Graduation

With the sound of “Pomp and Circumstance” ringing in their ears, the graduates of 2013 will be marching up to the stage and on to their future. There is a sense of accomplishment, pride and even relief at graduations because the participants feel they have completed something important. Texas Back Institute congratulates every graduate!

With graduations, it seems as if something has concluded, when in fact the term “commencement” suggests a beginning. This idea of “conclusion vs. commencement” has of course been employed by more than one valedictorian in their one, final address to their esteemed classmates.

Traditions of Graduation

This is the time of year when seniors in high school and college who have completed their courses successfully are awarded diplomas. This tradition goes back to the 11th Century when medieval colleges in Paris and Bologna reportedly began this practice.

Over the centuries, the traditions have evolved and changed, but many have remained remarkably similar to the original ceremonies. The students, who were known as apprentices in these early graduations, learned skills from the masters of the crafts and to note this accomplishment, they were give a “testimonial of skill,” now known as a degree.

The song that most of us associate with graduation ceremonies – “Pomp and Circumstance” – is a relatively new wrinkle on this ancient celebration. It was written by Sir Edward Elgar and first performed in Liverpool, England in 1901. Its melody, a combination of solemnity and dogged determination, is the perfect accompaniment to purposeful marching of the soon-to-be graduates.

Another interesting graduation ceremony tradition involves the attire of the honored matriculates. The cap and gown, which is worn by students and (in some cases) faculty, was once called a “hood” and this is believed to be dated back to ancient Celtic Groups. Capes and hoods were worn by the Druid priests to symbolize their higher intelligence.

What’s Next?   

After the music finally stops, the mortar boards are tossed and the diplomas are filed away, what happens then? The graduate – of high school or college – must commence the next stage of his or her life. For many, this means getting more education and beginning the process of deciphering how to spend the rest of one’s life.

Texas Back Institute is internationally known for its state of the art treatment of neck and back injuries, back pain, scoliosis, artificial disc replacement, occupational and sports medicine and its exemplary physical therapy practice. However, for the past 27 years, Texas Back Institute, led by one of the organization’s founding partners, Dr. Richard Guyer, has offered a select group of medical school residents a remarkable opportunity – a one-year fellowship to focus on spine surgery.

To anyone talking with Dr. Guyer about the Texas Back Institute fellowship program, it is immediately obvious that he is just as enthusiastic as the young doctors who are chosen for the program. Much like the master craftsmen who trained the apprentices in earliest institutions of learning, there is a commitment to teaching these future surgeons that goes beyond cursory. The doctors who emerge from this program are changed forever.

With his interest in teaching, we thought Dr. Guyer might be a good source of advice for graduates of any level – high school, college or graduate school. Here is that conversation.

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What areas of medicine will be in high-demand in the coming years?

There are so many opportunities in medicine, especially if a young man or woman is interested in computers, science or engineering. We’ve all read that more and more kids are interested in business, finance or high technology, but the opportunities in medicine are exploding. For example, the latest high tech robotic surgery equipment is still directed by a human who is a trained physician and many of the best practitioners of this specialty were video gamers when they were kids. Genetic engineering is going to be a very hot area of medicine in the coming years and this specialty requires a very analytical mind which many youngsters who are good at math and science possess.

If someone is graduating from college and accepted to medical school, what types of specialization might they consider for spine surgery or other specialties offered by Texas Back Institute?

When I first started in medicine, young physicians would spend a couple of years in medical school before they decided which specialty interested them. Things have changed a lot since then and now that decision is often made when they are in college. The types of procedures we do at Texas Back Institute involve a wide range of medicine. We handle spine surgery for both children and adults. Our doctors deal with trauma surgery which would be required for automobile accidents and other accidents. We treat injuries that are the result of aging – wear and tear damage. We also have quite a few sports injuries that our physicians treat. So you can see there is a wide range of opportunities just in the spine area.

How did the Texas Back Institute Fellowship program come about?

I’ve found that when you teach students, you learn as much as they do and I loved teaching. In the mid 80s, I approached my colleagues here and shared my passion about teaching. I mentioned that I’d really like to build a fellowship program here for residents who wanted to specialize in spine surgery. Since our beginning in 1986, we have trained more than 100 fellows and I have been the chairman of this program for 27 years. This keeps me young and sharp! We work hard at sharing the latest research and techniques about spine surgery for these young doctors and for everyone on the Texas Back Institute staff it is very gratifying when that light bulb comes on over the head of these talented young people.

How does the TBI fellowship program work?

These doctors have been through medical school and have completed their residency program. They find us through the network of former TBI fellows and through the American Academy of Orthopedic Medicine. Once they are accepted to the fellowship program, they work with all of the surgeons on our staff. They get hands-on training in deformative and degenerative medical issues, trauma, tumors and disc replacement surgery.

What are the criteria that Texas Back Institute uses to recruit new physicians to the practice? Does completing your fellowship help in gaining a position?

The last 4 or 5 physicians that we have hired have gone through the Texas Back Institute Fellowship program, so that suggests that there is an advantage of going through this training. When we recruit new doctors for our team, we look for a young woman or man with a high degree of intelligence, an excellent bedside manner, his or her ability to synthesize a large amount of information and apply it to treatment and most importantly we look for integrity.

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From Left to Right: Dr. Rey Bosita, Dr. Rajesh Arakal, Dr. Jack Zigler, Dr. Jason Sparks (Fellow), Dr. Richard Guyer, Dr. Ralph Rashbaum, Dr. Troy Morrison (Fellow), Dr. Kirill Ilalov (Fellow), Dr. Michael Duffy, Dr. Kenny Edwards (Fellow), Dr. Andrew Block, and Dr. Dan Bradley.

Successfully completing a course of study and celebrating this accomplishment with friends and family is one of life’s great pleasures. As speakers who are chosen to impart wisdom to a group of graduates are fond of noting, this ceremony is not the conclusion, it is the beginning. Congratulations to every graduate and their families. Now, let’s get busy!

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The National Football League is about 4 months from the opening day kick-off and yet millions of football fans will be riveted to their televisions and computer tablets on Thursday, Friday and Saturday. Why? The annual NFL draft of amateur players occurs on these nights and for at least 254 players, it’s the most important day in their young lives.

Being chosen in the NFL draft is the first official step to becoming a member of a very elite club. It’s a club which can be very lucrative and one where the membership is short-lived – usually about 6 years. It’s also a business where the occupational hazard often includes debilitating back pain.

Since Texas Back Institute specializes in spine injuries, artificial disc replacement, and treatment of chronic back pain, we thought it might be interesting for players and fans alike to get a glimpse into how these supermen withstand the back pain resulting from playing professional football. For this analysis, we’ve asked Dr. Shawn Henry, whose specialty at Texas Back Institute is spinal surgery, to give us his expert opinion on how these men survive a  physically demanding of team sports. But first, let’s look at this year’s draft.

Who Gets the Top Pick?

For the players who hope to hear their name called from the stage at Radio City Music Hall in New York City, draft day is the next step in a journey which likely started when they were about 8 years old, competing in Pop Warner or Pee Wee football. Through high school and college, these athletes have excelled in a game that requires strength, speed, year-round conditioning and athletic instincts only a tiny percentage of human beings possess.

Using a formula that allows the teams with the worst record in the previous year to get the earliest choices and theoretically the most talented players, the NFL draft has gone from a little observed event, watched by a few hardcore sportswriters in the early days of the league, to a three-day, fan-friendly happening. This year is no exception. The hoopla around the draft is palpable.

While it is always possible for a last-minute “trade” to occur among the teams which can change the order of their drafting position, as it stands now the first five teams in this year’s draft and their likely picks (based on media reports) are:

(1)  Kansas City – Luke Joeckel, OT, Texas A&M

(2)  Jacksonville – Dion Jordan, OLB, Oregon

(3)  Oakland – Sharrif Floyd, DT, Florida

(4)  Philadelphia – Star Lotulelei, DT, Utah

(5)  Detroit – Eric Fisher, OT, Central Michigan

For the rest of the draft order, you can click here.

Based on factors too numerous to list, many of the teams have more draft picks than others. For example, San Francisco, which had an excellent year in 2012, has the most number of picks in this year’s draft at 13. Theoretically, this should enhance their status in the upcoming season. Whereas, New England, New Orleans, Chicago and Carolina with the fewest number of picks (5) should be at a disadvantage. However, NFL fans know  having lots of draft picks seldom translates to a winning season.

When the smoke clears on Saturday night, 254 players will realize their dream of playing in the National Football League, assuming they make the team. Unfortunately, not every player drafted makes the cut and others in  this group can  sustain an injury in the summer training camps conducted by every team  prior to the opening of the season and their dream will die.

As noted earlier, a typical NFL career is extremely short – usually about 6 years for a player who is on the opening day roster. The reason for this is obvious when one watches the games each Sunday. The human body –even the superhuman bodies of these highly-conditioned players – has not evolved to the point of sustaining the type of repetitive trauma experienced in a typical season without injuries.

Some of these injuries can be  associated with the neck and back areas of the body and for some insights about these we asked the opinion of an expert, Dr. Shawn Henry an orthopedic spine surgeon at Texas Back Institute.

Henry_MD_web_1Over a typical season, the bodies of professional football players take a tremendous pounding. What is it about these player’s bodies that allows their backs hold up under this abuse?

In order to have attained their position in the NFL, a player has spent his life building muscle mass. This is the most important aspect of his conditioning is what allows the player to withstand the constant trauma of a typical season. This muscle mass gives dynamic support to the spine. Every player in the league has built strong abdominal muscles, quadriceps and other muscles groups and these “load share” the impact of the constant hits to the spinal column.

As fans, we often hear that a player has sustained a “stinger.” What is a stinger and is this a serious injury?

Basically, when someone gets hit hard in the neck and shoulder areas, the impact causes a temporary trauma to the peripheral nervous system. This causes a short-term burning, stinging pain. However, since this does not affect the central nervous system, there is no potential for paralysis and typically goes away in a short time.

The NFL Players’ Association notes the most common back problem among their members is degenerative disc disease, associated with arthritis. What does this mean and how can a player avoid this?

Actually, the most common back problem for every human, not just a professional football player, is degenerative disc disease. The medical term for this arthritic condition is “spondylosis” and it is a condition that is exacerbated by smoking, obesity and trauma. A player is not likely to smoke, but he may have tendencies toward obesity and withstanding physical trauma is a part of the job description. This trauma and weight can cause injury to the disc. For an athlete, good conditioning is the only way to help protect your spine.

There will likely be a great many young athletes watching the NFL Draft this weekend thinking they might get a chance to perform in the Big Show in the future. What can a young football player focus on in order to strengthen his back muscles?

The key is to build core, isometric spine stabilization. Weak core muscles cause injuries. They should also work on flexibility and increasing a range of motion in their muscle groups, their cervical spine and their lumbar spine areas. They should also make certain the correct equipment – helmets, pads, collars – are used in practice and game situations.

In your practice, what is the most common back injury  you see in younger athletes?

The most common ailment in high school and college athletes is a herniated disc in the neck and a pars fracture in the lower back. This is most commonly seen among interior linemen because they extend their spine by arching their back when they come off the line to block. With repetitive trauma a fracture can occur. Interestingly, because of the tendency to extend the spine, this condition also occurs with some regularity among equestrian competitors and ballet dancers.

What is the NFL doing to help control the number of spinal injuries among players?

Because of the potential for long-term neurological disorders, the league is researching the effects and prevention of concussions among players. There is no correlation between concussions – which affect the central nervous system – and back injuries. As for the league’s efforts in helping to reduce back injuries, there have been many advances in helmets, facemasks and neck wraps. Plus, a few years ago the NFL  introduced rules which prohibit “spearing” and this has probably resulted in fewer incidences of spine and back injuries.

Injuries Are a Part of the Game

Based on viewer ratings, the National Football League has become the most popular spectator sport in the United States. The athletes in this game are big, strong and fast and when they collide, injuries will inevitably happen. As every NFL coach says a few times every season: “injuries are a part of the game.” Hopefully, with better conditioning and high-tech equipment, these spine injuries will be limited in the future.

Dr. Scott Blumenthal was the first Orthopedic Spine Surgeon in the US to perform an Artificial Disc Replacement (ADR) surgery. This life changing surgery has now helped over 1,400 Texas Back Institute patients. Recently SpineUniverse.com featured the blog post below about the choosing the right spine surgeon for you.

Choosing the Spine Surgeon Who Is Right for You

Patients often wonder how to choose a spine surgeon to perform their total disc replacement.

The easy answer to this question is simple:  carefully.

The longer answer to this question is:  do your research, both on your surgeon and on the procedure.

Tips for Choosing a Spine Surgeon for Disc Replacement
While thousands of surgeons have been trained in disc replacement techniques, very few have adopted it into their clinical practice with any regularity.

Certainly, the bare minimum requirements for choosing a surgeon would be to ensure he/she is a board certified or board eligible orthopedic or neurosurgical spine surgeon.  “Board certified” means that the doctor has gone through a rigorous testing and peer evaluation process by a specialized medical board.

You can ask your doctor if he/she is board certified, or you can research it online.

Some tips to get a better feel for the expertise of the surgeon are:

  • Ask how long he/she has been performing disc replacement surgery and with what frequency they do this procedure.
  • Make sure your surgeon performs many types of surgery and can tailor your treatment to be most appropriate for your condition. Not every patient is best served with a spinal fusion, nor is every patient best served with disc replacement.
  • Make sure you have open communication with your physician.
  • Make sure you trust and have confidence in your surgeon’s abilities.
  • Look at the surgeon’s academic credentials or published papers.  Find out what they have written on disc replacement and if they are leaders in this specialized area of spine care.

A warning to patients:  Don’t depend on fancy advertising or marketing when choosing a surgeon.  Use all your resources when making a decision this critical. The Internet, medical directories and societies, as well as your regular physician can all be great resources in helping you decide which surgeon to go to.

There are also additional resources such as patient chat rooms and blogs where you can read about other patients’ experiences with surgeons.

Choosing a spine surgeon is a very important decision, and the more facts you can get, the better. Luckily, there are many resources to help you find a spine surgeon who is right for you.

Mistakes Men Make Concerning their Back Health

Men taking charge is nothing new in most situations.  At work, at the gym, on the sports field or even when a little spider invades the kitchen.  When it comes to their back health and safety men can be known for being a little lackadaisical.

Dr. Ted Belanger, an orthopedic spine surgeon at Texas Back Institute in Rockwall shares 5 mistakes men can make when it comes to their spine health.

 

1)       They don’t exercise their back.  Guys go to the gym and exercise their “glamour muscles” to get strong and look trim, but they only rarely do any exercises to strengthen their back.  Your back is made of the same tissues as your arms and legs, and responds to exercise in much the same way.  The old adage that it’s dangerous to exercise or use your back for strenuous activity is a myth.  You can strengthen it just the same as you strengthen your biceps—with repetitive range of motion against resistance until you reach muscle fatigue.

2)       They don’t do enough research.  Very often evaluation of back problems is sought without any careful research to determine who might be the best person to see.  There are big differences in the training, background, certification and experience of the various practitioners available to assess a patient with a complaint about their back or spine.  The list includes chiropractors, primary care physicians, physiatrists, pain management doctors, orthopaedic surgeons, neurosurgeons and orthopaedic spine surgeons.  Among these, no specialist has more training and experience assessing and treating musculoskeletal conditions than an orthopaedic surgeon.  Most of the others on the list either have very little musculoskeletal training (neurosurgeon) or have no experience at all in the surgical treatment of spine conditions (all the rest).  An orthopaedic spine surgeon is in the best position to diagnose and treat a patient with a back/spine problem, whether or not they need surgery.

3)       They don’t ask enough questions.  Patients often present for a second opinion to our clinic.  A common element of their frustration and sometimes confusion is a lack of understanding of their problem.  This can be avoided by insisting your questions be answered the first time around.  Bringing a list of standard questions is a great way to make sure you are communicating well with your doctor.  Good questions are:  What is my diagnosis?  What will happen if I don’t do anything about it?  What are my options to treat it and what can I expect from the treatment?  How does the treatment work, exactly?

4)       They don’t recognize the difference between amateur and expert advice.  People often put as much weight on their neighbor or friend’s back advice as they do their doctor. While good-intentioned, the patient should at least recognize that their doctor, particularly if they are an orthopaedic spine surgeon or neurosurgeon, has much more insight and understanding about the diagnosis and treatment options.  A common comment made by patients and their friends and family is “back surgery doesn’t work”.  But that’s a drastic generalization that simply isn’t true.  There are many different kinds of back surgery (discectomy, fusion, disc replacement, decompression, etc.) and many different reasons to undergo back surgery (degenerative conditions, fractures, trauma, scoliosis, deformity, tumor, infection).  Whether or not surgery is successful depends largely on the diagnosis you are treating, the details of the workup, the execution of the surgery, the choice of surgical technique, and the alignment of the expectations of the patient with what the surgery can accomplish.  Orthopaedic Spine Surgeons know this better than anyone else.

5)       They too often think their back problem is hopeless and they just need to “live with it”.  Patients are often afraid to seek advice about surgery because they are afraid.  They should think of the office visit the way the doctor does: a consultation to answer questions and provide information.  The decision about what treatment to participate in always rests with the patient.  If you are still not sure after visiting with a doctor, feel free to do more research, ask more questions, and seek more advice from experts.  Sometimes second or even third opinions are necessary to come to a decision about how to proceed.

If you or someone you know has fallen victim to one of these mistakes, it’s not too late.  Give us a call today and we will talk to you about your situation and help you figure out what the best treatments are for you!

1st US Service Member to Receive Artificial Disc Celebrates 8 Years Pain-Free

He was a U.S. Marine on Active Duty, planning a career as a Naval Aviator, when a herniated disc stopped everything. Alex Fender saw all his plans postponed, then stopped indefinitely, as physicians repeatedly told him that he would be ‘medically retired’ from the Corps at the age of 21. It was a prediction he refused to accept.

In 2004, Fender met Dr. Scott Blumenthal, a spine surgeon at Texas Back Institute in Plano. After the initial exam, Dr. Blumenthal suggested an artificial disc, which was a new procedure at the time.

Artificial Disc Replacement had just recently been FDA approved back then,” says Dr. Blumenthal, “I had exceptional outcomes since performing the first disc replacement in the US and I knew Alex would be a good candidate for this procedure.”

Fender was up and walking pain-free hours after his surgery. He had no complications, served four more years on Active Duty, and was honorably discharged in 2008.

Today, Fender is a successful entrepreneur in Dallas. He now serves as CEO of Funnel Science, an internet marketing and SEO agency.

“Staying healthy is objective number one,” says Fender. “You can’t get on with your life if you’re not able to get up and go to work. Texas Back Institute gave me that opportunity, and I’m glad to be an example of how well this surgery works.”

Artificial Disc Replacement

September 25, 2012

Dr. Scott Blumenthal was the first Orthopedic Spine Surgeon in the US to perform an Artificial Disc Replacement (ADR) surgery. This life changing surgery has now helped over 1,400 Texas Back Institute patients. Recently SpineUniverse.com featured a blog post about the history of artificial disc replacement.

The History of Artificial Disc Replacement

How Long Has This Spine Procedure Been Used?

          Submitted by on September 10th, 2012

Artificial disc replacement (ADR) or total disc  replacement (TDR) is a surgical procedure which replaces a degenerated disc in  the spinal column with an artificial motion device. It has been used in the  United States since the year 2000, but it originated in Europe almost 30 years  ago.

Before performing the first ADR in the United  States in March 2000, I did a lot of research on the procedure, including  visiting with a number of surgeons in Europe as well as the inventor of the  first FDA-approved ADR, Karin Buttner-Janz. Besides inventing the artificial  disc, she is well-known for being an Olympic and world champion gymnast from  East Germany.

With 12 years of experience, we have now  performed more than 1,400 disc replacements in our private practice alone.  Patients now have access to spine surgeons with extensive experience in disc replacement right here in the in the United  States.

Total disc replacement is an alternative to  spinal fusion. It is an innovative process of surgically removing a damaged  disc from the spinal column and replacing it with an artificial disc. This procedure can significantly benefit patients who suffer from herniated discs or degenerative disc disease with or without leg or arm pain.

Artificial disc replacement gives patients an opportunity to retain  mobility in both the neck (cervical spine) and lower back (lumbar spine). By  replicating the movement of a normal disc, ADR helps to alleviate adjacent disc  degeneration minimizing the need for additional spine surgery due to disc  degeneration or herniation.

Since 2000, a number of FDA studies of other  artificial discs began enrolling patients in the United States. Over a dozen  studies have been completed in the United States and currently there are four  discs approved for use in the United States.

The FDA-approved disc available for the low back  (lumbar spine) is the ProDisc-L.  For the  neck (cervical spine), the Bryan, Prestige, and ProDisc-C are available.

Looking forward to the future of artificial discs  in America: at least a dozen or so discs are either currently in-trial or have  completed the trials for FDA approval and will hopefully be available in the US  soon.

Artificial Disc Replacement

Texas Back Institute is a global leader and pioneer in spine care, having performed more than 1,400 artificial disc replacement procedures with 14 different types of ADR devices, beginning in 2000 with the first ever performed in the United States. One of the latest advancements in spine surgery, artificial disc replacement gives our patients an opportunity to retain mobility and resume their lives with minimal pain or discomfort. Led by the world-renowned spine surgeons at our Center for Disc Replacement, we perform this motion-preserving, life-changing procedure on patients from around the globe each year. If you’re suffering from chronic back or neck pain, our concierge services team will help you coordinate all aspects of your visit to TBI so you can receive treatment from some of the best spine surgeons in the world. It’s your time to get back to life.

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