Sci-Fi Surgeries: Lasers and Robotics

It may sound like the stuff of science fiction, but surgeries involving robotics and lasers are routine at Physician Partners of America. Our surgeons use cutting-edge tools to perform complex and precise procedures, allowing them to help patients by mitigating chronic pain, explicitly targeting tumors, and inserting neuromodulation devices, among other interventions. In addition, the minimally invasive nature of these procedures reduces the risk of complications and shortens recovery times for patients.

Many of these high-tech techniques use interventional radiology (IR), a method whereby surgery is guided by live medical imaging including x-ray fluoroscopy and MRI. Surgeons can, for example, treat cancer by delivering tumor-fighting medication directly to the source of the illness through pinhole-sized incisions,  targeting trouble spots without compromising other essential functions. In addition, surgeries performed using IR have significant advantages. In contrast, conventional surgery requires the doctor to reference still images taken before the procedure. With IR, the surgeon can “see” into the patient in real-time, eliminating ambiguity and surprises.

Laser spine surgery, a specialty of PPOA, is just as precise at treating spinal conditions, including degenerative disc disease, sciatica, and spinal stenosis. Through incisions smaller than an inch, surgeons use lasers to treat a variety of painful conditions. For stenosis, lasers relieve pressure on the spinal column from bony growths or deformation of the vertebrae by removing excess bone. To address osteoarthritis, facet thermal ablation deadens painful nerves without compromising feeling or movement.

Neuromodulation involves placing a small device near the spinal cord to electrically or pharmaceutically stabilize the nervous system like a pacemaker stabilizes heart rhythms. The procedure is minimally invasive and can treat ailments from chronic pain and incontinence to Parkinson’s Disease and ischemic disorders. Neuromodulation can even treat deafness via cochlear implants, which, instead of regulating existing nerve activity, actually create a response where none had existed.

PPOA is always mindful of the addictive potential of potent opioids and strives to give its patients a wide range of options to treat chronic pain. Thankfully, in 2021 technology has advanced enough that lasers and independent robotic implants are part of that range! To learn more about our modern technology and techniques, please contact your local PPOA clinic.

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Dr. Thomas Heil Performs SI Joint Fusions

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Dr. Thomas Heil grew up and earned his medical degree in West Virginia. He began a residency in General Surgery at the Mayo Clinic in Rochester, Minn., but later decided his passion lay in helping patients relieve their pain. After working in pain management for 20 years in Charlotte, NC., Dr. Heil decided to take his talents to Texas, where he now works at our Keller location.

While there is a wide range of conditions he treats, 50-75% of Dr. Heil’s patients come to seek relief from lower back pain. About 20-40% of these patients coming in for lower back pain treatment will find out their pain is stemming from their sacrum, therefore, their SI (sacroiliac) joint.

“Pain in the sacrum is a lot more common than most people would think and probably a lot less frequently diagnosed than it should be.” –Thomas Heil, M.D.

The Sacrum and SI Joint

The sacroiliac (SI Joint) can be found in the pelvis, right between the ilium and sacrum. It is also the lowest part of the spine and sits right above the tailbone. This joint is very important because it transfers energy from the upper part of the body to the lower part and is an essential component for shock absorption during activities such as walking.

Symptoms of Pain in the Sacrum

Some symptoms of SI joint pain can include:

  • Generalized pain in lower back/buttock region
  • Sharp or stabbing pain when movement occurs
  • Pain in sleeping positions and the changing of sleeping positions
  • Pain or stiffness when sitting for a long period of time

Conditions Related to Pain in the Sacrum

More often than not, pain the sacrum is caused by a joint aggravation or irritation triggered by overuse. Many times, strenuous exercise activities such as cross fit can contribute to this type of pain. With age also comes the degeneration of the fluid within the joint called synovial fluid. Your joints need this because when it begins to wear, your bones rub together. In the minority of cases, pain in the sacrum is related to another generalized inflammatory arthritic syndrome such as lupus or rheumatoid arthritis.

The Treatment

There have been a lot of different ways to treat pain in the SI joint over the years.

The first step to making sure the sacrum pain is coming from the SI joint is a diagnostic block. This is where your physician will put Novocain and some contrast agent down in the joint to ensure the right target is hit.

If the joint numbs up and feels great, sometimes just a steroid injection or two will clear it up well enough. But probably about 50% of the time those steroid injections are temporary. “Some people get several months of relief at a time but others only get several weeks,” Says Dr. Heil. “You certainly don’t want to keep getting injections that often.”

In the past, very large orthopedic procedures were done. During this time, the procedure would take probably 4-5 hours and patients would be in the hospital for a couple of weeks while in recovery. Over the past decade or so, new surgical techniques have been developed that are less- aggressive and minimally invasive. The most recent treatment option being offered is an SI Joint fusion that is about a 20-30 minute procedure that involves a very small incision- no more than the size of your thumbnail. Your physician will insert a little expander device into the SI joint and take out a small piece of the joint that is irritated and replace it with a bone graph. Usually within 4-5 days patients are starting to get over the soreness of the procedure and it is very effective as a long term treatment.

If you are Suffering from Pain in the Sacrum

Dr. Thomas Heil suggests anyone suffering from pain in the sacrum just takes it easy. If this is a new concern, try to reduce whatever you’re doing that is causing the irritation. Anti-inflammatories and rest can greatly reduce the pain. If the irritation persists, the next step would be to see a pain specialist to see if there’s something that can be done to more quickly resolve the problem so it doesn’t become a long term lingering issue.

“What we really want to do is start treating these problems aggressively early on in the process so people are not placed on these narcotics and opioids that have all of the side effects of addiction with it. So the earlier the patient can come in to see us the better off they’re going to be.” Thomas Heil M.D.

Dr. Heil is located at 4364 Heritage Trace Parkway, Suite 112A Fort Worth, TX 76244. We have 35 locations in Florida, Texas, and California that consist of trained specialists. If you are experiencing pain or would like more information, call us today to schedule a consult (888) 616-5110.

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Laser Spine Institute Closing

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Physician Partners of America Offers Solutions to Displaced Laser Spine Institute Patients and Workers

Physician Partners of America (PPOA) will open its doors to hundreds of chronic pain patients left in the lurch after Laser Spine Institute shut down operations suddenly on Friday, March 1. Some of those patients had traveled to LSI’s flagship clinic in Tampa from other states. It is also helping displaced employees, who were blindsided by the closure, to find work at PPOA, beginning with a job fair on March 6.

“We are pleased to offer to perform minimally invasive laser spine procedures on patients who were scheduled for those procedures at Laser Spine Institute in Tampa,” said Josh Helms, PPOA Chief Operating Officer. “We welcome these patients and can put them on our schedule immediately.” PPOA accepts Medicare and most insurances for minimally invasive and laser spine procedures. The cost to patients is typically much lower than Laser Spine Institute.

TO SCHEDULE with Dr. St Louis please call: 1-855-25-LASER

Physician Partners of America, headquartered a few miles from LSI in Tampa, will also see LSI patients for consultations.

 

Laser Spine Institute Closing
Dr. James St. Louis, chief of PPOA’s Minimally Invasive Spine Division since January 2018

 

 

PPOA leadership expressed extreme sadness to hear that Laser Spine Institute shut down operations citing insurmountable financial difficulties. It had closed three surgical centers as a cost-cutting measure in recent years at the same time PPOA entered a period of dramatic expansion.

PPOA operates more than 30 pain management clinics, two laser spine operations, and six outpatient surgery centers in Florida and Texas.

“Laser Spine Institute has brought name recognition to the community in Tampa and other cities and it’s an unfortunate situation,” said Helms. “At Physician Partners of America, we take comfort in hiring many of the displaced LSI workers and our ability to care for those patients in need.”

Help for displaced Laser Spine Institute Employees

Helms added that given PPOA’s expansion and commitment to the Tampa Bay community, it is in a good position to hire some of the 500 employees who lost their jobs at LSI.

“We have many open positions for the type of experienced healthcare workers that contributed so much to the culture at LSI,” Helms said. “We can offer them a new home in a strong and stable company.”

Displaced Laser Spine Institute employees are invited to a career fair at Physician Partners Institute from 11 a.m. to 4 p.m. this Wednesday, March 6 in its headquarters building, 550 N. Reo St. Tampa 33609. PPOA is hiring for 70-plus open positions, mainly in revenue cycle, collections, coding and clinical operations.

For information, they may contact hrdept@physicianpartnersoa.com.

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Frequently-asked Questions about Laser Spine Procedures

LASER SPINE PROCEDURES  – FAQs

The board-certified pain management specialists at Physician Partners of America now offer laser spine procedures for the most common chronic spine pain conditions. That allows you to seek pain relief close to home. It’s the latest alternative to opioid medication for back and neck pain.

Laser procedures are micro-invasive with an incision about the size of a grain of rice. The laser can be used to pinpoint and ablate pain-causing nerves. It’s precise, fast, effective, and spares your muscles the trauma of open-back surgery.

Here are a few frequently asked questions about laser spine and micro-invasive procedures.

Q: Does laser spine surgery use lasers?

A: Sometimes. The term “laser” is meant to convey the precision of the procedures. These minimally invasive techniques directly target the affected area while touching almost nothing else, acting with laser-like accuracy; but some procedures may still utilize lasers, especially on the soft tissues near the spine.

Q: Is there any recovery time?

A: There is some recovery time with laser spine surgery, but it is significantly shorter than traditional surgery. Most of the time you can go back to non-strenuous activity after only one or two weeks, and resume most strenuous activities after one month. That is far shorter than the sometimes six months some patients take to recover; but talk to your surgeon, as each individual may have different recovery times.

Q: How effective is laser spine surgery?

A: When performed by a skilled pain doctor, it is very effective, on par with open surgery. The techniques that are used continue to advance, with better approaches that offer better outcomes.

Q: Is laser back surgery covered by Medicare?

A: Yes! For most patients, Medicare covers some or all of your laser spine procedure. However, keep in mind that different plans may offer different payments. Contact us and we will be happy to provide you with an insurance benefits check to ensure that you are covered by Medicare or other insurance, or let you know how much it may be out of pocket.

Q: How do I know if I’m a candidate?

A: The best way to find out if you are a candidate for laser spine procedures is to contact us today for a consultation. We can talk to you about the available options – not just for spine surgery, but also for pain management – and see what is causing your pain and what treatment techniques are best for you.

If conservative treatment hasn’t worked for you, you may be a candidate for a laser spine procedure to treat your neck or back pain.

 

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Laser Spine Procedures Now in Palm Beach County

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Neck and back pain relief in Wellington and Boynton Beach

Dr. Alejandro G. Tapia is a board-certified and fellowship-trained interventional pain management physician in our Boynton Beach and Wellington locations.

A familiar face on local TV, he brings extensive experience in minimally invasive techniques to treat neck and back pain. Dr. Tapia is a member of the International Spine Intervention Society, Diplomat of the American Academy of Pain Management, American Society of Regional Anesthesia and the Florida Society of Interventional Pain Physicians.

His approach is evidence-based and devoted to using the most cutting-edge approaches medicine has to offer. That is one reason he has embraced laser techniques in his practice.

Laser Spine Procedures in Palm Beach County

The laser is the latest tool used by Physician Partners of America to relieve neck and back pain without opioids. It precisely targets pain-causing nerves along the spine and ablates them quickly. The incision is just 2-3 mm. – less than a quarter-inch. That means muscles are not cut or torn, and therefore, recuperation takes days instead of  months. You can walk out of the procedure suite. The majority of patients report that the original pain is gone.

Dr. Tapia performs this procedure for two common debilitating conditions: arthritis of the spine and facet disease.  His offices accept Medicare and most insurance. You can be sure he will explain all your options, from conservative to cutting-edge, and do his best to get you back to doing the things you love.

Make an appointment today to see Dr. Tapia about laser spine procedures in Palm Beach County. Make an appointment at PPOABoynton.com or PPOAWellington.com today!

 

 

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Laser Spine Procedures Available in Frisco TX

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Dr. Prasad Lakshminarasimhiah may have an unfamiliar last name, but his longtime patients in Frisco, TX, have no trouble saying how they feel about his approach to pain medicine.

He earns a 4.7 out of 5 stars on all the major review sites with such comments as:

“Very professional and caring!”

“He listens and cares about your pain.”

“The best pain management doctor in the DFW area.”

“Dr. P. has a great sense of humor to help alleviate your concerns.”

“I recommend him without reservation.”

Dr. Prasad is board-certified in Pain Medicine and Physical Medicine and Rehabilitation. A U.S. Army veteran, his interest in pursuing pain medicine was sparked by caring for injured soldiers at the San Antonio Military Medical Center in Texas.

His approach is comprehensive, evidence-based and devoted to using the most cutting-edge approaches. That is one reason he has embraced laser techniques in his practice.

Laser Spine Procedures in Frisco

The laser is the latest tool used by Physician Partners of America to relieve neck and back pain without opioids. It precisely targets pain-causing nerves along the spine and ablates them quickly. The incision is just 2-3 mm. – less than a quarter-inch. That means muscles and tissue are not cut or torn, and recuperation is measured in days, not months. You walk out after the procedure and, for most people, the pain is gone.

Dr. Prasad performs this procedure for two common debilitating conditions: arthritis of the spine and facet disease.  His office takes Medicare and most insurance. You can be sure he will explain all your options, from conservative to cutting-edge, and do his utmost to get you back to doing the things you love.

Make an appointment today to see Dr. Prasad in our Frisco pain relief clinic today! Call 972-737-PPOA (7762) or visit ppoafrisco.com to learn about laser pain procedures near you.

 

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PPOA Expands Use of Laser Procedures

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Laser procedures speed recovery for most patients

In its mission to combat the opioid crisis and follow best practices in medicine, Physician Partners of America is pleased to announce the widespread use of laser spine techniques.

PPOA pain management physicians are in the process of being trained in the use of the Holmium YAG laser to perform neck and back pain procedures. The laser is used to ablate pain-causing nerves, as well as tissue that is pressing on nerves.

“It’s better therapy, better efficacy, and the safety is unparalleled,” says Abraham Rivera, M.D., PPOA’s chief medical officer. “It’s a new set of skills that many physicians do not have.”

The company has invested in training and equipment for each of its pain management physicians.

Are laser procedures the best treatment for chronic pain?

The laser is the next step on the continuum of cutting-edge medicine, and Physician Partners of America has always focused on the latest developments in interventional pain management. That subspecialty of pain medicine focuses on treating pain at its source, rather than masking it with medication.

Interventional pain management encompasses a less-is-more approach:

  • Noninvasive techniques, such as injections and nerve blocks
  • Regenerative medicine, such as stem cell therapy and PRP

Patients who are ready for the next level of treatment can consider other approaches PPOA offers:

  • Minimally invasive surgical techniques, with incisions of less than one inch, and small instruments
  • Endoscopic procedures, which use a series of narrow, camera-enabled tubes through which the surgeon works

The laser can be used in any type of minimally invasive procedure.

What are laser spine procedures?

The laser procedures performed by PPOA pain management physicians require an incision barely wider than a needle.

The laser allows for precise targeting of nerves and tissue, quicker healing through muscle-sparing techniques, and a reduced chance of bleeding and infection. Patients walk out the same day and can get back to work or activities in days or weeks instead of months. It is a revolutionary instrument that PPOA uses to stay at the forefront of medical technology.

“It sets us apart from the competition,” says Dr. Rivera. “It’s not a procedure we make money on. That’s not the end result or purpose of it, but it’s something we believe gives patients much better results.”

Many patients choose PPOA for additional reasons: it accepts Medicare and most insurance, and has a long history of performing interventional techniques as an effective alternative to opioids. Services are available throughout Florida and in the Dallas-Fort Worth Metroplex. Initial appointments can be made the same-day patients call and transportation is available on a first-come, first-served basis.

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What is Facet Joint Disease and How Can a Laser Treat It?

Minimally invasive procedures offer hope for facet arthritis

Facet joint disease is one of the most common back pain problems and is often age-related. It can cause a range of issues from mild discomfort to throbbing pain. For patients who have not achieved results through conservative treatment, minimally invasive laser spine procedures can make a big difference in quality of life.

“The laser is an amazing tool for targeting the nerves that cause pain. It offers great precision and longer lasting results,” says Dr. James St. Louis, director of PPOA’s Minimally Invasive Group.

What are facet joints?

These joints are found on both sides of every vertebra (bone) in the spine. They not only stabilize and hold the spine together; they make it possible for your back to twist. Facets are lined with cartilage that acts as a shock absorber and maintains smooth movement between the vertebrae.

Facet joint disease happens when the joints degenerate to the point where the nerves that exit them are impinged. This can happen by the normal wear and tear as we get older – in short, spine arthritis. These joints can also be damaged through trauma, disease and obesity.

Symptoms of facet arthritis

The condition adds pressure to the nearby nerves and can result in swelling and inflammation. If this occurs in the upper part of the back, it will usually cause pain in the head, neck or shoulders. If it occurs in the mid to lower spine, it can cause radiating pain in the lower back, buttocks or legs. Left to progress, it may cause bone spurs, cysts or thickened ligaments.

This condition goes by different names: facet syndrome, facet arthritis, facet hypertrophy and spinal osteoarthritis. By any name, it should be evaluated and treated if it is causing symptoms. Left to progress, it can cause bone spurs, cysts or thickened ligaments.

Laser spine treatment of facet disease

The laser treats pain-causing nerves with less disturbance to muscle and tissue than other techniques. The result is less trauma to the body and a faster recovery. Our surgeons make a 2-3 mm. incision at the treatment site. A very narrow tube, about the width of a needle, is inserted and guided by live x-ray to the treatment area.  The laser is then threaded through the tube and used to ablate the nerve that is being compressed.

When to seek help for facet syndrome

We should point out that some people with facet joint disease never experience pain; in fact, they are surprised to learn they have this disorder. In others, mild symptoms can be treated with rest, physical therapy, heat therapy and anti-inflammatory medication.

On the other end of the spectrum are people who live with excruciating pain every day. For those whose quality of life is affected, minimally invasive laser spine procedures can in some cases provide instant relief.

A diagnosis from a Physician Partners of America board certified pain management physician or spine specialist can tell you how severe your particular case is and how it should be treated.

For more information about facet joint disease and treatment options, please contact our minimally invasive laser spine specialists at 855-25-LASER.

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Tiger Woods Back Surgery – How Does Golf Affect the Body?

He’s had four procedures in four years

Golf legend Tiger Woods’ back surgery saga has gained as much attention as his game and his personal life. His recent PGA Tour Championship performance marks his 80th win. It’s a stunning comeback after a five-year hiatus – and even more significant because he has undergone four operations for chronic pain.

Woods has suffered from pain in his lower back, known as the lumbar spine, and had discectomy surgery to relieve a pinched nerve in 2014. A discectomy removes a small piece of a vertebral disc that is pressing against pain-causing nerves.  This surgery does not affect range of movement.

One year later, he had to withdraw from the Wyndham Championship and undergo a second procedure to decompress another pinched nerve. One month after that, he has a third surgery to relieve pain from the second operation.

The golfer brushed it off as an occupational hazard. “It’s one of those things that had to be done,” he recently told People magazine.

Does Golf Cause Back Problems?

What is it about the game of golf that triggers back pain? Physician Partners of America pain management specialist Dr. Chad Gorman has a background in sports medicine and is a golfer himself.

“While golf is a beautiful sport that requires precision and eye coordination, strength, endurance and focus, there are many common injuries that golfers are prone to getting,” he said.

It’s well known that years of powerful swinging motions can cause tendonitis and “golfer’s elbow,” technically known as lateral epicondylitis.

Tiger Woods’ back surgery history shows that golfers are also prone to chronic lower back pain. “The amount of force that can be created while swinging a golf club puts golfers at increased risk of acute disc herniation, stress fractures and other common causes of back pain,” says Dr. Gorman, who practices in PPOA’s New Port Richey, Fla. location.

Disc herniation occurs when the soft center of a disc that separate spinal bones pushes out and presses against surrounding nerves. It can result in pain, numbness and weakness in an arm or leg.  Woods complained of severe leg pain after his third back surgery, and had to undergo a fourth in 2017. That specialized procedure, known as an interior lumbar interbody fusion, welds unstable vertebrae together so they heal into a single, solid bone.

Lower Back Pain Treatments

Woods recently told People that he is now pain-free, but has to make some adjustments to his swing. “He has had to change his spinal rotation significantly due to the fusion in his back,” Dr. Gorman observes.

For weekend golfers, surgery is not always necessary. Some benefit from aggressive physical therapy. Epidural steroid injections (ESI) and platelet-rich plasma and stem cell therapy can also help ward off surgery in some cases.

Physician Partners of America Pain Relief Group physicians offer ESI, regenerative medicine and other interventional treatments. In cases of pinched nerves or disc disease, the PPOA Minimally Invasive Spine Group offers laser-assisted procedures that can be done in one day with minimal downtime.

 

 

 

 

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Laser Spine Surgery Now Covered by Tricare at PPOA

Tricare makes pain relief affordable for active duty and veterans

Military members living with neck and back pain can now get affordable treatment with their military medical insurance. Physician Partners of America Minimally Invasive Spine Group accepts Tricare, including Tricare Prime, for laser spine procedures. This includes treatment for active duty, reserves and retired military.

Our laser spine surgeon, Dr. James St. Louis, is a U.S. Army veteran and has been treating fellow service members for 30 years. The surgical founder of Laser Spine Institute, he is pleased to extend this groundbreaking outpatient surgical option to patients at Physician Partners of America in Florida and beyond.

“Laser surgery allows patients to return to their activities within days or weeks instead of months, as is the case with open surgery – and that is in their best interest,” says Dr. St. Louis.

Causes of military back injury

The physical stresses of combat and the rigors of training – carrying weapons and heavy packs, running, jumping, marching and parachuting – can cause neck, back and musculoskeletal pain. Trips and falls are other common culprits. Left untreated, these and other spinal problems can lead to limited civilian job prospects and disability.

According to vetsnational.com, common back injuries associated with military service include:

  • Bulging and herniated discs
  • Compressed nerves
  • Intervertebral disc syndrome
  • Sacroiliac joint dysfunction
  • Cervical spine fracture
  • Misaligned vertebrae

Physician Partners of America can evaluate military patients for all of these conditions.

“I see a lot of herniated discs and compressed nerves in military patients,” says Dr. St. Louis. “Because they’re generally young and healthy, we can help them, in selected cases, without the need for spinal fusion.”

It also eliminates the need for opioid pain killers because it targets on the treatment area specifically without the side effects of oral medications.

What is laser spine surgery?

Minimally invasive laser spine procedures treat severe spine-related pain on an outpatient basis: no overnights in the hospital or weeks in bed recuperating. A small incision (less than one inch) and muscle-sparing surgical techniques are the key. Dilation tubes, about as wide as a magic marker, gently spread muscles instead of the cutting and tearing common with traditional open back surgery. The laser is used for ablations and removing tissue that presses on nerves.

Common procedures include laser facet ablation, laser discectomy, laminotomy and foraminotomy. These allow for decompression of nerves that exit the spinal canal.

The methods used in PPOA’s minimally invasive laser spine surgery​ allow for a fast recovery. Most patients are able to walk out of the surgery center the same day and resume activities in days or weeks, as opposed to months with traditional surgery. That – and the affordability that Tricare insurance offers – are a plus for military members.

“Military patients are the best patients,” says Dr. St. Louis. “They are motivated to get back to work. They’re generally healthy, have a good work ethic, and want to get back to a productive life.”

 

 

 

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