Interventional Spine &Pain     

     Rehabilitation Center


Reclast 

For the first time a once-yearly treatment is shown effective in significantly reducing the incidence of bone fracture across the most common osteoporotic fracture sites1
Additional data demonstrate patients can be directly switched from weekly Fosamax (alendronate) to Reclast and maintain bone benefits for a full year2

PHILADELPHIA, PA, September 16, 2006 -- New Phase III data presented for the first time demonstrated that the investigational treatment Reclast (zoledronic acid) 5 mg was highly effective in reducing the incidence of bone fracture in women with postmenopausalosteoporosis across the most common fracture sites - hip, spine and non-spine - with sustained effect over three years.1 Further data demonstrated that postmenopausal osteoporosis patients currently taking oral alendronate can be directly switched to Reclast and maintain beneficial bone effects for a full 12 months after a single dose.2These studies were presented today at the annual meeting of the American Society of Bone and Mineral Research (ASBMR) in Philadelphia.


Many of the medicines taken by mouth are hard to tolerate and require upright movement for time after taking, Require three other large calcium pills ans Vitamin D everyday.  They tend to be very hard on the patient's stomach and are often returned to Dr Mike with a wealth of comments about alternative uses.


For these reasons we proud to handle ReClast®.​.


GENERIC NAME: zoledronic acid

BRAND NAME: Reclast®

DRUG CLASS AND MECHANISM: Zoledronic acid is an injectable drug belonging to a class of drugs called bisphosphonates that strengthen bone and are used primarily to treat osteoporosis.  

Dr Mike and his staff a very good at starting small IV's.  Then you just sit for 20 minutes.  Zoledronic acid also is the active drug in Zometa, which is used for treating cancer. The bisphosphonate class includes etidronate (Didronel), pamidronate (Aredia),risedronate (Actonel), ibandronate (Boniva), and tiludronate (Skelid). Bone is in a constant state of remodeling. New bone is laid down by cells called osteoblasts while old bone is removed by cells called osteoclasts. Bisphosphonates strengthen bone by inhibiting bone removal (resorption) by osteoclasts. After menopause, there is an increased rate of bone loss leading to osteoporosis. Bisphosphonates increase bone density and decrease bone fractures. The FDA approved Reclast in August 2007. Reclast is far from perfect.


What is Osteoporosis?  Soft Bones?

this article respectfully borrowed  from the National Osteoporosis Association (NOF)

What is Osteoporosis? Osteoporosis is a disease of the bones. It happens when you lose too much bone, make too little bone or both. As a result, your bones become weak and may break from a minor fall or, in serious cases, even from simple actions, like sneezing or bumping into furniture.Osteoporosis means “porous bone.” If you look at healthy bone under a microscope, you will see that parts of it look like a honeycomb. If you have osteoporosis, the holes and spaces in the honeycomb are much bigger than they are in healthy bone. This means your bones have lost density or mass and that the structure of your bone tissue has become abnormal. As your bones become less dense, they also become weaker and more likely to break. If you’re age 50 or older and have broken a bone, talk to your doctor or other healthcare provider and ask if you should have a bone density test.Osteoporosis is CommonAbout 52 million Americans have osteoporosis and low bone mass, placing them at increased risk for osteoporosis. Studies suggest that approximately one in two women and up to one in four men age 50 and older will break a bone due to osteoporosis.  Osteoporosis is SeriousBreaking a bone is a serious complication of osteoporosis, especially when you’re older. Broken bones due to osteoporosis are most likely to occur in the hip, spine and wrist, but other bones can break too. Broken bones can cause severe pain that may not go away. Osteoporosis also causes some people to lose height. When osteoporosis causes the bones of the spine, called vertebrae, to break or collapse, it affects your posture and causes you to become stooped or hunched.Osteoporosis may even keep you from getting around easily and doing the things you enjoy, which may bring feelings of isolation or depression. It can also lead to other health problems. Twenty percent of seniors who break a hip die within one year from problems related to the broken bone itself or surgery to repair it. Many of those who survive need long-term nursing home care.Osteoporosis is CostlyOsteoporosis is responsible for two million broken bones and $19 billion in related costs every year. By 2025, experts predict that osteoporosis will be responsible for approximately three million fractures and $25.3 billion in costs each year.Osteoporosis can Sneak up on YouOsteoporosis is often called a silent disease because you can’t feel your bones getting weaker. Breaking a bone is often the first sign that you have osteoporosis or you may notice that you are getting shorter or your upper back is curving forward. If you are experiencing height loss or your spine is curving, be sure to talk to your doctor or another healthcare professional right away as the disease may be already be advanced.


The link above will take you to a YouTube Introductory video on the TruFuse "brand" Facet Fusion Technique.  The equipment is now even small than in this older video.

Click on the left

The Link Will Take You to a YouTube Video


Portion of Lumbar Disk Removed By Dr Mike at Wyandot  Hospital, 2010

Endoscopic Diskectomy

There are people that refer to this as Laser Spine Surgery.  The truth is that if it is done right you really don't need the laser, it just adds to the cost.  While the whole idea sounds really cool of using a laser bean on your spine, it really has not been shown to be any better than using the scope and tiny 3 mm grabbers and clippers to clean out and clean off the disk and nerve space.  The "Ellman Unit", is a type of electrocautery device that vaporizes the disk and some people do refer to as "the laser", but it not quite the same thing.

Facet Injection or RF (radiofrequency) is a safe, simple procedure, done in the office


  • Your skin is numbed with the smallest needle made - an insulin needle
  • The joint is injected with a needle the size of than used to give a flu shot
  • A facet injection takes less than 2 minutes
  • ​Radiofrequency can be up to 2 minutes per level
  • Most patients don't need sedation, but it is very easy to give you an IV and give light sedation.
  • This is not general anesthesia.  You will be awake and talking, but very calm.  
  • Dr. mike tends to sedate patients who have had a bad experience at outside facilities

Facet Fusion 

TruFUSE® Facet Fusion represents a new surgical option for back pain sufferers who don't qualify, or would like to avoid, major surgery.  Facet Fusion is a new turn on an old idea and used to treat a variety of back problems.  It can be included in the augmentation of other procedures for any location from C2-C3 to L5-S1, TruFUSE is the less invasive and less destructive option for back pain, but is far from a perfect technique.   The procedure is done through an opening smaller than a dime!  A small Bone Dowel is placed across the facet joint.  This is a more natural way to fuse the spine and avoids messing with the disk.  It leaves a large amount of bend and play that your spine was designed for.  Disk removal ("laser spine surgery") can also be done at the same time if needed.  There are patients who undergo TruFuse and later need to have additional more involved surgery.

Lumbar Facets Refer to Very Broad Areas

Pain can be anywhere in the lower back, across the hips and  may even come into the front

The Bottom Facet is Connected with Many Small Ligaments

These joints Move and the Ligaments can get pulled.  The muscles then get tight and it becomes a vicious cycle making the pain worse.

Thoracic Spine Facets have a known pain distribution as well

Dr Mike often uses manual medicine in conjunction with other treatments for thoracic facet pain

Chronic pain after spine surgery may be due to scar tissue or epidural adhesions.  The “LOA” or  "lysis-of-epidural- adhesions” is a 3 to 5 minute epidural-type procedure that seeks to break up some of these adhesions.  This is more than a simple "pain shot"

     Facets are Treatable

  • Facets can be injected with an anti-inflammatory medication
  • Facets are be treated with (RF) radiofrequency, or buzzing them.
  • Some people call this neurolysis, Rhizotomy (althought that's not a correct term)
  • ​                  can be injected into the muscles around and pinching the facets
  • Dr Mike does many radiofrequency procedures each day and has presented research on using phenol and other chemicals to enhance the long-term pain benefits

These are areas that facets may refer pain in the neck and shoulder regions

Facet Pain

Facets are small joints in the back part of your spine that lock and interconnect vertebrate with the ones above and below.  They can become irritated and inflamed like any other joint.  They are very amenable to treatment

The L5 dermotome

is the most common

Every nerve leaving your spine goes to a strip of skin called a dermatome.  Much the way you can hit your “funny bone” at the elbow and pain shoots down your hand, a nerve can get irritated or compressed at the level of the spine and shoot down your leg or arm.  This can happen in shingles as well.  People often use the word “Sciatica”  
Fell free to print and shade in or circle exactly where you are hurting

Scheduling  419 522 1100  Fax 419 522 4118

Small nerves that transmit pain from your spine can be "buzzed" with a 10- minute radiofrquency procedure


The practice of Interventional Pain Management and Minimally Invasive Spine & Pain are evolving fields.  Many treatments, medications, and equipment uses presented are potentially considered to be off-label and non-FDA approved as are many things in primary care.  However, they are standard-of-care.  This is simply the nature of the specialty.  It is also a fact that anything bad can happen anytime any healthcare provider does anything for any  patient.   Dr Mike has never had an infection, bleeding, spinal cord injury or other life threatening complication.


Most people who have had spine surgery still have considerable symptoms in the leg and back.  

* This is one of the reasons we  try and avoid major surgical interventions for patients who have no weakness or other neurologic loss


Type Here you can see the improvement in the angle wedge deformity after Dr Mike has fixed the fracture


you can see the "RamRod" and how it is pushing the cement into the small cracks, filling the vertebral fracture cracks.  Notice how it stops when it reaches the edge of the bone

Dr Mike giving a "Thumbs Up" during a Khyphoplasty                                           Filler Pipes and their "RamRods" in place

Vertebroplasty/Khyphoplasty


We provide Vertebroplasty and Khyphoplasty services for acute compression fractures at Wyandot Memorial Hospital, Shelby Hospital and MedCentral Mansfield Hospital.

 

The bones, or vertebrae, that make up your spine are very strong, but sometimes a vertebra can fracture just like any other bone in your body. Vertebra fractures are usually due to conditions such as: osteoporosis (a condition which weakens the bones), a very hard fall, excessive pressure, or some kind of physical injury.  When a bone in the spine collapses, it is called a “vertebral compression fracture”, which is different from a Burst Fracture or Chance Fracture.

These fractures happen most commonly in the thoracic spine (the middle portion of the spine), particularly in the lower vertebrae of the thoracic spine.  A drop in estrogen in women at the time of menopause and a drop in testosterone in men is a leading cause of bone loss. Other causes of bone loss include: Being confined to a bed, Certain medical conditions, taking certain medicines, other risk factors include: Absence of menstrual periods (amenorrhea) for long periods of time, A family history of osteoporosis Drinking a large amount of alcohol, Low body weight and  Smoking