

Living magazine recently did a feature in their March issue showcasing “Super Docs” throughout the community.  Well guess who made it on the list….Texas Back Institute. Congratulations on being “SUPER“!

Our Plano physicians


Dr. Henry and Dr. Duffy

Dr. Gibbs, Dr. Lankford and Dr. Guyer at our Trophy Club office



Dr. Belanger, our newest physician at our Rockwall office


Our Flower Mound and Denton physicians, Dr. Arakal, Dr. Bradley, Dr. Marchetti and Dr. Bosita

We know finding a spine specialist can be a complex process and our goal is to make it as easy as possible.  With 20 physicians and 14 convenient locations throughout the metroplex – let us help you get back to life!



Check out our new radio commercial. What do you think? Did you know Texas Back Institute has trained over 90 spine surgeons now practicing in the US?  Did you know TBI surgeons performed the first artificial disc replacement, have written over 200 articles for scientific journals and have pioneered numerous minimally invasive surgical techniques? 

Sounds like the work of Super Heroes to me!

August marked the one year anniversary for our Mansfield office.  We had been trying to come up with a way to thank all the people who helped make our first year successful so we decided to have an anniversary party!  We held the party last night and it was awesome!

Some of Dr. Duffy’s patients attended as well as referring physicians and their office staff. Check out the pictures!  We had a great time!

The Mansfield team.  Tammy, Dr. Duffy, Diane, Misty, Candace, Vera and Sandra

We started off with a few words from the TBI leaders.

Dr. Hisey, Mr. President & Trish, CEO or as Dr. Hisey said, the woman who does it all.

Stephanie Boston, our HR director and Lise McConnell, our director of finance.

Vera Johnson and one of Dr. Duffy’s patients, Mary Boyd-Long

Mike Lish, winner of the $250 golf package

Dr Hisey relaxing

Jaclyn McDaniel our sales and marketing coordinator and Vera Johnson, our office manager.

Candace Nelson, Dr. Duffy’s assistant with Jeric Hopkins and Sandra Perez, two members of the sales team.

Thanks to everyone who helped, participated and made this a great event!

As the weather cools off heading into the fall, maybe you’re thinking about a backpack trip you didn’t want to do during the hotter summer months. We thought it would be a good time to remind everyone of a few tips to help you protect your back and avoid back pain while enjoying this wonderful outdoor sport.

 1. Get your back in shape before you backpack. Exercises to strengthen and stretch your back as well as daily exercise will help get you in shape before you go.

 2. Stretch before you strap on your backpack and trek. There are a number of back stretches recommended by professionals. One we recommend you do slowly is to position your left foot about six inches behind you and position your right foot, toe-to-heel, behind the left foot. Then place your hands on a solid vertical object at shoulder level. Allow your body sag slowly forward, which increases the natural curve of your lower back. Now allow your back to twist slowly towards the left or right. Reverse your feet and do repeat this slow twist I the opposite direction. Make sure your motion is slow without any bouncing.

 3. Take short trips. If back pain is sometimes a problem for you, avoid long backpacking trips that require carrying heavy gear. If you’re a beginner, work your way up to longer trips that require heavier backpack loads.

 4. Plan trips with fewer obstacles, less inclines and other challenges. If you suffer from back pain or are a beginner, start with easier courses. More stringent courses can add stress to your back. If you stumble trying to cross big obstacles, the added pack weight can throw you off balance and result in injury.

 5. Lighten your load every way you can. Invest in a good, lighter weight backpack and gear. Look for multipurpose gear that allows you to leave multiple items behind. Lastly, take only what you’ll really need.

 6. Lift your backpack onto your back slowly and correctly. 1) Set one foot firmly on a solid object. 2) Slide your backpack by the shoulder straps up to your knee.  3) Put one arm into one shoulder strap. 4) Lean slightly forward and let your backpack pivot slowly around to your back. 5) Slip other arm into the other strap. 6) Adjust your backpack and all straps.

 7. Use trekking poles. These been shown to reduce the weight on your back and hips and can also help stabilize your walking over rough terrain by reducing side-to-side swaying.

 Backpacking is a great way to get exercise and enjoy the beauty of nature. Safe trekking!

Dr. Michael Duffy

Orthopedic Spine Surgeon

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