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.

guyer

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!

iron-man-3-730x400The movie smash hit of the summer is Marvel’s Iron Man 3 and its popularity can be explained on several different levels. The “superhero” in this blockbuster flick is both physically and emotionally scarred, so in many ways, he’s just like you and me. Plus, the action and special effects are non-stop. This science fiction, where the lead character’s  human body part is replaced by an artificial part, is science fact at Texas Back Institute.  How so? Read on.

Artificial disc replacement, pioneered by several spine surgeons at Texas Back Institute, including Dr. Scott L. Blumenthal, is in many ways more futuristic than the suit of iron that brash-but-brilliant industrialist Tony Stark wears to heroic advantage in Iron Man 3. Before delving into the reasons for Stark’s angst and ultimate redemption, we asked Dr. Blumenthal to gives us some insights into the ways he and his colleagues are transforming patients in pain to Iron Men and Women.

Artificial Disc Replacement – Medical Fact not FantasyScott L. Blumenthal, M.D

In post-movie interviews fans of Iron Man 3 have said that one of their favorite aspects of the story is the blurring of science fiction and medical fact. Since you have taken a part of the body – the disc that cushions the spinal vertebra – and replaced it with one that is artificial and more durable, what are your thoughts about this advancement?

When I started in medical practice, we talked about the TV show The Six Million Dollar Man. For anyone younger than 30, this was a fictional story about a man who had been critically injured and had many of his organs, muscles and limbs replaced by much stronger artificial ones. At this point in medicine, this replacement of real with artificial body parts is becoming reality, not fantasy. For generations, spine surgeons have been fusing vertebra when the discs wear out or are damaged.  Our patients were constantly asking “Why can’t you just  replace it?” Well, after much development and testing, now we can. In patients who have back pain resulting from damaged disc we can replace it with one that is man-made.  My colleagues and I formed the Center for Disc Replacement and now the fantasy is going to be main stream medicine.

What enabled Texas Back Institute to be at the forefront of this procedure?

Our advantage came from our opportunity to do the FDA testing of this procedure here at our clinic. This procedure had been very popular in Europe for many years (before being considered in the U.S.) and many people with the resources to travel there, were getting the benefit of this technology by going over there. Because we were asked to assist in this testing, we were the first practice to be able develop protocols for the procedure. Our experience here far outweighed other physicians in this country. We started lumbar disc replacement and went on to cervical disc replacement. We discovered extensive evidence that strongly suggested artificial disc replacement speeded recovery, so our patients returned to work sooner. We found this procedure had better outcomes than fusion and the overall costs were less.

What brought about the development of the artificial disc?

It’s a combination of factors. There is substantial patient demand and the technology in the composition of the artificial discs is excellent and continues to get better than it was 12 years ago when we started. Plus, there is a measurable economic benefit to disc replacement as opposed to other procedures.

Do you mean there are economic benefits to patients in the form of cost vs. outcome?

Exactly. This is why the major insurance companies – not known for their investing in medical technology simply because it seems to be good technology – have decided to cover this procedure. They clearly have good data that proves the costs for artificial disc replacement are reasonable when outcomes, long-term recovery and the incidence of future problems are considered.

What other medical advancements – which may seem like science fiction now – do you see becoming medical fact in the immediate future?

I see stem cell therapy becoming an important new frontier for back surgery and specifically disc damage. Patients are looking for different, non-invasive ways to alleviate back pain and these stem cells – some harvested from the patients suffering from the pain – have the potential to change the way we treat damaged tissue.

Watch Dr. Blumenthal comment on technology and spinal care.


What Makes Iron Man 3 So Interesting?

As the advertising blurbs about Iron Man 3 note, “the movie pits brash-but-brilliant industrialist Tony Stark (also known as) Iron Man against an enemy whose reach knows no bounds. When Stark finds his personal world destroyed at his enemy’s hands, he embarks on a harrowing quest to find those responsible. This journey, at more »every turn, will test his mettle.” Whew! All that in about 2 hours!

As fans of the three movies know, the first of the Iron Man films revealed Stark as a clever, resourceful scientist-adventurer-tycoon who launched his super-character and super-suit while trying to escape from a platoon of Middle Eastern terrorists. This film was followed by a sequel called, Avengers , which did not receive the same level of enthusiastic critical review or box office support. However, the third installment – Iron Man 3 – has critics and, more importantly, paying customers, raving.

Part of the reason this current Iron Man saga has been so successful has to do with the evolution of the lead character played brilliantly by Robert Downey Jr. This star has had his own, well-chronicled personal challenges and the Tony Stark character he plays in the movie is experiencing many of these same – all too human – difficulties.

Iron Man 3 is replete with action, special effects and the superhero formula that seems to cure all boredom. However, the lead character spends less time in his iron suit, fighting bad guys and more time contemplating his place in the universe. One reviewer was on the mark when he noted Stark discovers the answer to the question that has been haunting him: Does the man make the suit or does the suit make the man?

Watch the Iron Man 3 trailer here.

Since Dr. Blumenthal and his colleagues at Texas Back Institute  are turning what was medical science fiction a few years ago into medical fact today, we had to ask him if he had a favorite superhero when he was growing up? His answer should give hope to those who don’t particularly care for Iron Man, but do long to go where no man has gone before!

Blumenthal notes, “Actually, I was not a big fan of superheroes. I’m more of a Trekkie. Fortunately, the new Star Trek – Into the Darkness opens tomorrow and I will be there!”

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.

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.”

Best Doctors in Dallas 2012

September 26, 2012

D Magazine Announces It’s Best Doctors in Dallas 2012 List

D Magazine just published their newest issue and it included the 2012 Best Doctors in Dallas list.  Texas Back Institute is excited to announce several of our physicians made the list.  This year, Drs. Scott Blumenthal, Renato Bosita, Jr., Richard Guyer, Michael Hisey and Jack Zigler were all listed as “Best Doctors in Dallas”, by D Magazine.

At Texas Back Institute, we know we have fantastic physicians, but it is always nice to have a magazine as prestigious as D Magazine say this as well! Check out our profile below.

Photo by: Lisa Means

(Not pictured: Dr. Hisey)

The write up is a little hard to read above, so see below for a close up.

Written by: Jennifer Hayes

TEXAS BACK INSTITUTE

Orthopedic Spine Surgery, Physical Medicine and Rehabilitation

What’s New in Spine Care

Celebrating 35 years of excellence in spine care, Texas Back Institute is known worldwide for providing the latest, state-of-the art treatments and technology for neck and back pain. One example is a new FDA-approved neuro-stimulation system which can help provide instantaneous pain relief for patients with chronic pain. This new spinal implant uses the same “human controller” technology which is found in interactive games, such as Wii and smartphones, and can understand whether a patient is sitting, standing, running, or walking and can adjust the level of stimulation accordingly.

Texas Back is on the leading edge of robotic spine surgery and helped develop the first surgical robot in the world designed specifically to operate on the spine. Accurate to less than half a millimeter, it enables surgeons to plan the optimal surgery using a computed tomography (CT)-based 3D simulation of the patient’s spine. Surgeons can map out the patient’s spinal anatomy and plan the entire procedure before the patient even arrives for surgery. This allows the surgeon to be more efficient and precise and anticipate potential complications before they occur. This technology can be used in biopsies, to treat thoracic-lumbar fusion and vertebral compression fractures, and to correct scoliosis.

The goal for any spine surgery patient is to be able to get back to living an active lifestyle while retaining as much motion as possible. Both of these goals can be achieved through artificial disc replacement. This surgery allows patients to continue their dynamic lifestyle by combining a motion-preserving technology with a minimally invasive approach. Surgeons at the Texas Back Institute were the first in the U.S. to use this technology in a clinical trial in 2000 and have continued to be on the forefront of artificial disc replacement surgical techniques. As we get older, the discs in our spine begin to dehydrate and degenerate which can cause pain and numbness in the arms, legs, shoulders, neck, and sometimes hands. The artificial disc is designed to restore proper spacing between the vertebrae and also preserve the motion of a healthy disc. Texas Back participates in numerous clinical trials involving artificial disc replacement. Many of these trials have an immediate positive impact on patients. Our experience shows faster patient recovery while preserving motion in the spine. Minimally invasive spine surgery has been a philosophy of Texas Back Institute since its inception and continues to be the goal with every patient.

The physicians at Texas Back Institute are leaders in surgical and non-surgical treatment options for back and neck pain, from the most common outpatient procedures to the most complex cases. Thanks to advanced diagnostic testing and an unparalleled commitment to patient care and satisfaction, physicians can identify potential causes of your back and neck pain and create a treatment plan for your specific needs.

Texas Back Institute has locations in Plano, Frisco, Arlington, Dallas, Denton, Flower Mound, Fort Worth, Mansfield, McKinney, Rockwall, Trophy Club, Midland, and Wichita Falls.

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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