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.

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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.

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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.

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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.

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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.

It’s a Boy!

July 31, 2013

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On the evening of July 22, 2013, the fountains of Trafalger Square in London were gloriously illuminated by blue lights, signifying the heir to the British throne, Prince William, and his wife, Kate Middleton, had given birth to a prince. His Royal Highness, Prince George Alexander Louis of Cambridge, came into the world at a healthy weight of 8 pounds, 6 ounces and it seems the entire world took a collective breath.

In a time of 24-hour news cycles and second-by-second social network updates, the birth of the royal baby was the stuff of water-cooler discussions around the world. In fact, British bookmaker, Coral, noted that this birth was the biggest, non-sporting betting event in history. Everyone, it seems, is talking about babies and moms, royal and otherwise those of us at Texas Back Institute are no exceptions.

The spine specialists at Texas Back Institute treat many new mothers and mothers-to-be who are experiencing back pain associated with childbirth. While the world is fascinated with little Prince George, we chatted with Dr. Nayan Patel whose expertise in physical medicine and rehabilitation makes him an excellent source for analyzing the causes of back pain among pregnant and post-partum women. His insights shine some medical light on the back pain millions of mothers experience. However, before getting his thoughts, let’s take a look at the impact the newest prince has had already.

It’s a Boy!

With this much interest in the birth of Britain’s latest heir, one could predict some ripples running through the media and even the economy as a whole. However, very few could anticipate the tsunami of media coverage and economic impact transpiring immediately before and after the July 22nd birthdate.

On the economic front, the British birth has been very good for business – worldwide – resulting in a feel good bump in sales in a wide range of categories. The UK-based Centre for Retail Research estimates England will get a $373 million (US) boost, with $133 million in festivities, $123 million in souvenirs and toys and $117 million in books and DVDs. Because Americans and Australians can’t seem to get enough of the royal child, it expects exports to these two countries to exceed $57 million in sales.

Because of the popularity of the royal couple and their new baby, whatever choices they make in the way of “baby accoutrements” will likely drive big sales worldwide. Experts say the sales of prams and baby pushchairs should increase dramatically. They expect whatever baby clothes, cribs and toys the royals buy for little George will get the Baby Cambridge bounce.

Even US – based retailer, Target is celebrating the arrival of the royal baby. This company has been featuring Princess Kate’s maternity clothing throughout her pregnancy and is selling a special line of baby clothes in honor of the newest prince. Target’s campaign theme – “We may not know anything about being third in line to Britain’s throne, but we know about babies (and their first-time moms and dads)”- suggests a reason for our fascination with this event. More on that later.

A Royal Pain in the Back

When all the media noise dies down (if only for a few hours) and Princess Kate is left alone to enjoy some quiet time with her baby, there is a very good possibility she will be left to deal with the problem that new moms everywhere have to deal with – chronic back pain. This pain often accompanies pregnancy and continues in many post-partum women.

patel

Dr. Nayan Patel of Texas Back Institute notes, “Back pain occurs in approximately 50 percent of pregnant women on some level. It can start as early at the first trimester and continue for as long as 18-months after delivery. It can be very painful and adds to the stress of being a new mom.”

What causes this pain? Dr. Patel says, “Many people feel the added weight of the baby strains the back muscles and causes pain. However, in most cases, the real culprit for the pain is the perfectly natural process of a hormone being released in a pregnant women’s system to allow for the muscle ligaments to expand and allow for the passage of the baby through the birth canal.”

Dr. Patel continued, “This can lead to a condition known as ligamentous laxity – basically loose ligaments – which can lead to sacroiliac joint dysfunction and pain. The sacroiliac joint is the joint in the bony pelvis between the sacrum and the ilium of the pelvis which are joined by strong ligaments. The sacrum supports the spine and is supported by an ilium on each side.”

How does Dr. Patel treat this condition? “With women who are pregnant, we are very careful to avoid anti-inflammatory medicines because the baby is receiving everything the mother is ingesting. So, for pregnant women, we often prescribe a visit to the chiropractor for adjustment therapy and physical therapy, especially aquatic therapy. As for post-partum back pain, we typically prescribe the anti-inflammatory medicines and if the pain continues, physical therapy,” he notes.

“Women who are pregnant are typically younger and this is case with Princess Kate. This youth allows the muscles and ligaments to rehabilitate quicker and if Prince George’s mom is experiencing any back pain, she will likely recover quickly.”

Why We are Fascinated by the Royal Baby

Whether Princess Kate has a royal pain in the back or not, she is without doubt the most high profile mom of the decade and perhaps in history.  What is it about this event that fascinates people around the world?  Child birth is the most common occurrence on the planet, and yet we can’t seem to get enough details about the royal birth.

Some of the more philosophical pundits and pop culture observers have suggested a reason for this fascination. The marriage of the British heir to the throne, Price William, to Kate Middleton a commoner was similar to a fairy tale to many people. The couple is charming and attractive and they are a real-life prince and princess. Their having a beautiful baby just enhances the fairy tale. And after all, most of us love happy endings in our fairy tales!

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.”

The EMG Study

As featured on Spine-Health.com. Dr. Patel is a physiatrist and treats patients suffering from neck and back pain.

Contributed by Nayan Patel, MD

For the spine patient with Failed Back Surgery Syndrome, the electrodiagnostic study helps the physician assess for nerve damage coming from the cervical or lumbar spine, as well as evaluate for other nerve-related problems in an extremity (such as peripheral neuropathy).

Because symptoms from a patient withFailed Back Surgery Syndrome can be complicated, additional electrodiagnostic tests can help the physician with accurate diagnosis of the origin(s) of the patient’s pain.

An electrodiagnostic study, commonly called an EMG, is used to evaluate muscle and nerve function of a person who has extremity or facial pain, numbness and/or weakness. The study can be used to assess for cervical or lumbar radiculopathy (nerve damage from spine disease), any co-existing peripheral neuropathy (nerve damage from diseases like diabetes), myopathy (muscle disease) or focal neuropathy.

The test also helps localize the location of spinal nerve damage as well as distinguish if the damage is new or old, and progressive or stable.

There are two parts to an electrodiagnostic evaluation: nerve conduction study (NCS) and electromyography (EMG).

Nerve Conduction Study (NCS)
The NCS is done with a stimulator that generates a mild shock that travels down the nerve; the signal generated is picked up by an electrode placed at a specific distance. The data obtained give the testing physician information regarding the speed and strength of the nerve signal. The NCS picks up signals from two types of nerves: the sensory nerve, which provides sensation signals from the skin, and the motor nerve, which provides power signals to the muscles.

Electromyography (EMG)
The EMG study is done with a sterile, small gauge amplifier needle inserted into the muscles of an affected extremity. Each muscle is powered by specific sets of spinal nerves: for example, the bicep is powered by the C5 and C6 spinal nerves. If an abnormality is seen in the activity of a muscle or group of muscles, the physician can determine which spinal nerve is likely involved. The study can also help assess the age, extent, and possible progression of damage.

The complete EMG test takes 30 minutes to one hour. Although uncomfortable for some patients, the test is well tolerated and there is no persistent discomfort. The ordering physician may use the study in conjunction with other diagnostic studies, such as an MRI or CT scan, especially if the problem is thought to originate in the spine.

Since a patient who has failed spine surgery syndrome can have complicated symptoms, the evaluating surgeon can have difficulty telling if a person’s ongoing pain is coming from a spinal nerve. The EMG study will help evaluate active versus inactive spinal nerve damage as well as localize the spinal level of nerve damage. It will also help assess for any coexisting peripheral nerve damage.

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