FOR IMMEDIATE RELEASE

Reston, Virginia, January 16, 2013 – Dr. Thomas C. Schuler, Chief Executive Officer and Spinal Surgeon at the Virginia Spine Institute, is the first spinal surgeon in the country to perform a hybrid multi-level cervical artificial disc replacement with spinal fusion. This innovative and complex procedure is the first viable treatment option to resolve a combination of degenerative disc disease and herniated discs with normal discs interspersed. While this multifaceted procedure has been utilized in Europe for numerous years, Dr. Schuler remains on the forefront of spinal health innovation by bringing this advancement to the United States. This novel procedure was performed at Reston Hospital Center. The Bryan® cervical artificial disc is approved by the FDA.

“I am proud to be the first spinal surgeon in the country to perform this complex and innovative procedure stabilizing the spine while sparing normal discs and preserving motion. Advances like this will continue to bring the highest quality of spinal health care to patients, alleviating pain and getting them back to their families, and their lives that much faster,” comments Dr. Thomas C. Schuler.

This intricate procedure treats herniated discs, as well as severely degenerated discs, interspersed with normal discs. This innovative hybrid construct procedure included the following, performed through a small incision in the front of the neck:

1. Artificial disc placed at the top of the patient’s neck (C3-4).
2. The next level (C4-5) was healthy and left un-operated.
3. The following level (C5-6), which was severely unstable and degenerative, therefore was fused.
4. The lowest level (C6-7), which contained a herniated disc, received an artificial disc.

The advantage of combining these technologies is that it preserves normal motion and function. The artificial discs preserve normal motion and decrease stress on the adjacent healthy discs, reducing damage to nearby discs and joints. Post surgical care and risks are similar to those that occur with traditional spinal surgery, although recovery has been known to be faster with a reduced amount of post surgical pain. The unique nature of the Bryan® cervical artificial disc is that, to date, it most similarly mimics that of a natural human disc with titanium endplates encasing a polyurethane center and saline cushion.

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Lateral (Side) Post Surgical Xray View

Anterior Posterior (Front) Post Surgical Xray View

View complete news piece here: NBC Nightly News

Spinal cord stimulation is helping some patients resume an active lifestyle that was once stunted by sciatica. NBC’s Dr. Nancy Snyderman reports.

By one estimate, 80% of us complain of back pain. it’s a problem so chronic for people, they’ve run out of solutions that at least conventional medicine can offer them. as we’ve been asking in our series, what is the alternative. our report tonight from dr. nancy snyderman .

>> reporter: kathy is playing music again. a small but significant sign that her days of agonizing back pain are over.

>> i’m feeling much more hopeful.

>> reporter: when two surgeries failed to reduce the excruciating nerve pain shooting down her legs commonly called sciatica, she turned to technology and a device called a spinal cord stimulater.

>> i can increase or decrease the intensity.

>> reporter: the goal, pain relief , and reduce dependency on powerful painkillers. neurostimulation has come a long way.

>> once we get the stimulation into the right area, we finetune it.

>> reporter: implanted under the skin of the lower back, the device lets the patient control the amount of electrical current traveling to the nerves.

>> they can’t get adequate relief with nerve pain medications, that’s the time to think about a spinal cord stimula stimulater.

>> the spinal cord stimulater is just one step in resuming an active lifestyle . kathy is complimenting her recovery with regular workouts.

>> that strength is pulling out of your legs.

>> reporter: mira teaches her technique called gyrotonic. one of a variety of strengthening and breathing methods that is important to maintaining back health.

>> it’s important to get your muscles strong beforehand. if it’s an accident you haven’t planned for, get the body moving as quickly as possible.

>> reporter: other treatments for back pain, acupuncture. mounting evidence suggests it is a viable early option for stimulating the body’s natural painkillers.

>> you get this brain activity that releases endorphins and just the release into the body has numerous physiological effects that can help with stress, sleep, pain relief .

>> reporter: in the case of the stimulaters, the surgery takes two and a half hours, the device stays in for life and the battery is replaced every ten years. good news, the risks are minimal and this is covered by insurance. doctors want patients to be pain free and off narcotics.

The Virginia Spine Institute is an award-winning medical practice in the DC area solely dedicated to spinal health care. Over the past 20 years we have improved the lives of over 50,000 patients. What makes us different is that we have assembled the top specialists from multiple disciplines of spinal health care under one roof to provide convenience of specialty care for our patients!

The Virginia Spine Institute is a Pioneer in the Field with these Leading Advances:

• First Robot-Guided Spinal Surgery in Mid-Atlantic Region
• First Use of Genetic Engineering in Surgery (all surgery not just spinal) in Washington, DC Metro Area
• First Use of Bioresorbable Implants in Spinal Surgery in Washington, DC Metro Area
• First Implantation of a Cervical Disc in Washington, DC Metro Area
• First Implantation of a Lumbar Disc in Washington, DC Metro Area
• First Artificial / Prosthetic Disc in Washington, DC Metro Area
• First Recombinant hDNA Product for Spinal Surgery (BMP) in Washington, DC Metro Area
• First Vertebroplasty for Osteoporotic Compression Fractures in Washington, DC Metro Area
• First Kyphoplasty in Washington, DC Metro Area
• First DLIF/XLIF: Minimally Invasive Spinal Surgery Through a Lateral Approach in Washington, DC Metro Area
• First MIS surgery: Microlaminectomy with Tubular Retraction System (Medtronic) in Washington, DC Metro Area
• First Treatment with Spinal Cord Stimulator in Washington, DC Metro Area
• First Use of Genetic Testing / Counseling for a Spinal Condition (Scoliosis) in Washington, DC Metro Area
• First Use of Scoliscore, the genetic test to help predict a teenagers risk of scoliosis curve progression

Recent Awards:

• U.S. News & World Report Top Doctors (top 1% nationwide)
• 100 Best Spine Surgeons and Specialists in America
• Washingtonian Top Doctors
• 70 Best Pain Management Physicians in America
• Patients’ Choice Awards
• Nationally Recognized: 12 Spine Surgeons for Professional Athletes & 10 Spine Surgeons for NFL Teams
• Spine Consultants to the Washington Redskins Since 1993
• Washington Business Journal’s Best Places to Work
• Super Doctors

FIRST ROBOT-GUIDED SPINE SURGERY IN MID-ATLANTIC REGION IS PERFORMED

Dr. Thomas C. Schuler and Dr. Christopher R. Good, Spinal Specialists at the Virginia Spine Institute, Make Breakthrough in Spinal Health Care by Performing First Robot-Guided Surgery during a Thoracic Fusion Procedure to Repair a Spinal Fracture

Reston, Virginia, July 13, 2012 — Dr. Thomas C. Schuler and Dr. Christopher R. Good, Spinal Specialists at the Virginia Spine Institute, performed the first robot-guided spine surgery procedure in the Mid-Atlantic Region at HCA Reston Hospital Center. This advancement that these leaders in modern spinal health care pioneered provides surgical candidates with less exposure to radiation, smaller incisions which yield a faster recovery, and increased surgical accuracy resulting in less risk for revisions or nerve damage.

Mazor Robotics’ Renaissance™, manufactured by Mazor Robotics Ltd., is one of the only robotic guidance products in the United States used for implantable devices during spine surgery. The experts at the Virginia Spine Institute will continue to utilize this new technique to perform minimally invasive spine surgeries and complex spinal reconstructive surgeries.  All of the spinal specialists at the Virginia Spine Institute are trained in the use of the Renaissance™ Robotic system and are double board certified in their chosen specialty of orthopaedic surgery or neurosurgery, as well as spinal surgery.

The era of modern spinal surgery only began over the past 15 to 20 years. Prior to the early 1990s, the instrumentation that was available to treat spinal conditions was mainly first and second generation equipment. Now, with the assistance of this state-of-the-art technology, spinal specialists can optimize their expertise while minimizing the trauma to the body, preserving maximum function, and accelerate a patient’s return to his/her life.

“This monumental advancement will reshape the future of spine surgery. It is rewarding to be able to elevate the level of safety for patients while helping them recover faster and return to full active lifestyles again,“ comments Dr. Thomas C. Schuler.

“Robot-assisted surgery represents a major technological breakthrough for patients. My experience with robotic surgery began six years ago and it is very exciting to see the progress that has been made. Robot-assisted surgery helps make surgery safer and I am proud to be able to offer this revolutionary technology to my patients,” comments Dr. Christopher R. Good.

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You know what they say, time flies when you’re having fun! It’s hard to believe this year we are celebrating 20 years in business. We couldn’t have done it without our patients’ loyalty, medical team’s dedication, and the support of our administrative staff. To say THANK YOU we are extending  an exclusive, You Scratch Our Backs, We’ll Scratch Yours promotion*.  For each friend or family member you refer to the Virginia Spine Institute, during the months of September 2012 through September 2013, you will receive a  gratitude package chock full of VSI love (a free 30-minute massage at Virginia Therapy & Fitness Center)!

* Promotion Details: Everyone is eligible to take advantage of this promotion and may receive one free massage per referral (multiple referrals accepted). For this anniversary offer, referral must occur during the month of September 2012- September 2013 and must schedule and fulfill an appointment at the Virginia Spine Institute. Massage at Virginia Therapy & Fitness Center must be redeemed by date printed on gift voucher and said voucher must be presented at time of service.

Check out these photos from the VSI archives:

First VSI Office -- Circa 1992

Ribbon Cutting at Current VSI Office -- 2005

As Men’s Health Month comes to a close (June) we hope the spirit of caring for the males in our lives continues all year round. Healthy living should be a part of your daily routine. The goal of Men’s Health Month is to heighten the awareness of preventable health problems and encourage early detection and treatment of disease among men and boys. Alarming statistics show that men’s health is at great risk.

Reduce your risk of being a statistic by following these guiding principles to a better you:

• Get active! Try to strive for a minimum of 2 1/2 hours per week of physical activity.
• Avoid smoking and secondhand smoke.
• Eat healthy fruits , vegetables, and lean protein. Try to limit “junk” food.
• Make sure you are getting enough sleep, generally 7-9 hours a night.
• Listen to your body. Pay attention to signs and symptoms and get them checked out by your doctor.
• Schedule your annual physical exam.  Check-ups can help to diagnose issues early or before they get worse.
• Get vaccinated! Immunizations are needed for ALL ages, make sure you are up to date on yours.
• Keep your blood pressure, cholesterol and BMI in check!  Talk to your doctor about your numbers to make sure that you are in the healthy range.

Which principle are you most challenged to maintain?

Whether you’re a competitive athlete or a weekend warrior, you can’t let muscle pain slow you down.

This new technique for pain management and sports related injuries applies the use of acupuncture needles to deactivate the trigger point (muscle knot), reduce pain and restore normal function to the involved muscle.
This innovative technique is successful in treating shin splints, achilles tendonitis, plantar fasciitis, rotator cuff injuries, tendonitis, whiplash, TMJ disorders, and much more. You can’t afford to live another day in pain!
This new physical therapy intervention can get you back to your active lifestyle without missing a beat.

What is Trigger Point Dry Needling?
Trigger Point Dry Needling (TDN) is an effective treatment that uses small, thin needles (acupuncture needles) that are inserted into the muscles at the trigger points that are causing pain referral. The insertion of the needle into the trigger point is meant to disengage the trigger point. By disengaging and desensitizing the trigger point; results should include improved flexibility and diminished symptoms.

What is a Trigger Point?
A trigger point is a local spot located in a taut band of skeletal muscle that often refers pain. Acute trauma or repetitive micro trauma can lead to the formation of trigger points. Symptoms of trigger points are persistent pain that results in a decreased range of motion in the affected muscle or muscles.

What Does Trigger Point Dry Needling Address?
Dry Needling is a form of treatment for muscular tightness and spasm which commonly follows injuries and often accompanies the degenerative processes.  This muscular tightness and spasm will cause compression and irritation of the nerves exiting the spine. When the nerves are irritated, they cause a protective spasm of all the muscles to which they are connected.  This may cause peripheral diagnoses, such as carpel tunnel, tendonitis, osteoarthritis, decreased mobility and chronic pain.

Is Trigger Point Dry Needling- Acupuncture?
The only thing that Dry Needling and Acupuncture share is the needle. Read here to learn more about acupuncture.

Is This Going to Be Painful?
Typically, you do not feel the needle being inserted. You may feel a twitching or cramping in the muscle where the needle is inserted- which signifies the local twitch response. You may also feel referred pain to another area of the body. Though these feelings may be momentarily uncomfortable and somewhat painful- it will only last briefly. You may develop some soreness in the area that was needles- this should go away within the next day or so.

Will My Pain Go Away After One Treatment?
Generally, it takes a few sessions to have a positive effect, though some people can feel an immediate decrease in pain and an increase in mobility.

Should I Expect Any Side Effects?
You may feel sore immediately after treatment; this is normal but does not always occur.  It can also take a few hours or the next day before you feel soreness. The soreness may vary depending on the area of the body that was treated as well as varies person to person. Typically, it feels like you had an intense workout at the gym.  Soreness generally lasts 24-48 hours.

It is common to have bruising after treatment; some areas are more likely than others. Some common areas are shoulders, base of neck, head and face, arms and legs. Large bruising rarely occurs, but can.  Use ice to help decrease the bruising.

It is common to feel tired, nauseous, emotional, giggly or “loopy”, and/or somewhat “out of it” after treatment.  This is a normal response that can last up to an hour or two after treatment.  If this lasts beyond a day contact your provider as a precaution.

There are times when treatment may actually make your typical symptoms worse.  This is normal.  If this continues past the 24 hour – 48 hour window, keep note of it, as this is helpful information and your provider will then adjust your treatment plan based on your report if needed.  This does not mean TDN cannot help your condition.

During my Air Force Flight Surgeon training I learned that airplane seats have been designed to safety standards but not necessarily for comfort. Many of the airline seats lack lumbar support and cause your back to be in the uncomfortable position of a “C”. Legroom is another issue for most travelers, as you can imagine being over 6 feet tall is an even bigger problem.  The unfortunate person in the seat ahead can rarely recline, as there is no space for their seat back and one’s knees to coexist. With this tight space, you need to be concerned about a couple issues:  blood flow in your legs (and the risk of DVT: Deep Venous Thrombosis*), and support for your back.

Travel Tips Before the Flight:
•    Book an aisle seat. This makes it so much easier for when you need to get in and out and can give you more room if you need to stretch out a bit.
•    Pack as lightly as possible, especially if you are carrying your luggage. If possible use a carry-on with wheels.
•     Pack some relaxing music to listen to. This can help you relax more and ease tension and stress which can exacerbate pain.
•    Drink plenty of water. Altitude changes can cause dehydration! Try to avoid tea, coffee and alcohol as these will dehydrate you further.

Get Your Blood Flowing:
•    Move about the cabin when appropriate and stretch every hour or so
•     Do some calf squeezes
•    Move your ankles in a circular motion

Create your own lumbar support:
•    Carry on a small towel, t-shirt, or blanket
•    Roll your item of choice and place is in the small of your back
•    Roll it with enough thickness so that your knees are not being pushed forward

Since each chair is different, and each person’s lumbar lordosis (curve in the low back) is different. One size does not fit all; just try it until it feels right.

What About Those Long Car Trips? Many of us will be driving for long distances to reach our destinations this summer.
•    Take frequent breaks at rest stops. Be sure to stretch and move around.
•    Remove your cell phone and/or wallet from your back pocket. Leaving these items in your pocket can create an abnormal sitting position which can exacerbate your discomfort.
•    Make use of your car’s lumbar support. If your car does not provide adequate support, try rolling up a shirt or small towel.
•    Utilize heated seat feature (when available) to help ease back pain.
•    Share the driving role whenever possible.
•    Maintain good posture.

So, on your next trip, don’t forget to bring something small which you can roll up and give yourself some low back support.  And, don’t just sit there, take breaks to keep your legs moving to get the blood flowing.

*  Most people will never get a DVT.  However, some risk factors include sitting still for a prolonged period of time, not moving or pumping the calf muscles, or anything which does not allow the blood to flow in the legs.  Since the return of blood from the legs (the venous return) requires the muscles of the calf and leg to squeeze the veins, if the legs do not move, the blood does not flow as well.

If you are riding your bike over rough terrain or over long distances, increased jarring and compression can occur affecting the discs in the spine, which can also cause back pain. In order to prevent back pain or injuries when bicycling it is  important to choose the best bicycle for your purpose. When choosing a bicycle, getting the advice of an experienced rider or a professional bicycle shop can ensure that you have the best bike for your body and your riding style.

For beginners or people with back or neck problems:

• Consider using a mountain bike with higher, straighter handlebars to allow you to ride in a more upright posture
• Bigger tires and shock absorbers can decrease stress on the spine while riding
• Other biking accessories including seats, padded covers, and gloves can also decrease the amount of stress on your body

Seat Height:

• Sit on the seat and dangle your feet- you should not be able to have the balls of your feet touch the ground
• Seat height should allow your legs to extends with a slight flexion at the knees
• Position the seat  at a level where you can maintain a stable position- not too forwards or too backwards

Handlebar Height:

• Your posture should have a slight flexion at the lower back with a wide chest and shoulders
• Arms should not feel overstretched
• Avoid low handle bars- this can cause excess lordosis (curvature) of your lumbar spine
• Your wrists should not be over extended

Remember when riding that the pulling component with your legs is just as important as a pushing component!  Following these tips and making sure you have the proper equipment can help you get great exercise and have fun while minimizing your chance for injuries.

“Chasing records doesn’t keep me on my bike. Happiness does.” – Lance Armstrong after his third Tour de France victory

The Virginia Spine Institute is proud to support our Spinal Champion, Giddeon Massie who secured his 20th career National Championship title. After years of cycling, the miles had finally taken a toll on Giddeon’s spine which led him to seek treatment. Today he is a Spinal Champion! If you have suffered from back or neck pain and have overcome it through either nonsurgical or surgical treatments, you are one of our Spinal Champions. Submit your story today to mystory@spinemd.com.