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Pain Prevention

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Become Pain Free | Pain Specialist in Texas

Once you encounter back or neck pain, you are four times as likely to experience it again. This is why prevention is essential to your long-term recovery.

One of the best ways to avoid back pain is by exercising and stretching. Low-impact aerobics, such as walking or swimming, is an ideal way to prevent or treat back pain. Stop if the exercise becomes painful, and always remember to stretch. Stretching is easy to incorporate into your daily routine. You can even do it in front of the television.

Below are some more specific ways to prevent back or neck injuries:

Sitting for long periods

The spine likes movement. Anything that puts the spine in a static position creates stress, which can cause back and neck pain. Every hour, stand, walk around, bend, arch backward gently, and twist. Doing so at regular intervals will lengthen the amount of time you can sit comfortably. Also, get an ergonomically-designed chair or an orthopedic insert to support your spine, espetexas spine center provides information about preventing back pain neck pain ergonomic chaircially if your job involves long periods of sitting. Or roll up a towel, and place it behind your low back.

A comfortable way to stand

Prolonged standing can also strain the back. If you have to stand for long periods of time, prop one foot on a small stool or telephone book to reduce stress in the low back. Alternate with the other foot. Every half hour, bend over and touch your toes, with your knees slightly bent, or do some of the stretching exercises shown in the Seton Spine and Scoliosis website. They will help loosen your muscles, ligaments and joints.

Plane rides

While traveling on a plane, it helps to raise your feet on a briefcase or a bag underneath the seat in front of you. Ask for a pillow to place behind your low back to improve lumbar support. It is important to get up frequently and walk to the bathroom and back, whenever possible. Avoid hour-long periods in your seat.

The best sleeping position

Avoid sleeping on your stomach, which arches your back and puts pressure on your spine. Instead, lie on your back with a small pillow tucked under your knees. This position unloads the spine. An alternate position is to lie on your side with a pillow between your knees. If you like sleeping on your stomach, place a soft, flat pillow under your stomach to eliminate some of the arch that can stress your back.

texas spine center provides information about preventing back pain neck pain, information about choosing the right mattress, sleeping position

Mattress considerations

It is important to sleep on a mattress with optimal back support, whether it is a conventional mattress or a waterbed. Older waterbeds were mushy and provided little support. However, now there are waterbeds that allow you to adjust their firmness. A good mattress should relate to your body shape. Generally, go with what feels comfortable to you.

Pain is a signal from the body to the brain that something is wrong. Either the back is too weak, too inflexible, or the wrong body mechanics were used to perform a task.

 

Become Pain Free | Pain Specialist in Texas

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February 11, 2013 at 7:45 pm

Posted in Complex regional pain syndrome, Dallas Doctors, Dallas Texas Pain Doctor, Discectomy and Stabilization, Endoscopic and Laser Spine Surgery, Failed back surgery syndrome, fellowship in Disorders of the Spine, fellowship trained Orthopaedic Spine Surgeon, Fibromyalgia, Fort Worth Orthopedic Surgeon, Injured on the Job, injured workers, Laser Back Surgery, laser spine procedures, Laser Spine Surgery, Low back pain, Lumbar and Cervical Radiofrequency, Lumbar Microdiscectomy, M.D., minimally invasive procedures, Minimally Invasive Spine, minimally invasive spine procedures, Minimally Invasive Spine Surgery, Minimally Invasive Stabilization, Minimally Invasive Surgery, MIS, Myofascial pain syndrome, Natural and Ethical, Neck pain, Neck Pain Treatment Texas, Neuropathic Pain, non-invasive procedures, North American Spine Society, Obese Patients, Open Surgery and Minimally Invasive Surgery, Pain, Pain Doctor, Pain Doctor Dallas, Pain Doctor Fort Worth, Pain Doctor Irving, Pain Doctor Plano, Pain Doctor Texas, Pain Doctors, Pain Dr, pain management, Pain Medicine, Pain Prevention, Painful nerve injuries, Painful osteoarthritis, patients’ own stem cells, Pelvic pain/Genital pain

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A new hope for back pain sufferers?

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(CBS News) Back pain is one of the most common of human complaints, which is why new treatments in the works are raising so many hopes. Our Sunday Morning Cover Story is reported now by Martha Teichner:

 

Consider the human spine, in all its glory.

 

The 24 vertebrae, cushioned by gelatinous discs . . . the little facet joints that help make your back flexible . . . all the ligaments and muscles and nerves.

 

The spine’s elegant complexity is a miracle of engineering, or a curse when something goes wrong.

 

Eight out of ten Americans will experience debilitating back pain sometime in their lives.

 

“My pain was very excruciating,” said Lenda. “I couldn’t walk, I couldn’t bend over. I couldn’t lie down.”

 

“I’d say, ‘Oh Lord, can’t you help my back, it does hurt bad’ – he didn’t help me a bit,” said Leila.

 

And the most common culprit?

 

“I think most people would think it’s the inter-vertebral discs, whether it’s herniated or whether it’s just worn and arthritic and associated with pain,” said Dr. Augustus White, a professor at Harvard Medical School. He has literally written the book on lower back pain.

 

He says the easiest way to understand a herniated disc is to think of a jelly doughnut: When what Dr. White calls “the jelly” gets squeezed out, it presses on nerves, which can mean excruciating pain. Barring serious illness, the first line of treatment may not be what the patient (who only wants a quick fix) wants to hear.

 

“You need to make sure the patient doesn’t have tumor or infection,” said Dr. White, “but once you rule those out, you can be confident that you’re not going to harm the patient by saying, ‘OK, give yourself four to six weeks.'”

 

Believe it or not, 90 percent of disc injuries heal themselves after a few weeks, especially with physical therapy. But waiting it out can be torture, and not everybody gets better. So that’s where surgery comes in.

 

More than 1.2 million Americans undergo spinal surgery each year. That’s more than TRIPLE the number of coronary by-pass surgeries (415,000), and nearly FOUR TIMES the number of hip replacements (327,000).

 

Approximately 300,000 of those back surgeries were spinal fusions, where vertebrae are joined surgically so they can’t move. They’re often held in place, permanently, with metal screws or rods.

 

For many patients, surgery is the only answer – salvation. But for all too many others, it can be a nightmare.

 

Which brings us to Dr. Kevin Pauza, a founder of the Texas Spine and Joint Hospital in Tyler, Texas.

 

“I spent decades treating patients who’ve had surgery, the surgery was fusions,” Dr. pauza said. “Patients would do well for a year or two, and they’d always come to me and need more help.”

 

In his experience, fusion was usually the wrong answer: “The spine’s made to be a structure that bends with every movement we make, and if we immobilize a segment of the spine, the adjacent segment breaks down. That’s known as the domino effect.

 

“So my thought was, can we do something to that disc so that we don’t have to fuse it? Can we bring the disc back to life?”

 

And that’s the headline of this story. Just imagine: A procedure that repairs and re-grows discs, that doesn’t involve spinal fusion, that’s no more than minimally invasive, outpatient surgery.

 

The inspiration came to him when he thought about something as basic as how an ordinary cut heals.

 

“I realized what heals a cut is something that’s very simple: It’s two products that are in you and I, they’re in everybody.”

 

In our blood plasma – they’re called thrombin and fibrinogen. For the cut to heal, the two components come together, and they make a substance called fibrin.

 

When the two components, in concentrated form, are injected into the disc through a kind of squirt gun Pauza invented, just like epoxy glue, they combine and become fibrin.

 

Injected into the damaged disc, the compound acts like a sealant, filling cracks and crevices, and eventually allowing the disc to re-grow. “It allows our degenerated disc to turn into a young, healthy, normal disc,” said Dr. Pauza.

 

Rusty Templeton is typical of Dr. Pauza’s failed fusion patients. He had his surgery in 2008, but the pain came back and was agonizing.

 

“I’ve kind of damaged the disc above and below my fusion, and of course that fusion disc is also in pretty bad disrepair,” said Templeton.

 

Templeton is given a local anesthetic. The procedure takes about five minutes…there’s no incision..no hardware…

 

Typically, at first, patients feel discomfort. “Some patients even say, ‘Gosh, I wish I never had this done,'” said Dr. Pauza. “And then several weeks later, the patients just turn a corner. We tell them that they can expect that there will be one day where they have pain, and the next day, it’ll just stop.”

 

Dr. Pauza is hoping for Food and Drug Administration approval of the procedure by 2015, and to make it available to the public shortly thereafter. Phase III clinical trials are underway now at 20 sites around the U.S.

 

Dr. Pauza has successfully treated more than a thousand patients in his private practice. “We started treating the first patients approximately five or six years ago, and the success rate is approximately 86 percent,” he said.

 

So how did Rusty Templeton do? “My pain before was at least a ten,” he said. And two months after the procedure? “It’s still around a five, because I have underlying issues. But I can lay down now. I can, you know, walk around. I can drive where I couldn’t drive before.

 

“The pain level I had before the procedure was probably around anywhere from about a six to worse, eight,” he said.

 

Christopher Joseph is a home restorer who was in a car accident. How was his pain two months after the procedure? “Right now, it’s at zero.”

 

Dr. Michael DePalma is a spine specialist in Richmond, Va. The North American Spine Society has just published his paper on the latest experimental therapies involving disc restoration.

 

“Stem cells are something that’s being investigated to replenish cells within the disc directly, injecting growth factors, which are proteins, to try to stimulate repair in a disc have also been evaluated,” said Dr. DePalma.

 

He is involved in 4 different FDA trials of the new procedures and believes these so-called biologics are the future of back treatment. Based on the results so far, he thinks Dr. Pauza’s fibrin sealant offers the most promise.

 

If the treatment, asked Tecihner, is even 50% successful with someone, is that significant? Dr. DePalma replied, “It’d be huge.”

 

And then there’s the cost. Compare spinal fusion and fibrin treatment: “The treatment for a fusion – and this is the hospital fee – typically is in the $100,000 range, not including the physician’s fee,” he said. “We don’t have a set cost for [fibrin] treatment yet, but it’s approximately 95 percent less than the cost of a fusion.”

 

Dr. Pauza expects it to be widely available within five years.

 

“It’s the first time in history that we’ve been able to cause new tissue to grow within the spine. This procedure is the procedure that really the world has been waiting for,” he said.

 

Is it? The procedure is only for back pain sufferers with specific disc problems, but there are a lot of those . . . and Dr. Kevin Pauza is absolutely sure he’s found a better, safer, cheaper way of improving their lives.

 

 

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January 31, 2013 at 4:01 pm

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Minimally Invasive Spine Surgery

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Minimally Invasive Surgery:

Recent surgical advancements have focused on performing surgery through smaller incisions, with less disruption to surrounding soft-tissues. The idea behind minimally invasive surgery is to perform the same treatment without damage to normal surrounding tissues. The drawback of minimally invasive surgery is that sometimes the underlying problem may not be adequately addressed because of an inability to get to the problem. Whenever a new minimally invasive procedure is introduced, there is almost always controversy as to whether or not the procedure is as good as traditional surgery.

Endoscopic Spine Surgery:

Endoscopic spine surgery uses specialized video equipment inserted through small incisions to see the structures of the spine. Similar to arthroscopic surgery of a joint, endoscopic surgery has advanced over the past decade from merely being able to look to the area of interest, to the ability to repair and reconstruct a variety of complex problems.The benefit of endoscopic spine surgery is the potential to address problems through very small incisions. By not damaging the muscles around the spine, recovery can often be much faster than with a larger surgical exposure.

Microdiscectomy, Microlaminectomy and Microforamenotomy:

All of these micro-surgeries are variations of standard surgeries used to take pressure off of the nerves around the spinal cord. Traditionally done through larger incisions, the micro procedures use smaller incisions and specialized surgical instruments to accomplish the same goals of traditional surgery.There is no rule on where the line between traditional surgery and micro surgery is drawn. To some doctors this means a smaller incision, to others it means the use of special surgical instruments. Many variations of a procedure could be considered micro surgery.

Laser Spine Surgery:

Laser spine surgery is a technique that uses a laser to remove damaged tissues. Because a laser can be inserted through small incisions, it can be used to cut away damaged tissues (such as disc fragments) without having to make a large incision.There is significant controversy about laser spine surgery as this technique has not been shown to have significant benefits, despite advertising that may make you think otherwise. Often marketed in magazines and the Internet, laser spine surgery has become the focus of some lawsuits formisleading patients about expected results from surgery.

Is It Better?:

Is minimally invasive surgery better? There are many ways to answer this question. The bottom line is that we simply do not know. There are theoretic advantages, and there are possible downsides. But there are very few studies that compare the possible risks with the potential benefits of minimally invasive surgery.The bottom line I suggest is to find a surgeon who, above all, is interested in fixing your problem, not someone who is selling you on a smaller incision. If the same benefit can be achieved without damage to normal tissues, then minimally invasive surgery may be a good option.

Sources:

Mathews HH and Long BH “Minimally Invasive Techniques for the Treatment of Intervertebral Disk Herniation” J. Am. Acad. Orthop. Surg., March/April 2002; 10: 80 – 85.

Become Pain Free | Pain Specialist in Texas

Kyphoplasty Surgery, Kyphoplasty, Kypho, Vertebroplasty, Back Surgery, Spine Surgery

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What is Vertebroplasty & Kyphoplasty?

Vertebroplasty and kyphoplasty are minimally invasive procedures for the treatment of vertebral compression fractures (VCF), which are fractures involving the vertebral bodies that make up the spinal column.

When a vertebral body fractures, the usual rectangular shape of the bone becomes compressed, causing pain. These compression fractures may involve the collapse of one or more vertebrae in the spine and are a common result of osteoporosis. Osteoporosis is a disease that results in a loss of normal bone density, mass and strength, leading to a condition in which bones are increasingly porous, and vulnerable to breaking. Vertebrae may also become weakened by cancer.

In vertebroplasty, physicians use image guidance to inject a cement mixture into the fractured bone through a hollow needle. In kyphohplasty, a balloon is first inserted into the fractured bone through the hollow needle to create a cavity or space. The cement is injected into the cavity once the balloon is removed.

Performing Kyphoplasty Surgery

  1. During kyphoplasty surgery, a small incision is made in the back through which the doctor places a narrow tube. Using fluoroscopy to guide it to the correct position, the tube creates a path through the back into the fractured area through the pedicle of the involved vertebrae.
  2. Using X-ray images, the doctor inserts a special balloon through the tube and into the vertebrae, then gently and carefully inflates it. As the balloon inflates, it elevates the fracture, returning the pieces to a more normal position. It also compacts the soft inner bone to create a cavity inside the vertebrae.
  3. The balloon is removed and the doctor uses specially designed instruments under low pressure to fill the cavity with a cement-like material called polymethylmethacrylate (PMMA). After being injected, the pasty material hardens quickly, stabilizing the bone.

Kyphoplasty surgery to treat a fracture from osteoporosis is performed at a hospital under local or general anesthesia. Other logistics for a typical kyphoplasty procedure are:

  • The kyphoplasty procedure takes about one hour for each vertebra involved
  • Patients will be observed closely in the recovery room immediately following the kyphoplasty procedure
  • Patients may spend one day in the hospital after the kyphoplasty procedure

Patients should not drive until they are given approval by their doctor. If they are released the day of the kyphoplasty surgery, they will need to arrange for transportation home from the hospital.

Recovery from Kyphoplasty

Pain relief will be immediate for some patients. In others, elimination or reduction of pain is reported within two days. At home, patients can return to their normal daily activities, although strenuous exertion, such as heavy lifting, should be avoided for at least six weeks.

Candidates for Kyphoplasty

Kyphoplasty cannot correct an established deformity of the spine, and certain patients with osteoporosis are not candidates for this treatment. Patients experiencing painful symptoms or spinal deformities from recent osteoporotic compression fractures are likely candidates for kyphoplasty. The procedure should be completed within 8 weeks of when the fracture occurs for the highest probability of restoring height.

It is not known whether kyphoplasty or vertebroplasty will increase the number of fractures at adjacent levels of the spine. Bench studies on treated bone have shown that inserting PMMA does not change the stiffness of the bone, but human studies have not been done. Osteoporosis is a chronic, progressive disease. As stated earlier, patients who have sustained fractures from osteoporosis are at an increased risk for additional fractures due to the loss of bone strength caused by osteoporosis.

Come visit one of our doctors in our group today!

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Laser Spine Surgery Does it Work?, Laser Spine Institute, LSI, Laser Back Surgery, Laser Spine Work

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Here’s the real answer: www.becomepainfree.com can help!

A board certified typically does spine surgery and or fellowship trained spine surgeon to relieve pain and other symptoms by decreasing the pressure on a compressed nerve or by stabilizing the spine.  In the case of a herniated or ruptured disc area, a discectomy may be done to remove the damaged portion of a disc in the spine; or a laminectomy may be done to remove bone spurs or other spinal growths. In cases where the spine is very unstable, a spinal fusion can be performed to secure together two or more of the vertebral bones so that they “fuse” together.  These surgeries are now often performed using minimally invasive techniques that minimize damage to the surrounding tissue and allow for a faster recovery with much less blood loss. Laser spine surgery is often promoted as being minimally or even noninvasive and risk-free.  However, these laser spine procedures do require incisions and the laser itself can result in many serious complications.

LAser SPine

Laser

Laser spine surgery or Laser Back Surgery has never been studied in a controlled clinical trial to determine its effectiveness. Marketing pitches for spine surgery performed with a laser often make bold major promises of pain relief for chronic neck and back pain and a quick return to normal life; sometimes in a matter of days. What is often not clear from marketing hype is that laser spine surgery or laser back surgery done at such places as the laser spine institute does actually involve surgery.  An incision is required to allow access to the spine area in need of care.  A focused beam of light (laser) is then used only to remove the soft tissues over the spine.   Bone and ligament are then removed in order to free the nerve from compression using small instruments.  The laser in laser spine surgery or laser back surgery actually plays a very minor role in the total surgical procedure of the spine.

Lasers are certainly not new technology by any means.  Lasers have been available for use in medicine since 1973.  However, they have not been widely adopted as a tool to be used in spinal surgery ever.  The fact is that most neurosurgeons do not use or recommend the use of lasers for any spine surgery because there are no clear benefits and there are other well-established and documented studies proving the effectiveness of more modern and established spine surgery techniques.

The Importance of a Proper Diagnosis of you Condition

It is important to have a proper diagnosis of your problem before deciding to undergo spine major surgery.  Most cases of back and neck pain are muscular in origin and do not require or benefit from surgery. Unless severe pain or muscle weakness is making walking or performing daily activities extremely difficult, surgery is rarely the first line of treatment ever. Anti-inflammatory medication, physical therapy and exercise, lifestyle changes and other noninvasive treatment modalities such as therapeutic massage are often successful at resolving back and neck pain.

If conservative treatments fail to reduce back pain, then surgery may be necessary, depending on your current diagnosis. For example, if you have a herniated disk with leg or arm pain as a major symptom that hasn’t been relieved with other treatments, discectomy may be appropriate. If surgery is recommended, get a clear explanation of your diagnosis and how the surgery will help relieve your symptoms.

Traditional spine surgery has been tested in numerous clinical trials.  The major vast majority of patients who undergo discectomy for treatment of a herniated disc experienced relief from pain and other symptoms.  In elderly patients diagnosed with spinal stenosis, laminectomy is also a highly effectively procedure. Very few neurosurgeons regard laser spine surgery as a viable alternative to conventional spine surgery techniques. BecomePainFree spine surgeons do not use or recommend laser spine surgery or laser back surgery such as the ones done at the laser spine institute.

Mayo Clinic Opinion on Laser Spine Surgery

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Become Pain Free | Pain Specialist in Texas

 

 

About Minimally Invasive TLIF Transforaminal Lumbar Interbody Fusion

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Overview  from https://www.becomepainfree.com/

A Transforaminal Lumbar Interbody Fusion (TLIF) is an operation often indicated for patients suffering from back and/or leg pain caused by the natural degeneration of the disc space or some type of traumatic event.

The Minimally Invasive TLIF technique is a less invasive option incorporating the use of specially designed instruments that allow surgeons to achieve the same clinical goals of traditional, “open” TLIF but with much smaller incisions, causing less damage to the surrounding soft tissue.

 

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Procedure

The technique incorporates use of the II Tubular Retractor System and CD  II Spinal System. The METRx® II System provides minimally invasive access to the spine through tubular portals, while the CD  II Spinal System uses an innovative arc device to percutaneously (without a large skin incision) deliver screws and rods for spinal fusion.

* Through a minimal incision in the patient’s back, the surgeon uses specially designed dilators in the  II Tubular Retractor System to spread the muscle and tissues of the back. A tubular retractor, or “portal”, is then inserted over the dilators to maintain a clear pathway to the spine.

* Accessing the spine through the II Tubular Retractor, the surgeon removes a portion of the bone and the disc material, and places an implant in the disc space between the vertebral bodies. This spacer may serve to restore the natural height of the disc space, “unpinch” the nerves, and act as a scaffold for bone growth or “fusion” between the vertebral bodies.

* Finally, the surgeon may use the  Spinal System to place screws and rods in a minimally invasive fashion. These screws and rods are intended to stabilize the vertebral bodies while the bone fuses or heals.

Your browser may not support display of this image. Traditional, “open” TLIFs may often involve significant blood loss and a lengthy hospital stay. However, the Minimally Invasive TLIF technique may offer many patient benefits, including:

* Decreased intraoperative blood loss2
* Shorter hospital stays1
* Smaller incisions and scars
* Decreased post-operative medication needed while in the hospital1

1 Isaacs. Minimally invasive microendoscopy-assisted transforaminal lumbar interbody fusion. J. Neurosurg: Spine. 3:98-105, 2005.

2 Park, Won Ha. Comparison of one-level posterior lumbar interbody fusion performed with a minimally invasive approach or a traditional open approach. SPINE 32(5):537-543, 2007.

 

Minimally Invasive Spine surgery These Dallas Doctors perform minimally invasive spine procedures: 

(These surgeons have extensive experience in both neurosurgery and orthopedics)  

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