If you’ve been told you have a herniated disc, you probably have also been told you need a spinal fusion, which up to 2019 has been the traditional treatment for herniated discs. However, that advice for a spinal fusion — especially in the neck — may no longer apply, according to Sanjay Jatana, MD, a fellowship-trained cervical spine specialist at a Denver-based spine center which is part of Spine Center Network.
“The most current spine research from the North American Spine Society has shown that artificial disc replacement can reduce the risk of herniations at other levels in the neck,” explains Dr. Jatana. “With spinal fusion, you are locking two vertebrae together. The proven downside, however, is that fusion then puts extra stress on the discs above and below. The result can be a second herniated disc caused by the first fusion. With an artificial disc, you are preserving the rotation of the neck which lessens the risk to other disc levels. This is especially important in the neck as you only have seven levels to maintain needed rotation.”
Artificial disc surgery — also referred to as motion preservation surgery — has been rapidly evolving with new implants. The FDA has approved several artificial discs for use at two levels in the neck, notes Dr. Craig Humphreys, a fellowship trained spine surgeon at Kenai Spine, also within Spine Center Network. Dr. Humphreys is one of few spine surgeons in Alaska proficient in artificial disc surgery in both the neck and low back.
“These are exciting times for the field of spine, as each year there are new discs that not only preserve the natural rotation of the spine, but also try to mimic the natural disc with some ability to compress up and down. Mother Nature is quite an excellent engineer in that the healthy disc provides ample rotation but also some shock absorption. It’s a tall order to replicate the healthy disc with something that also doesn’t wear out too soon requiring it to be replaced — which can be a complex re-do surgery.”
“With lumbar artificial disc surgery we have to be very selective as to which discs qualify,” explains Dr. Humphreys. “The fear of having a disc wear out requiring revision surgery has caused many spine surgeons to move cautiously with lumbar disc replacement. While access to the front of the neck for artificial disc surgery is straightforward, that is not the case for the lumbar area. With lumbar artificial disc replacement the surgoen has to go through the abdomen and navigate around internal organs. Still, we believe that for the right person, artificial disc can be a great option that preserves the natural motion of the back and neck, and reduces the risk of a future herniation at another level.”
“The burden is on the patient to become well informed about their treatment options, and to research a second opinion when they are told they need spine surgery,” adds Dr. Jatana. “It takes extensive training and experience to implant an artificial disc, and only a small percent of spine surgeons are really proficient in that. If you live outside a large metro area, you will have to recognize that you may have to travel to a regional spine center for the most advanced spine care.”
SpineCenterNetwork.com is the only national listing of spine centers that combine the expertise of non-surgical physical medicine MDs collaborating with top-trained spine surgeons and spine therapists. The spine centers within SpineCenterNetwork.com all emphasize patient education, non-surgical treatment options and the most advanced minimally invasive spine surgery. As a community service, the spine centers distribute a free 36-page Home Remedy Book to those in their state. Patients can request a copy through SpineCenterNetwork.com.
More than 235 TV stations, daily newspapers and business journals across the United States featured Spine Center Network in 2017 related to its recommendation to consumers to pursue a second opinion for spine surgery — a common requirement of some health insurance plans.
SpineCenterNetwork.com was developed to address the issue of treatment bias, a major concern of health insurance plans, employers and primary care referral physicians, explains Bob Reznik, MBA, president of Prizm Development, Inc., the most experienced developer of regional spine centers of excellence. SpineCenterNetwork.com is the only national network of multi-disciplinary spine centers that meet credentialing criteria. To be included, a spine center must combine the expertise of spine-specialized surgeons along with non-surgical MDs who specialize in non-surgical treatment options, including spinal injections.
The spine centers also have affiliated spine therapists who help many patients back to activity without surgery. If surgery is necessary, the spine surgeons in Spine Center Network emphasize minimally invasive spine surgery techniques and instrumentation that shortens the incision to about an inch to reduce blood loss and the need for outside blood, shorten time in the hospital with many patients going home the same day, and enabling many patients to get back to activity faster and with less pain and discomfort.
"Sadly, research has shown there can be tremendous treatment bias based on who you see for back or neck pain,” explains Reznik. “If you see a surgeon first, you may get a surgical recommendation too early. Spine Center Network tries to provide the consumer a listing of centers that emphasize a multi-disciplinary approach to spine problems with non-surgeon MDs and spine therapists working closely with spine surgeons who have advanced training in minimally invasive spine surgery techniques. Some experts in other countries believe half of the spine surgeries in the United States may be unnecessary. The person who is told they need spine surgery would be smart to get a second opinion from a center that has non-surgical capabilities rather than just a spine surgeon. Also, a spine center is more likely to offer advanced technology like the artificial disc to retain normal motion of the spine, rather than a traditional fusion which can cause future disc herniations."
August 22, 2017
Anyone who has had an attack of back pain, or neck pain, immediately fears the worst: spine surgery. And with good reason. Some prominent athletes who have spine surgery appear to be worse off after spine surgery then they were before. According to Dartmouth Medical Atlas, there is significant treatment variation related to spine care, with some states having twice the rate of back surgery as other states.
“In the field of spine, there can be specialty bias based on the training of the doctor,” explains Wayne Mounts, executive director of South Carolina Spine Center. “Spine surgeons can be naturally biased to using spine surgery, while non-surgeons can be equally biased to hanging onto the patient past the point when non-surgical options have failed to work.“
SpineCenterNetwork.com was developed to address the issue of treatment bias. SpineCenterNetwork.com is the only national network of multi-disciplinary spine centers that meet credentialing criteria. To be included, a spine center must combine the expertise of spine-specialized surgeons along with Physical Medicine and Rehabilitation MDs who specialize in non-surgical treatment options, including spinal injections. The spine centers also have affiliated spine therapists.
“The solution is to have a spine center that combines under one roof Physical Medicine MDs who exhaust non-surgical treatment options first, and then if those fail to work, the patient is triaged to a spine surgeon who is trained in minimally invasive spine surgery,” adds Mounts. “We also caution people that if they’ve been told they need spine surgery, it’s a good idea to get a second opinion from a multi-disciplinary spine center to confirm that they really need it, and if they qualify for minimally invasive spine surgery or an artificial disc which can improve their clinical outcome.”
Another issue with spine is that pain can be a misleading symptom. For example, here are four symptoms and when you need to see a doctor quickly:
1. BACK SPASMS can often resolve on their own with anti-inflammatories and rest.
2. FALL OR CAR ACCIDENT needs to be seen quickly if a fracture is suspected.
3. RADIATING PAIN into an arm or leg needs to be seen in a week.
4. NUMB FOOT OR HAND, or loss of bowel/bladder control, are all emergency symptoms that need to be seen by a spine specialist immediately to prevent permanent paralysis of the muscles and nerves.
As a community service all the spine centers in SpineCenterNetwork.com distribute a free 36-page Home Remedy Book which has home remedies and special stretches that can relieve back and neck pain symptoms and prevent a future back pain attack. The handbook also features symptom charts that explain when it’s crucial to go to the doctor fast. Back and neck pain sufferers can request a copy — as well as an appointment for second opinion at any of the multi-disciplinary spine centers — at SpineCenterNetwork.com.
In 2017, Baptist Health worked with Prizm Development to create a new spine center that includes the expertise of a non-surgical MD specialized in spine, a doctorate-level spine therapist and five neurosurgeons. The new spine center located in Little Rock, Arkansas, near the main campus of Baptist Health, combines under one roof in internal injection suite, a complete physical therapy exercise gym and physician exam rooms. The spine center is located adjacent to a complete diagnostic center with X-ray, MRI and CT.
In 2016, Reading Neck & Spine Center was added to Spine Center Network. The spine center is based in Reading, Pennsylvania, and has a satellite offices in Wyomissing and Pottsville in the center of Pennsylvania steel country. The spine center acts as a resource for those with back and neck problems from across Central Pennsylvania. Dave Abraham, MD, a founder of the spine center, specializes in minimally invasive spine surgery, with many patients having spine surgery at the nearby Surgical Institute of Reading and able to go home later the same day.
In 2015, Kenai Spine was added to Spine Center Network, acting as a regional Spine Center of Excellence for the State of Alaska. The spine center has two offices in Anchorage and an office on the Kenai Peninsula in Soldotna. Kenai Spine combines under one roof three fellowship-trained spine surgeons (the highest level of medical education possible), a Mayo Clinic-trained MD who specializes in non-surgical care and spine specialized physical therapists. Kenai Spine, founded in 2011, has helped thousands of back and neck pain sufferers across Alaska get back to activity, most of them with non-surgical treatment options. If spine surgery is necessary, the spine surgeons operate through new minimally invasive instruments the width of a ballpoint pen — to reduce the length of incision, shorten time in the hospital and speed return to activity with a less painful recovery. Kenai Spine is also one of the few centers in the U.S. to use advanced O-arm surgical navigation technology. Some patients qualify for the most advanced artificial disc, Mobi-C, which can help lessen the risk for future disc herniations.
In 2013, Self Regional Healthcare called upon Prizm to help them improve how they manage back and neck pain through their spine center service line. The spine program at that time included three fellowship-trained spine neurosurgeons. Over 2014 and 2015, Prizm helped the spine service line to mature into a more complete multi-disciplinary spine center with two specialists in Physical Medicine and Rehabilitation (PMR), and a better-integrated spine therapy department. "The spine center now is proficient in managing those back and neck pain cases that don't need surgery," explains Bob Reznik, MBA. "The PMR specialists manage the non-surgical treatment options and triage those patients who need surgery more adroitly to the specialists. Now everything related to spine is in one location for the convenience of the person with back or neck pain: diagnostics, X-ray, MRI, spine surgeons, MDs who specialize in non-surgical treatment and spinal injections and therapy. It's now a true destination center for spine care that attracts patients from a 100 mile radius." In 2014, South Carolina Spine Center met the credentialing criteria to be included in SpineCenterNetwork.com, the only national listing of credentialed spine centers.
On January 1, 2014 three specialty groups — Precision Spine Care, Dr. Jonathan Blau and Texas Pain — combined their resources to create a regional center of excellence for spine care and pain management under the name Precision Spine Care.
The merger combines the expertise of three fellowship-trained pain specialists within Texas Pain; physical medicine specialist Jonathan Blau, MD; along with three spine-specialized neurosurgeons and a second physical medicine specialist to create a fully comprehensive spine and pain center for the East Texas region in 2014.
With the merger, effective January 1, 2014, Precision Spine Care now includes a multidisciplinary team with two physical medicine and rehabilitation (PMR) physicians who specialize in the nonsurgical management of back and neck pain; three fellowship-trained pain medicine physicians; and three neurospine surgeons. Click here to read more about Precision Spine Care's Center of Excellence.
April 10, 2013-- Spine Center Network and Bob Reznik, MBA featured in Becker's Spine Review article entitled "5 Qualities of Spine Center Leaders for Today & Tomorrow"
Spine Center Network was developed by Prizm Development, Inc., two years ago and now acts as a national network of credentialed Spine Centers of Excellence for payors and consumers. Inclusion in the network is based on credentialing criteria that includes having fellowship-trained or highly specialized spine surgeons integrated with spine-specialized physical medicine physicians and spine therapists. Spine Center Network represents those spine centers that meet the credentialing criteria. It currently includes about 18 spine centers across the United States. Read the complete article here.
Spine Center Network is focused on providing information for payors, employers and consumers about spine care providers. The company creates a list of "spine centers of excellence" that emphasize non-surgical treatment options before surgery. Read more.
Wouldn’t it be convenient if someone created a listing of spine centers of excellence across the United States that all emphasize non-surgical treatment options before surgery?
Where the staff included board-certified spine specialists who are fellowship-trained in spine — the highest level of training available in the United States?
Where each center featured a team of non-surgical spine specialists who are board-certified Physical Medicine & Rehabilitation physicians, working closely with ortho & neuro spine surgeons, and spine-specialized therapists to find NON-surgical treatment options for those with back pain ….
Where each center reports their Clinical Outcomes annually on a Clinical Outcome Report Card that is produced by an outside organization for credibility….
Where each center measures patient satisfaction by having a nurse call patients after their treatment to track their satisfaction with the care they received…
Where the physicians and the centers share no ownership or partnership in the network, but merely share a philosophical desire to continually improve spine care, and their belief that proper spine care is to exhaust non-surgical options first, before resorting to spine surgery…
Where the physicians and the staff want to create a better experience for the person with back and neck pain, so he or she can get back to activity, their favorite sport, with the least amount of pain, discomfort and time off work…
"The network is a byproduct of extensive one-on-one meetings with payors, employers and work comp carriers who were looking for spine programs that emphasized conservative care first," explains Bob Reznik, MBA, president of Prizm Development, Inc. "We've been asked for something like this for years. Whenever we complete a case rate contract in a market, the medical director will ask us, 'Where else do you have centers like this?' Dartmouth Medical Atlas has documented tremendous treatment variation in spine care," says Reznik. "Some spine surgeon practices emphasize excessive and aggressive surgery. Other spine doctors can emphasize too many injections or manipulations. Sadly, too many times the back pain sufferer is punished with a safari through trips to multiple offices with biased opinions, misleading information, fragmented care, conflicting diagnoses and treatment plans — and often an unnecessary surgery. That is the perceived problem with spine care today."
Health insurance plans and national employers who want to identify spine centers who conceptually believe in a non-surgically oriented approach to spine care, with the use of Physical Medicine and spine therapy, all under one roof. This network can be useful to create a referral network for their covered lives or employees with back or neck pain.
Workers Compensation Carriers and Employers who have a vested interest in helping injured workers get back to activity.
Back and neck pain sufferers who are searching the Internet for places to go for relief of symptoms, second opinions and information on who to pursue for proper treatment. All of these participating spine centers have content-rich online spine encyclopedias that can accessed through this spine center network web site.
The common thread that weaves all these separate spine centers together is that all are based on a common spine center model created by Prizm Development more than 15 years ago. This spine center model is based on more than 1,000 one-on-one interviews by Prizm staff with health insurance company medical directors, workers compensation insurance companies and health benefit managers from large employers from across the United States.
"While many hospitals and physicians think the answer to the problem of fragmented, biased and dysfunctional spine care is to add MORE physician specialties into a building, we’ve listened to customers — and they say they want LESS specialties involved, LESS bias, LESS fragmentation and LESS disagreement among specialists," says Reznik.
Consequently, Prizm created a spine center model that is restrictive to three core specialty groups. Prizm’s spine center model is based on a 3-legged stool concept, where a multi-disciplinary team of Physical Medicine physicians, spine surgeons (ortho & neuro) and spine therapists act as the foundation for care.
The second foundation of this spine center model, is the philosophy that — absent emergency symptoms like loss of bowel/bladder control or weakness in a foot or hand — non-surgical options need to be explored and exhausted first before spine surgery.
The third common aspect among these spine centers is that they use spine-trained physical therapists who have advanced training and experience in the niche of spine care. These therapists are typically located in the same building so care can be expedited and information gathered by the physician can be shared by the therapist in the treatment plan.
The fourth common aspect is the philosophical commitment by all these spine centers to educate the health care consumer to seek out non-surgical treatment, second opinions for spine surgery, and if spine surgery is necessary be prudent about where you choose to go. All of these spine Centers of Excellence have invested their own money to create an educated health care consumer. As a free community service, all these centers mail out — at their cost — a 36-page Home Remedy Book to thousands of back pain sufferers annually. Each also has an on-line spine encyclopedia at with exercises, symptom charts and medical illustrations on spine. They believe an educated health care consumer will choose wisely, and will often choose the best possible place to go, which may be these spine centers.
The fifth requirement is the willingness to use Prizm’s outcome system to publish an annual Clinical Outcome Report Card for referring physicians and payors. This outcomes system reveals the percent of patients receiving conservative care options like therapy and injections, the percent of patients who receive surgery, functional status, patient satisfaction, and the percent of patients who are still taking five or more pills daily for pain relief three to six months after first visit.
Back or neck pain sufferers who are seeking a physician can request a second opinion from 16 spine centers located across the United States in California, Colorado, , Illinois, Indiana, Maine, Michigan, New York, New Jersey, Nevada, North Carolina, South Dakota and Texas. The network will expand to include other regional centers as they meet inclusion criteria.
Click here to download the PDF from Becker's Orthopedic & Spine Review.
The spine centers of excellence listed on the Spine Center Network national map represent a listing of spine centers in the United States that emphasize nonsurgical options and spine-specialized surgeons who emphasize minimally invasive spine surgery. These spine centers are located in the following areas of the country: Augusta, Southeast Georgia; Little Rock, Arkansas; Providence, Rhode Island; Athens, East Georgia; Soldotna / Kenai / Anchorage, Alaska; Auburn, Maine; Panama City, Florida panhandle; Tyler, East Texas; Rockford, Chicago area, Illinois; Reading, Central Pennsylvania; South Bend and Elkhart, Indiana; Greenwood, western South Carolina; Birmingham, Alabama; and Reno, Sparks, Carson City, Nevada. Some of these spine centers are referred patients from Canada or Mexico under bundled predictable rates.