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.

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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.

Day 1

 

Annnnd we’re off! The 2013 Uganda Spine Surgery Mission officially began on Thursday, August 8 at London Heathrow Airport. This year’s team of six– the smallest team yet– gathered from a smattering of departure cities, including Dallas, Toronto and Tel Aviv. Flying in from Dallas were team lead Dr. Izzy Lieberman, his daughter (and chef extraordinaire) Danielle, and two veteran spine surgery missioners, scrub nurse Sherri LaCivita and medical equipment sales rep Rob Davis. Dr. Zvi Gorlick, a family physician in Toronto, joined the team for the first time, as did I (Jennifer Teichman), a medical student from the University of Toronto.

After a quick caffeine boost at the airport, we dumped our luggage at airport storage and scurried into London for the day. When a two-hour line thwarted our attempt to visit the Sherlock Holmes Museum, we hopped into a cab and found ourselves at Trafalgar Square after a quick drive-by of Buckingham Palace. All six of us clambered up the gigantic lion statues for our first team photo.

Trafalgar Square

 

 

 

Phone Booth

We met Ros Eisen, secretary of the Putti Village Assistance Organization for delectably crispy fish and chips at The Seashell, where Zvi insisted on ordering every dish on the menu that happened to be unavailable that day. Re-energized, we made our way to Big Ben, which several of us were surprised to learn referred to the bells rather than the clock tower itself. Dr. Lieberman surprised us with tickets for the London Eye, which proved to be the highlight of the day. We sipped champagne 40-something stories atop London and congratulated ourselves for a day well-spent. Then, it was back to Heathrow for our 9:00pm flight to Entebbe.

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The 2013 team on the London Eye

Quote of the day: “No time for dresses.”- Dr. Lieberman, after Danielle expressed a desire to change out of her yoga pants and into a dress for our day in London. We mean business!

 

Day 2

 

We touched down in a rainy Entebbe around 7:30am, sleepy-eyed yet itching to get started on the mission! Our collective enthusiasm met its first challenge when my laptop was stolen from the airplane. As a newcomer to the mission, I learned my first lesson of the trip: keep your valuables on you at all times, no exceptions. Our first driver, Eric, then appeared not with the 40-seat bus we thought was to be provided by the Mbrara University of Science and Technology (MUST), but with a small pickup truck and a 6-person van. This was my first hint that things don’t always go as planned in Uganda. We loaded the truck with our bags, piled ourselves into the van and started the bumpy 60 minute drive into Kampala, the capital and largest city in Uganda. Our first stop was Case Medical Centre, a private hospital that served as a base for the mission in previous years. This year, however, we were only there to pick up the medical equipment they had stored for us from last year.  Danielle and I held down the fort by the luggage-laden truck while the rest of the team retrieved the equipment. Rumor has it that while hoisting a big bag of surgical equipment, Zvi lamented Izzy’s choice of profession, and graciously provided us with our first quote of the day: “Why couldn’t you have been an ophthalmologist!?”

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After a true feat of space-maximization, the equipment was loaded into the truck and sent off to Mbarara to await our arrival the next day. Meanwhile, we headed to our Kampala accommodations, the Speke Hotel, for a much needed shower and change of clothes. With the whole afternoon still ahead of us, we paid a visit to the Galilee Community General Hospital, a Jewish Hospital in Kampala interested in future collaboration with the Uganda Spine Surgery Mission. We toured the facilities, including the new hospital building currently under construction. It was particularly interesting to learn about some of the considerations given to building and maintaining a small hospital on philanthropic support; the constraints of space, funds, resources and expertise were evident throughout our tour of the main hospital and construction site. Nevertheless, the team agreed that the new hospital promised to be a valuable addition to the community.

The team returned to the hotel to rest before dinner, a good idea since dinner turned out to be a marathon for the stomach and palate. We feasted on delicious Indian cuisine at Khyber Pass, one of two kitchens at the hotel and a favourite of previous incarnations of the Spine Surgery Mission. By the end of the night, several pants buttons were unbuttoned (mine included), and our droopy-eyed procession made its way to bed.

Quote of the day (#2): “I’m so full, I don’t even have room for a tic tac”

Day 3

 

Move in day! We awoke to a beautiful morning in Kampala, and hit the road after a hearty breakfast at the hotel. First stop: The Nakumatt Oasis, the Zeus of all department stores. There, amongst the impeccably clean and organized isles, one can find everything from toothpaste and vodka to washing machines and power tools. It puts Walmart to shame. After stocking up on what is reportedly the world’s best coffee beans, we piled back into the van and continued the five hour trek to Mbarara. Newly paved, the road to Mbarara traverses a landscape of rolling green hills, flat valleys of cultivated land and dirt paths dotted with shacks selling local fruit, meat, fish and potatoes. There was a collective cringe as we passed trailer after trailer of live bulls packed tighter than sardines, their ferocious horns piercing the air above them. Every half hour or so, the serene landscape was broken by the bustle and dirt of a small village with decrepit store fronts ironically painted in advertisements for Coca Cola and Nokia. Within an hour of the ride, our clothes were covered in a thin film of copper-red dirt kicked up by fellow drivers and boda-boda cyclists.

 

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We made a pit stop at the Ugandan equator, where we stretched our legs and shopped for local artisan crafts. Like school kids watching their first science experiment, Zvi, Rob and I oo-ed and aw-ed at a demonstration of water spinning in opposite directions in funnels placed on either side of the equator. Cooler still, water placed in a funnel centered on the equator didn’t spin at all as it drained! Call me a nerd….

We arrived at our hotel in Mbarara, the Lakeview, and were pleased to find large, comfortable rooms. Anxious to start our work, we gathered our medical equipment and drove to the Mbarara Regional Referral Hospital, our base for this year’s mission. We were met there by a spectacular surprise: last year, the hospital had opened an entirely new wing including an Intensive Care Unit, Emergency Department and operating theatres. We set to work right away, unloading the equipment from the truck and transporting it to a temporary storage room in the Emergency Department.

 

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Unloaded and eager to explore, we began a tour of the new building. The Emergency Department is a bustling continuum of corridors and open spaces filled with beds and curtains, each bed occupied by a patient and surrounded by family members. The spill-over of family members sit quietly on benches lining the hallways, many of whom carry infants. It seemed many of these families had not been home for days. Passed the Emergency Department, we found the ICU, a stark contrast to the crowded hallways of the ER. The ICU is a quiet space with each bed contained in a separate glass room. Computer monitors displaying patients’ vital signs hang over the beds, much like one would find in any hospital in North America. Already impressed, we then proceeded to the surgical wing. Dr. Lieberman’s expression was that of a kid in a candy shop when he first laid eyes on the operating rooms. Big, bright, clean, well-equipped and windowed… we hadn’t expected anything close to this! The team’s excitement was palpable.

We left the hospital elated and even more motivated to kick off a great week at Mbarare. After an “edible” dinner at the hotel, we headed to bed for a good sleep before our first big day at the hospital.

Quote of the day:

“It’s ok, you can take your skirt off here.. we’re all medical professionals”

“The food is…. edible….”

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Dr. Lieberman’s first glimpse of the OR

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.

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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!

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In many ways, social media such as Facebook and Twitter are more a blessing than a curse for healthcare. Just ask Cheryl Zapata, Chief Development Officer at Texas Back Institute. Each week, more and more of her professional hours are spent researching the ways social media can help the physicians and professional staff of this 36-year old practice continue to deliver world class spine care.

While many, if not most, individuals use Facebook to LIKE the latest movie or keep up with the activities of friends and YouTube to see the latest TV show or music video, a medical practice such as Texas Back Institute has more serious, long-range goals for these revolutionary communication tools.

These plans are being formulated in the context of strict adherence to patient care and privacy. While the social media objectives of Texas Back Institute are quite serious, the brilliance of these social media and the reason for their meteoric rise in popularity among almost every age group partially lies in their informal and fun presentation of vast amounts of content. In the social media world, content is indeed king.

The executive team and physicians at Texas Back Institute recognize the amazing power for health information and patient-centered care social media such as Facebook, Twitter, YouTube and blogs can deliver. There has never been a more powerful healthcare communication tool than social media as a few quick examples will suggest.

Social Media is Affecting Healthcare Now

The foundation of social media is a very powerful form of crowdsourcing.  This term, coined in 2006, is defined by several online dictionaries as the practice of obtaining needed services, ideas, or content by soliciting contributions from a large group of people, and especially from an online community. It combines the efforts of “crowds” of self-identified volunteers, workers, friends on Facebook and followers on Twitter where each one on their own initiative adds a small portion that combines into a greater result.

Healthcare has many examples where the crowdsourcing aspect of social media enabled meaningful data for patient care. Epidemiology, which is the study of patterns and causes of illness and diseases among a given group, has used social media to solve healthcare mysteries in several, high profile cases.

For example, the July 18, 2013, edition of Clinical Infectious Diseases, it was noted  Facebook users in Minnesota were able to identify tainted food as the source of a strep throat outbreak. The outbreak affected 18 of 63 attendees at a banquet and after seeing multiple posts about team members falling ill, a parent alerted the Minnesota Health Department which conducted phone interviews and analyzed DNA from strep samples eventually determining the source of the illness was a pasta dish at the banquet.    

This was not the first case solved by social media. The Los Angeles County Department of Public Health used social media to trace an outbreak of Legionnaire’s Disease at a trade conference held at the Playboy Mansion in Los Angeles in 2011. Last year, a social media-public health company called “Sickweather” accurately predicted the 2012 flu season six months in advance of the Center for Disease Control by using social media trend tracking. Clearly, social media is already involved in the delivery of healthcare.

Building a Community with Social Media

Many physicians, hospitals, clinics and healthcare executives are extremely mindful and even concerned about inappropriate use of social media by healthcare professionals. This causes a reluctance to embrace these tools. However, the fact remains these media are already being used to positively impact patient outcomes and they may be the most powerful tools to date for the practice of medicine.

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Cheryl Zapata believes when the medical practice goals and business practices of Texas Back Institute are properly aligned with social media, positive patient outcomes can occur. “The big thing social media can do for our practice is to build a community, where everyone – the patients, physicians and professional staff – is focused on patient care, pre-surgical education, preventative health practices and post-surgical therapy.”

She continued by noting, “We want our patients, our physicians and staff to be a part of something important. This community can be informed and built by timely and relevant social media content and we can glean insights about better patient care by monitoring these social media. Social media platforms are robust and extremely user friendly and it’s incumbent on us to take advantage of these communication tools.”

“We want more conversations among our physicians and patients, not less,” she noted. “And we want our physicians to be comfortable with the transparency social media affords.”

Even this blog you are reading is a part of the Texas Back Institute’s commitment to community building. “We focus considerable resources on building the ‘smart content’ in this blog which is updated every week and often several times per week. We want to be a part of the conversation our patients, physicians and staff are having. Perhaps this involves a blog post dealing “water cooler conversations” – sports injuries, news or technology – and how this topic relates to back injuries and health. If so, all the better.  We want to be relevant, accurate, timely and sometime entertaining.”

Post Your Comment

Texas Back Institute has built an international reputation through its leading-edge medical advances. For example, artificial disc replacement procedures were pioneered by the physicians at Texas Back Institute and it helped introduce this technology to the U.S. This same, innovative spirit is evident in the social media plans for organization.

The next time you see a YouTube video of information about post-surgical recovery of one our patients or a blog post about the back injuries and recoveries of Major League Baseball players; don’t forget to post a comment. We want to know what you’re thinking and how we can make this community even better!

All Star Back Care

July 15, 2013

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When Dr. Rey Bosita of The Texas Back Institute talks about back health and baseball, his voice reveals his passion for both subjects. He clearly loves the game and his medical profession. This makes Dr. Bosita the ideal source to share information and opinions about the 2013 Major League Baseball All-Star game and how these athletes deal with back injuries.

Since Texas Back Institute is the Official Spine Specialist for the Frisco RoughRiders, the AA affiliate of the Texas Rangers baseball club, Bosita knows all about baseball-oriented back injuries. Before getting his thoughts on back injuries and ball players, let’s take a brief look at the 2013 MLB All-Star game.

The Fan Favorites

This year’s All-Star game will be played at Citi Field in New York City, the home field for the National Leagues New York Mets, on Tuesday evening, July 16, 2013. As always, the game will be nationally televised on Fox and the festivities begin at 7 p.m. (Central).

The MLB All-Star game owes much of its popularity to the fact that professional baseball fans can vote on the players who will take the field. Of course, this “popularity contest” format has gotten negative comments in the past – particularly from traditional baseball fans who feel that a player’s on-field abilities and performance in the first half of the season, rather than his name identification – more often than not, the popular vote reflects what type of season the starting lineup players are having. A great example of this is Baltimore Oriole’s first baseman, Chris Davis.

After being traded from the Texas Rangers to the O’s, Davis is having a remarkable year at the plate – 85 RBIs and 33 homeruns. In the All-Star voting, he finished with 8,272,243 fan votes to edge out last year’s triple-crown winner, Miguel Cabrera of the Detroit Tigers, who amassed 8,013,874 votes. Since neither plays for teams in large metropolitan markets, where vote totals can be manipulated by in-stadium promotions and both are having great years, it appears the fans made the correct, non-partisan, decision.

On the National League side, St. Louis catcher Yadier Molina was the leading vote-getter and he joins 4 other Cardinal teammates to make the Midseason Classic lineup. The NL player who has gotten lots of attention for his amazing season after being called up from the Los Angeles Dodgers minor league team, Yasiel Puig, failed to make the All-Star team this year.

2013 Major League Baseball All-Star Starting Lineups

The American League Starters include:

Joe Mauer (C – Twins)

Chris Davis (1-B – Orioles)

Robinson Cano (2-B – Yankees)

J.J. Hardy (SS – Orioles)

Miguel Cabrera (3-B – Tigers)

Mike Trout (OF – Angles)

Adam Jones (OF – Orioles)

Jose Bautista (OF – Blue Jays)

David Ortiz (DH – Red Sox)

For the National League:

Yadier Molina (Catcher – Cardinals)

Joey Votta (1B – Reds)

Brandon Phillips (2B – Reds)

Troy Tulowitzki (SS – Rockies)

David Wright (3B – Mets)

Carlos Beltran (OF – Cardinals)

Carlos Gonzales (OF – Rockies)

Bryce Harper (OF – Nationals)

Over the course of their careers, most if not all of these All-Stars have had to deal with injuries and some have been serious. Unlike football, baseball is considered a non-contact sport. However, there are more than a few collisions between runners trying to make it home and catcher trying to guard the plate and the constant swinging and throwing can take its toll on these athletes. Injuries to the spine and back are very common in this sport and we talked with Texas Back Institute surgeon, Dr. Rey Bosita to shed some light on how playing baseball can be dangerous to your back health.

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Now Batting – Dr. Rey Bosita

Dr. Bosita was between appointments when we caught up with him and asked him about the most common back ailments for professional baseball players. He said, “Lumbar sprains and other muscular strains are the most common back problems for baseball players. However, the most serious injury is a disc herniation. This involves the damage to the disc, which cushions the vertebra in the spinal column. When a player has a herniated disc, there is intense pain and any movement – whether it’s swinging a bat or throwing a baseball – almost impossible.”

So, what causes a herniated disc?

Dr. Bosita noted, “It can occur as a result of repetitive stress, for example if a player is swinging a bat for hundreds of times each week. A disc can be herniated when a player takes a powerful swing and misses or it can be the result of a collision on the base paths.”

Texas Back Institute is the Official Spine Specialist for the Frisco RoughRiders team and because they are just starting their careers in professional baseball, these players tend to be younger than those in the “big show” in Major League Baseball. Does the age of a player have any effect on the likelihood of back injuries?

“Definitely,” notes Dr. Bosita. “Older players have much more wear and tear on their back muscles, discs and vertebra and the constant repetitive stress from playing more than 160 games a year can gradually wear down these back muscles and cartilage. Plus, younger players tend to be in better condition and their muscles can withstand the quick starts and stops of baseball.”

Bosita was quick to note that some older players such as retired Baltimore infielder Cal Ripkin showed remarkable conditioning and ability to play with pain. “During his famous and historic complete games run, Ripkin played with a lumbar compression. This would have incapacitated most players, but Ripkin continued to play every day with this condition.”

What type of conditioning exercises do professional baseball players use to avoid the back sprains and other, more serious injuries?

Dr. Bosita said, “Cross training exercises which are designed to improve flexibility and strength and proper pre-workout stretching and post-workout cool downs are the most important elements of a conditioning regimen. Since baseball players are required to go from a complete stop to full-speed at the crack of a bat, it’s important that they remain loose even when they are in the dugout. Stretching will help with this.”

The All-Star Team at Texas Back Institute

The All-Stars who take to the field on July 16th are at the very top of their profession. Their conditioning is impeccable and their knowledge of potential injuries is extensive. And yet, the odds are very good that at some time, in the course of a season, they will experience a back injury that can potentially end their season or career.

If these athletes, with all of their physical conditioning and knowledge can be sidelined by back injury, it goes without saying that non-athletes can also experience the pain and physical limitation of back injury or pain. When this happens, it’s a good idea to go to the specialists – the All Stars – who deal with these issues every day: Texas Back Institute.

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Sizzling Safely

A sizzling barbecue, surf and sun at the beach or a symphony concert – however you choose to celebrate this Independence Day, we at Texas Back Institute hope you’ll do it safely – and remember the sacrifices of those in uniform. The US currently has about 68,000 service members in Afghanistan alone.

Many domestic military bases have cancelled traditional celebrations due to that $85 billion across-the-board spending reduction, otherwise known as the ‘sequester’.
Fort Hood officials confirmed this year’s on-post Fourth of July celebration will be significantly smaller. Camp Lejeune in North Carolina is one of the bases that won’t have fireworks at all this year.

Still, North Texas will have plenty of celebrations. We have a complete list here.

Cutbacks in public celebrations may mean more private celebrations. So – if you’re stocking up on the bottle rockets and firecrackers, please make safety a top priority!

Safety First:
(According to the US Consumer Product Safety Commission there were an estimated 9,600 fireworks-related injuries during the 4th of July season in 2011.)

Obey local laws. If fireworks are not legal where you live, do not use them.
Know your fireworks.  Read the warning labels and descriptions before igniting.
Parents and caretakers should always closely supervise teens if they are using fireworks.
Parents should not allow young children to handle or use fireworks.
Never attempt to alter or modify consumer fireworks.
Fireworks should only be used outdoors.
Always have water ready if you are shooting fireworks.
Always have a fire extinguisher ready.
Alcohol and fireworks do not mix.  Save your alcohol for after the show.
Report illegal explosives, like M-80s and quarter sticks, to the fire or police department.
Also, don’t forget the family dog may be frightened by the sound of fireworks. Be careful to properly protect this vulnerable family member from the potentially serious results of emotional anxiety, dangers of overreacting, and attempts to run away.

Fun July 4th Facts:

U.S. Population in July 1776: 2.5 million
Source: Historical Statistics of the United States: Colonial Times to 1970

The nation’s estimated population on this July Fourth: 316.2 million 
Source: U.S. and World Population Clock

Numbers of signers to the Declaration of Independence: 56

Benjamin Franklin, John Adams, Thomas Jefferson, Roger Sherman and Robert R. Livingston comprised the Committee of Five that drafted the Declaration. Jefferson, regarded as the strongest and most eloquent writer, wrote most of the document.

John Hancock, President of the Second Continental Congress, was the first signer. This merchant by trade did so in an entirely blank space making it the largest and most famous signature – hence the term John Hancock, which is still used today as a synonym for signature.

Benjamin Franklin (age 70), who represented Pennsylvania, was the oldest of the signers. Franklin County, Pa., had an estimated population of 151,275 as of July 1, 2012. Edward Rutledge (age 26), of South Carolina, was the youngest.

Two future presidents signed, John Adams (second President) and Thomas Jefferson (third President). Both died on the 50th anniversary of signing the Declaration (July 4, 1826). There are 12 counties nationwide named Adams and 26 named Jefferson.

Have a Happy July 4th!

Balance and Back Pain

June 28, 2013

nik-wallenda-s-successful-tightrope-walk-over-grand-canyon-covered-by-discovery-channel

After Sunday’s spectacular walk on a 2-inch steel cable across the Grand Canyon, aerialist Nik Wallenda earned a new title: daredevil. His exploits also suggest how important one’s balance is to daily activities – not just survival on the high-wire.  The physicians at Texas Back Institute have first-hand experience helping regular people correct the back pain which can cause a loss of balance, leading to potential injuries from a fall. More on that later, but first let’s briefly review one of the most dramatic walks in history!

Representing the next generation of the famous “Flying Wallendas” family, known for its daring and sometimes deadly stunts on the high wire, Nik Wallenda completed a tightrope walk that took him a quarter mile over the Little Colorado River Gorge in northeastern Arizona. He walked 1,500 feet above the river on the Navajo Nation near the Grand Canyon with no net or safety vest.

This feat was broadcast live on the Discovery Channel and had viewers around the world griping the arms of their chairs for more than 22-minutes. The life-or-death drama was further enhanced by the fact that viewers could hear Wallenda speaking to himself from the mobile microphone attached to the aerialist and see what he was seeing from a camera placed on the aerialist. Throughout the spectacle, he was heard praying and attempting to calm himself as the 40-miles per hour winds above the Grand Canyon buffeted his taunt cable.

After the stunt was completed, Wallenda was asked by the media to recount the things that were going on in his mind during his walk. He noted at one point during the walk he “knelt down and I thought of my great-grandfather and that everything I do is to honor him,” Wallenda said. “It took my mind off all this movement underneath me … and I was able to focus on him and regain composure.” Nik’s great-grandfather, Karl slipped and fell to his death from a high wire in Puerto Rico in 1978 when he was 73 years old.

Here’s is a brief video clip, courtesy of the Discovery Channel of Wallenda’s amazing walk across the Grand Canyon.

http://dsc.discovery.com/tv-shows/skywire-live-with-nik-wallenda/videos/final-moments-of-nik-wallendas-historic-walk.htm

Lack of Balance is a Big Healthcare Problem

Tightrope walkers such as Nik Wallenda have an uncanny sense of balance. How else could he and the rest of the Flying Wallendas successfully walk more than 1,400 feet on a steel cable no thicker than 2-inches?

Clearly, most people don’t have this superhuman sense of balance. In fact, many people struggle to keep their balance when walking on a perfectly flat surface. Why? Sometimes this is due to an inner-ear injury, but often this has to do with the effects of back pain.

The Center for Disease Control and Prevention (CDC) notes that “in 2000, falls among older adults cost the U.S. health care system over $19 billion dollars or $30 billion in 2010 dollars. With the population aging, both the number of falls and the costs to treat fall injuries are likely to increase.”

The federal agency also notes:

  • One in three adults age 65 and older falls each year.
  • Of those who fall, 20% to 30% suffer moderate to severe injuries that make it hard for them to get around or live independently, and increase their risk of early death.
  • Older adults are hospitalized for fall-related injuries five times more often than they are for injuries from other causes.
  • In 2009, emergency departments treated 2.4 million nonfatal fall injuries among older adults; more than 662,000 of these patients had to be hospitalized.

How Does Back Pain Affect Balance?

As these healthcare costs suggest, this lack of balance is a problem which is both painful and expensive. We talked about balance and how it is affected by back pain with Texas Back Institute spine surgeon, Dr. Jessica Shellock.

shellockCan back pain cause a loss of balance?

Absolutely.  When someone suffers from back pain, there is usually some amount of muscular spasm or imbalance that can lead to an alteration in their overall spinal alignment. That’s going to present many times as a change in posture, such as the patient leaning to one side or even stooping forward. Sometimes on a radiograph we can see a subtle curvature of the spine that’s not scoliosis but actually a musculature imbalance because of pain. When we are unable to walk effectively then our balance will be hampered as well.

Does this lack of balance due to chronic back pain affect only older people, or do younger people have this problem as well?

Anybody in pain because of their low back, whether young or old, can be affected.  However, one issue that preferentially affects the older population is degenerative changes in the neck that can result in compression on the spinal cord.  This can also cause balance problems.

Here’s a quick video synopsis of Dr. Shellock’s thoughts on back pain and its effect on balance.

What are the back injuries or diseases that can cause a loss in balance?

Anything that can cause back pain, such as a herniated disc, pinched nerve, muscular strain or ligamentous sprain in the back can result in a loss of balance.  Degenerative changes in the neck or mid-back that create spinal stenosis, or pressure on the spinal cord, can result in a loss of balance.

How can these back problems, and the concurrent loss of balance, be corrected by surgery or therapy?

Understanding the source of the pain is key.  For example, if the cause of the limp is due to muscular pain or a ligamentous injury, physical therapy to address the problem and restore balance may be very successful. Alternatively, if compression of the spinal cord is causing the problem, we can take surgical actions to relieve this compression. In most cases, physical therapy can correct the root causes for muscular pain and misalignment of spine and also help many patients with pain from a herniated disc. Surgery is always the last resort in patients who’ve failed to respond to these more conservative measures.

Don’t Try This at Home

Walking across the Grand Canyon on a 2-inch steel cable is not something anyone – except maybe another Flying Wallenda – will do. The amazing sense of balance  Nik Wallenda showed was no doubt learned at an early age and could even be genetically determined. Most of us just want to be able to walk down a flight of stairs without taking a tumble.

If back pain is keeping you from maintaining your balance, it could be as simple as working on muscular strength with the specialists at Texas Back Institute’s physical therapy department. If  your condition is more serious, state-of-the-art diagnosis and appropriate therapy from our spine  specialists can have you back on the tight-wire of life sooner than you think!

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