Technological advances such as artificial discs and implantable devices which stimulate the spinal cord have fundamentally changed the treatment of chronic back pain. As a world leader in the research and treatment of the causes of back pain,Texas Back Institute has pioneered the use of both of these treatments.

Now, the surgeons and back specialists at Texas Back Institute are leading the way again in the treatment of chronic back pain. As is often the case, this new treatment and device came about as a result of the unintended consequences of a previous advancement.

Texas Back Institute is one of only a few organizations in the world to offer patients the first and only implantable neurostimulation system, indicated for the use in the treatment of chronic back and limb pain, which is designed for full-body Magnetic Resonance Imaging (MRI) safety. Before this device was available, patients who had this spine stimulation device implanted were unable to undergo an MRI. More on this later.

We asked Dr. Michael Hisey, an orthopedic surgeon at Texas Back Institute, what impact this MRI-friendly, implantable neurostimulation device will have on the treatment of chronic back pain. He said, “This newest generation of neurostimulators takes away the biggest limitation of having a stimulator implanted.  Now patients who have chronic issues requiring frequent MRI’s are a candidate for this pain relieving technology.”

Neurostimulation Implants

Over a short time, neurostimulation treatment has become a god-send to millions of people who have chronic back pain. This therapy uses a medical device placed under the patient’s skin to deliver mild electric impulses to the spinal cord. These impulses block pain signals from reaching the brain.

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The device used by Texas Back Institute surgeons – called RestoreSensor ™ – is manufactured by Medtronic (MDT – NYSE) and has proven to be an effective therapy in the treatment of chronic back pain. Other medical device companies also make implantable neurostimulation devices. However, until now, they have all faced a serious challenge. The patients who had them could not undergo an MRI exam.

Implants and MRI Exams

The MRI exam is a universally accepted standard of care in the diagnosis and treatment of major health conditions, including cancer, stroke and neurological problems. The challenge of using implantable neurostimulation devices to combat chronic pain was made more difficult by the fact that they were not compatible with the MRI. When exposed to the magnetic waves of the MRI, patients could be harmed, the device could be destroyed or both.

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Dr. Hisey notes, “MRI’s are commonly used to diagnose and monitor the progress of chronic conditions and to diagnose new problems.  With the previous generation of neurostimulators, patients were not allowed to have an MRI.  This significantly limited their doctors’ ability to diagnose the patient’s problems, often delaying treatment and limiting the doctors’ ability to make specific diagnoses.  In the case of acute conditions such as strokes, minutes of delay in diagnosis can make the difference between a warning stroke with no permanent damage and a significant stroke with permanent brain damage.  Giving the doctors back all of their diagnostic tools is critical.

Recently, a patient required an urgent MRI 7 days after having his stimulator implanted, and, because of the SureScan technology, he was able to have the scan and move on with treating his problem”

This Changes Everything

In the world of medical technology development, a challenge often leads to new and better technologies. Such is the case with the RestoreSensor implant.

Texas Back Institute is now one of a very few practice groups in the world to implant a patient with the new RestoreSensor SureScan™ with Vectris® SureScan® MRI percutaneous leads. This technology, recently approved by the U.S. Food and Drug Administration (FDA), changes everything.

Patients who have this spinal implant to control their chronic back pain and need the diagnostic tool of an MRI can now safely undergo this procedure. Dr. Hisey notes, “With this technology, patients who are receiving neurostimulation treatment via the SureScan implant to manage their chronic pain now have access to the full benefits of MRI scans without compromising their healthcare and their physicians have the best opportunity to identify potentially life-threatening medical conditions.”

Here’s how the RestoreSensor SureScan device works.

How Important is this New Advance?

MRI scans allow physicians to make a wide range of health diagnoses by viewing highly detailed images of internal organs, blood vessels, muscle, joints, tumor, areas of infection and others. An MRI scan uses magnetic field and radio frequency pulses to create images of structures inside the body. Where CT scans are used for imaging hard materials, such as bones, MRI scans are used to image soft tissues.

Because of its accuracy and relative ease of use, the MRI scan is a critical diagnostic tool and its use has dramatically increased. Several healthcare sources estimate that more than 60 million MRI procedures are performed worldwide each year. In the United States, the number of scans has almost doubled in the past decade, with 32 million scans – more than one MRI per second – performed in 2011.

The spine surgeons at Texas Back Institute have utilized the neurostimulation devices since they were approved by the FDA to help long-suffering patients with chronic back pain live with less pain. Now, this technology has gotten even better.

If you would like to learn more about the implantable neurostimulation system designed for full-body MRI safety, contact Jaclyn McDaniel at or 972-608-5006.


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Last year, Dr. Richard Guyer, an orthopedic spine surgeon at Texas Back Institute, logged more than 100,000 air miles. This means he knows a lot more than he wants to know about the misery and health risks of air travel.

With his specialized medical knowledge and his status as a (very) frequent flyer, Dr. Guyer’s thoughts on what the Wall Street Journal (WSJ) calls “The Incredible Shrinking Plane Seat” are experientially based. Recently, he offered several suggestions on how those of us who are planning that long trip to see relatives during the Thanksgiving and Christmas holidays can avoid some of the health problems associated with airline travel. If you haven’t traveled by plane in a while, commercial airlines have become what Dr. Guyer calls “sardine cans” and this situation may be getting worse.

Squeezing in One More Seat

In an effort to increase their highly profitable premium sections – first class and business class – the large air carriers have directed their manufacturers to make more room “up front.” In the process of expanding these premium sections, the economy class has “shrunk” because more seats have been added. Up until now, this reconfiguration has occurred only on planes that fly short trips. However, if recent reports from business publications and news networks are to be believed, this trend is likely to exacerbate.

International carriers such as American, United, Air France, Air Canada and Emirates Airlines have all been adding more seats in economy section and, rather than violating the laws of physics, they’re doing this by making the seats smaller. The October 23, 2013, edition of the WSJ noted, “Now the big carriers are cutting shoulder space by wedging an extra seat into each coach row. That shift is bringing the short-haul standard to long-haul flying.”

The standard size seat for long trips in the 1970s and 1980s was 18 inches. These were found on 747 jumbo and Airbus jets. The seats were widened on the 777, made by Boeing, in the 1990s and early 2000s. Now, in an effort to have more inventory to sell, seats which are only 17 inches wide are coming for these long-haul planes.

While it doesn’t seem this reduced seat size would make much difference, this change has had a domino effect.  It has resulted in more seats, smaller arm rests, more narrow aisles, more bumped elbows, less leg room and more grief for anyone traveling in the economy section. It might also lead to health problems, some of which are life-threatening. This brings us back to the road warrior of Texas Back Institute, Dr. Richard Guyer.

How Dangerous are Crowded Planes?

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Most everyone agrees that air travel can be challenging, but can it also be dangerous to one’s health? In the opinion of Dr. Guyer: yes. He notes, “If a passenger is unable to move flying for several hours is a terrible experience. This crowded situation makes it almost impossible to rest, forget about sleeping!”

He added, “Plus, if the passenger has any physical ailment such as muscle strains, back problems, knee or hip problem, these will likely become intolerable after a long flight. The most dangerous condition that occurs when legs are immovable over a long flight is the potential for a blood clot to form in the leg and travel to the lung, causing a life-threatening situation.”

Is there anything that can be done to counteract this situation? Dr. Guyer recommends some exercise. “When I’m on a cramped plane, I pump my feet up and down while I’m seated. This gets circulation moving in the lower leg. I also make it a point to walk to the back of the plane every hour and then do toe-rises and other leg flexing exercises.”

He also suggests taking a “baby” aspirin before the flight. “The passenger should check with his/her doctor before taking this aspirin, but part of the problem of flying involves the extended sedentary position. These mild aspirins thin the blood just a little.”

What about back pain which can occur when a person is forced to stay in a cramped position for several hours? Dr. Guyer said, “If the passenger doesn’t move over change positions over the course of the flight, severe back spasms can occur and the best way to avoid this is to employ one of those airline blankets. Simply fold it several times and place it in your seat just above the hips. After 15 or 20 minutes, remove the blanket and repeat this process over the course of the flight. Changing the support on the back will nourish the muscles and keep blood flowing to the area. This will keep the back from stiffening up.”

What if there are no blankets left? “In a pinch, I have used my suit coat or overcoat rolled up and placed against the seat. The objective is to get a little different support on the lower back for a brief period.”

There Ought to be a Law

Even before the tragedies of 911, the airline industry had been highly regulated. Now, there are even more regulations – from onerous and some say invasive passenger pre-screenings to on-board meal utensils. Is it time for some type of airline regulation related to the size and comfort of the plane’s seats?

Dr. Guyer did not hesitate, “Absolutely. There is copious research supporting the positive effects of adding just 1 inch to the width of the seats. The airlines are transporting human beings, not just cargo and the health of these passengers is in jeopardy. If it takes an FAA regulation to make this happen, I’m in favor of it. It’s time the airlines start to use some common sense and common courtesy.”