Make Pain a Thing of the Past – laser spine – Physician Partners of America

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Orthopedic Surgeon, Minimally Invasive Laser Spine Surgeon

Dr. Keith Girton has performed more than 6,000 minimally invasive outpatient spinal surgeries in 30 years, and proudly offers his skill and experience to Physician Partners of America patients in Melbourne and Orlando, Fla. A board-certified orthopedic surgeon and minimally invasive laser spine surgeon, Dr. Girton’s practice encompasses a wide variety of procedures to help people suffering from chronic pain.

Born in Columbus, Ohio, Dr. Girton attended a combined program with Otterbein College and The Ohio State University. This special program enabled him to complete both his Bachelor of Arts and medical degrees in six years. After becoming board-certified in family practice, he went on to complete an orthopedic surgery residency at Ft. Worth Affiliated Hospitals in Ft. Worth, Texas.  He joined the U. S. Air Force, where he attained the rank of major and served as an orthopedic surgeon at Scott AFB near Bellville, Ill. While there, he became certified by the American Board of Orthopaedic Surgery.

Dr. Girton later joined the Laser Spine Institute and practiced minimally invasive outpatient spine surgery primarily in the Philadelphia area. He was featured in Philadelphia magazine’s Top Docs edition and was honored as Most Valuable Surgeon for the Laser Spine Institute’s seven national facilities in 2013.

During his time at the Laser Spine Institute, he performed thousands of minimally invasive outpatient spinal surgeries on patients from every state and many countries including Egypt, Bahrain, South Africa, Nigeria, and Venezuela. After the prestigious spine care company closed its doors in March 2019, Dr. Girton joined Physician Partners of America where he continues to offer the best available surgical care to the Space Coast and Central Florida.

Dr. Girton is a member of the American Academy of Orthopaedic Surgeons, the North American Spine Society, the Society for Minimally Invasive Spine Surgery, and the American Medical Association.


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.


If you’ve been investigating laser spine procedures in Orange Park, FL or the Jacksonville area, contact Dr. Harsh Dangaria.

Based in our Orange Park, FL pain management clinic, he is double board-certified in Pain Management and in Physical Medicine and Rehabilitation. Dr. Dangaria has contributed to many peer-reviewed journals and textbooks, and is a sought-after speaker at academic meetings.

An expert in treating many kinds of pain conditions through interventional and nonsurgical treatments, Dr. Dangaria is universally known for treating patients with both compassion and customized treatment plans. He is consistently five-star rated by his patients with such comments as:

One of the nicest doctors I have ever met

He understands me and my pain

His expertise in the field is evident and he is ahead of the curve when it comes to new and innovative treatment for many different pain conditions.

So it’s only natural that Dr. Dangaria would begin treating neck and back pain with laser spine procedures. The laser is the latest tool used by Physician Partners of America specialists to relieve pain without opioids. It precisely targets pain-causing nerves along the spine and ablates them quickly.

The incision is just 2-3 mm. – that’s smaller than one quarter-inch.  Muscles and tissue do not have to be torn or cut, so recovery takes in days or a few weeks, not months as is typical with open-back surgery. You walk out on your own after the procedure and, for most people, the original pain is relieved quickly — sometimes instantly.

Dr. Dangaria performs this procedure for two common debilitating conditions: arthritis of the spine and facet disease.  His offices accept most insurance as well as Medicare. 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.

Learn how laser can rechange your life! Make an appointment with Dr. Dangaria at or call (904) 844-0017 to see if you’re a candidate for laser spine procedures in Orange Park, FL or anywhere along the First Coast.

Don’t miss a money-saving opportunity –

The clock is ticking on your health insurance costs and expenses for the year. Have you met your deductible? Have you used up your FSA or HSA? On Jan. 1, many insurance plan deductibles – the amount you’re responsible for paying before your insurance plan picks up the bill – reset to $0. You have just a few weeks left to “use it or lose it.”

If this applies to you, here are four health insurance tips to help you make the most of your healthcare dollars.

Have you met your deductible?

If you have or are close to it, schedule a visit to a primary care doctor for those tests you’ve been putting off. If your goal is to get pain-free in the new year, schedule an appointment with an interventional pain management specialist or laser spine surgeon. Physician Partners of America offers fast appointments at its pain management, laser spine and orthopedic practices.

To get a handle on health insurance costs, it’s also a good idea to refill prescriptions and schedule lab work and imaging before year’s end if insurance is likely to pick up the tab. Of course, it’s important to check your plan, as your coinsurance must also be factored in.

Still have a way to go to meet your deductible?

You should not put off seeing a doctor for serious or nagging conditions; but if you’ve only used up a fraction of your deductible, any major expenses in November and December will likely come out of your pocket. If you have chronic spine pain, here’s good news: You can schedule a second opinion with a Physician Partners of America laser spine surgeon in Texas or Florida, and have the procedure when your deductible resets in January.

Do you have a Flexible Spending Account (FSA)?

Flexible Spending Accounts let you set aside tax-free money at the start of each year to pay for certain healthcare expenses. The downside? What you don’t use by Dec. 31, you lose. It’s important to get everything you need now. The list of eligible expenses is long and surprising: it includes prescriptions, imaging, and even travel expenses related to medical treatment for patients and certain caregivers. Pain patients eligible for laser spine procedures by renowned specialists Dr. James St. Louis and Dr. Phillip Kravetz may be able to get reimbursement for airfare, meals and lodging.

What if you have a Health Savings Account (HSA)?

Unlike the FSA, Health Savings Account dollars roll over from one year to the next. There is no pressure to spend it by the end of December. If you are young and in good health, some financial advisors suggest putting any leftover HSA funds in a tax-free investment like mutual funds to increase its value.

Good health and more money top the list of New Year’s resolutions. Get a start on both by using your end-of-year health insurance dollars wisely.


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.





Does Medicare Cover Laser Back Surgery?

Good news for seniors who have put off treating neck or back pain because of cost: Physician Partners of America is one of the few healthcare providers that accepts Medicare for minimally invasive laser spine procedures.

These procedures typically cost patients thousands of dollars without Medicare or insurance coverage.

With most laser spine surgeries, the surgeon and the surgical facility are billed separately. Physician Partners of America accepts traditional Medicare for both the physician and the facility, allowing the procedure to be become more affordable for Medicare patients.

“No one should be forced to live with excruciating pain because they can’t afford surgical intervention,” said James St. Louis, D.O., MS, director of PPOA’s Minimally Invasive Laser Spine Group. “We are pleased to be able to make this life-changing option to our patients very affordable.”

Laser spine surgery performed by experts

Dr. St. Louis, the surgical founder of Laser Spine Institute in Tampa, Fla., joined PPOA in January. Phillip Kravetz, M.D., another pioneer in the field, will perform these procedures in Texas.

Minimally invasive laser spine procedures are fast becoming the gold standard for addressing severe spine-related pain. Minimally invasive refers to the small incision (less than one inch) and tiny instruments used to perform a procedure. Narrow dilation tubes are fed through the incision to spread the muscles surrounding the back. In contrast, traditional open back surgery uses a five- to six-inch incision. Through this a surgeon must cut and tear muscles to reach the spine.

The laser is mainly used for ablations and disc work.

Laser spine surgery isn’t the only way PPOA ensures a good patient outcome. Its surgeons also use intraoperative neuromonitoring to further ensure safety of the patient’s neural system during the operation. IONM can “see” what neither the doctor nor the fluoroscopy (live x-ray) machine can, and it helps avoid accidental injury.

The methods used in PPOA’s minimally invasive laser spine surgery allow for a totally outpatient procedure. 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.

Life changing procedures

Patients who have had this procedure at Physician Partners of America call it nothing short of a miracle.

“I couldn’t walk. I could hardly leave my couch, couldn’t bend over to pick anything up without pain, said Medicare patient Laura Wall, 63, of Sun City Center, Fla. Since she’s had laser spine surgery by Dr. St. Louis, “I can swim and walk and do everything I want. Looking forward to working out. It’s the best move I’ve ever made. I’m very satisfied. More than satisfied.”

Patients can make an appointment with Dr. Kravetz at 817-576-0885, or reach Dr. St. Louis by calling 855-25-LASER.


Laser Spine Surgery "Quick Answers"

A: Laser Spine Surgery is covered by Medicare if the surgeon and the facility where the surgery is performed are both in network with Medicare.

A: Minimally Invasive Spine Surgery is covered by Medicare if the surgeon and the facility where the surgery is performed are both in network with Medicare. You can expect to contribute to part of the costs as you would with most surgical procedures covered by Medicare.

Pioneer in MIS surgery joins Hurst location 

Phillip Kravetz, M.D., has joined Physician Partners of America (PPOA) Minimally Invasive Spine Group, and in doing so will bring minimally invasive laser spine procedures to the company’s Texas territory. He will begin seeing patients on June 11 in the Hurst and Frisco offices.

Dr. Kravetz is among a relatively small group of spine specialists who use minimally invasive techniques to treat complex spine cases, such as fusion and adult-onset scoliosis (curvature of the spine). These conditions have traditionally been been corrected with open-back surgery.

Performing them with minimally invasive, laser-assisted techniques improves patient outcomes. It involves only a one-inch incision, faster recovery time, and less post-operative discomfort.  Muscles surrounding the spine are gently spread apart using dilation tubes instead of the cutting and tearing used in open surgery.

“Through unique training and a lot of experience, I can treat both simple and complex cases in a minimally invasive fashion,” he says.

Dr. Kravetz is board-certified in Orthopedic Surgery with a specialty in Spinal Surgery, and he is a member of the National Board of Physicians and Surgeons.

A native of the Detroit area, he attended the University of Michigan Medical School. While earning his medical degree, he did a Howard Hughes Medical Institute research fellowship in Molecular Pharmacology at Harvard Medical School and at the Dana Farber Cancer Institute.

He went on to complete an internship in General Surgery at Rush Medical Center in Chicago, and his residency in Orthopedic Surgery at Henry Ford Hospital in Detroit.  He completed his fellowship at the Institute of Spinal Disorders at Baylor University Medical School in Houston.

Dr. Kravetz began training in minimally invasive spine procedures when the technique was in its infancy, in 2001. After mastering the technique, he began teaching other surgeons worldwide.  “I’m really big on education and teaching, ” he says.

His desire to inform also extends to his patients. He takes his time showing them how the spines works and how his procedures can help them. “If they understand their spine problem and about the surgery itself, they are more likely to have a good outcome and be more comfortable,” he says.

Dr. Kravetz comes to PPOA after nearly 20 years in private practice and actively educating other surgeons about minimally invasive spine techniques. He is now accepting appointments at  1717 Precinct Line Road, Suite 204 Hurst, TX 76054 and 5575 Warren Parkway, Suite 104, Frisco, TX, 75034.

Call (817) 576-0885. Same-day appointments are available.

PPOA launched its Minimally Invasive Spine Group in Florida in January with the hiring of James St. Louis, D.O.