Thoracic Disc Herniation

Thoracic Disc Herniation


Physical Therapy for the Mid Back

Why am I having this problem? The majority of thoracic disc herniations occur due to wear and tear. This is called degeneration. As a disc’s nucleus ages, it begins to crack and tear. These injuries can be repaired using scar tissue. As the annulus weakens over time, the nucleus may herniate through the damaged annulus. T11 and T12 are common areas for spinal degeneration. T12 is the place where the lumbar and thoracic spines meet. This link is susceptible to the forces of daily activity such as twisting and bending. It is here that most thoracic disc herniations occur.

Sometimes, however, a thoracic Disc may herniate abruptly (an acute injury). A car accident or fall can cause a thoracic disc to herniate. A sudden and powerful twist of the middle-back may cause a herniated thoracic disc.

Thoracic disc herniation can be caused by diseases of thoracic spinal nerves. Thoracic disc herniations in Scheuermann’s patients are, for example. Although evidence isn’t conclusive, it seems that patients with Scheuermann’s disease may have multiple herniated discs.

When a thoracic disc herniates, the spinal cord can be damaged. The spinal canal in the thoracic spine’s narrowest part is very dangerous. Anything that takes up space within the canal can cause injury to the spinal cord. Most disc herniations of the thoracic spinal canal push back rather than deflecting towards either side. This causes the disc material to push straight toward the spinal cord. A herniated disc could cut off the spinal cord’s blood supply. Discs that protrude into the critical zone (T4-9 of the thoracic spine) can cut off blood supply to this area of the spine. This can lead to severe paralysis and weakness in the legs.

SYMPTOMS

What does this condition feel like? Thoracic disc herniation symptoms vary. The location, size, pressing and damage to the spinal cord will all affect the symptoms.

Pain is the most common symptom. Although the pain is usually located around the injured disc, it can spread to one side or both of the mid-back. A common sensation is a band of pain around the chest. Patients might experience pins, pins, or numbness. Others report feeling weak in their arms or legs. A disc material that presses against the spine cord can also cause dysfunction in the bowel or bladder.

Disc herniations could also affect areas that are not connected to the spine. The pain from herniations of the upper thoracic spinal spine can radiate to one or both of the arms. A herniation that occurs in the middle part of the thoracic spinal spine can cause pain to radiate to the abdomen or chest, mimicking problems with the heart. A lower thoracic disc herniation may cause pain in your groin, lower limbs, and mimic kidney pain.

DIAGNOSIS

How do doctors diagnose the problem? A complete history and physical examination are necessary to diagnose the problem. Your doctor will ask about your symptoms and how it affects your daily activities. You will be asked questions such as where you feel pain and whether you feel numbness in your legs or arms. Your doctor will also ask you what activities or positions are making your symptoms worse. Next, the doctor examines your back to find out if you have any symptoms or back movements that cause pain. You are also assessed for your skin sensation, muscle strength and reflexes.

X-rays reveal the bones. Unless one or several of the discs has calcified, X-rays don’t normally show the discs. This is crucial in diagnosing thoracic disc herniation. It is quite reliable to identify disc herniation if a calcified disc appears to poke into your spinal canal on an X-ray. While it’s not known why a problem thoracic disc sometimes hardens due to calcification, past injury is one possibility.

Magnetic resonance imaging (MRI), is the best way to diagnose a herniated thoracic spine. Magnetic resonance imaging (MRI) uses magnetic waves to visualize the soft tissues. It provides a clear view of the discs, and whether any have herniated. This machine takes pictures that look like slices of an area where your doctor is interested. The test doesn’t need dye or a needle. The test revealed that many people have thoracic spine herniations, even if they don’t experience any symptoms. Doctors have suggested that thoracic spine herniations, which are not associated with symptoms, may be normal.

Doctors used myelography to diagnose thoracic Disc Herniations prior to MRI. Myelography is only half of the way to diagnose this condition. Myelography is an X Ray test. A special dye is injected in the area around the spinal canal. An X-ray will show the dye. This dye helps a doctor determine if the disc is pushing into a spinal canal.

You may order computed tomography (CT scanning). This is a detailed X Ray that allows doctors to view the body’s tissues in images that also look like slices. Images provide additional information about calcified discs. The CT scan may be combined with myelography by doctors. Myelography dye is used to highlight the spine and nerves during a CT scan. The myelography dye can be used to improve the accuracy and diagnostics of a CT scan that is used for diagnosing a herniated or bulging thoracic disc.

Thoracic disc herniations are diagnosed by doctors using MRI. When preparing for surgery to repair a herniated cervical disc, doctors may also use CT scans or myelography.

TREATMENT

What treatment options do you have?

Nonsurgical Treatment

Patients with symptoms due to a herniated thoracic disc are closely monitored by doctors, even if the herniation’s size is small. Severe neurological symptoms may develop quickly if the disc is putting pressure on the spinal chord or the blood vessels leading to the spine. Surgery is required immediately in these situations. Nonsurgical treatment is recommended unless your condition is serious or rapidly getting worse.

Your doctor may recommend immobilizing the back initially. The best way to calm inflammation and reduce pain is to keep the back still for a brief time. It might be necessary to stay in bed for a few days. This is because lying down on your back can cause pressure to nerves and discs. Doctors recommend against bed rest. They prefer that patients engage in normal activities. Patients can use pain to assess how much is too much. You can also immobilize your back with a brace for as long as one week.

Patients with thoracic disc herniation may be prescribed certain medications by their doctors. Aspirin and ibuprofen may be prescribed for patients with thoracic disc herniation. For back spasms, muscle relaxants might be prescribed. Sometimes, oral steroids are used in tapering doses to treat pain that spreads to the arms or legs.

Most likely, your doctor will have a Physical Therapist oversee your rehabilitation program. Physical Therapy focuses on pain relief, improving back movement and encouraging healthy posture. A Physical Therapist can help you develop a rehabilitation plan that will address your current condition and help prevent future problems.

Most people suffering from a herniated cervical disc can heal themselves without having to undergo surgery. Patients are usually advised to try nonoperative treatment for at least six weeks before they consider surgery.

SURGERY

Surgery may be recommended by a surgeon if patients are not improving with nonsurgical treatments or if their condition is getting worse. If the herniated disc is affecting your spinal cord, it may be necessary to have surgery. Surgeons will look for signs such as weakness in the arm or leg muscles, pain which doesn’t go away, and problems with your bladder or bowel.

This condition requires surgical treatment

  • costotransversectomy or discectomy
  • transthoracic decompression
  • Video-assisted thoracoscopy Surgery (VATS).
  • Fusion

Costotransversectomy

To open the space between the bones and the disc, surgeons use costotransversectomy. The surgeon works from the back of a spine by removing a small section of two or three ribs connecting to the spine. (Costo means rib.) The transverse process (the bony knob) on the side is then removed. Ectomy simply means to remove. This creates space for the surgeon. Small instruments are used to remove the damaged disc. Surgeons take great care to not injure the spinal cord.

Transthoracic Decompression

Transthoracic refers to the surgical approach. Trans is transliterated to mean across or through. The chest is known as the thoracic region. In transthoracic surgery, the surgeon works through the chest cavity to reach the injured disc. This gives the surgeon a clear view into the disc.

The surgeon places the patient on one side and cuts a small hole through the ribs of the thorax (the chest) on the other. The opening is then opened and instruments are placed through it. This releases pressure from the spinal cord (decompression).

Video-Assisted Thoracoscopy Surgery

VATS (video assisted thoracoscopy) is one of the latest developments in thoracic surgical. The procedure uses a thoracoscope (a tiny television camera) that is inserted into the side-of-the-thorax via a small incision. The surgeon can view the area in which he or she is working with the camera. Other instruments can be used during the procedure by making small incisions. While repairing and cutting damaged disc portions, the surgeon can see the TV screen.

Cutting and removing damaged parts

As minimally invasive surgery (VATS), it is less taxing on patients. Advocates claim that this type is less invasive, reduces scarring around nerves and joints, and speeds up recovery.

Fusion

The disc may be removed in part or whole. This can cause the spine to become loose and unstable. Following surgery, fusion may be required. Arthrodesis, which is the medical name for fusion, can be described as a procedure that involves locking the vertebrae in place. This procedure stops movement between the vertebrae and locks them in their place. This helps to stabilize the bones and relieves pain. Fusion surgery is rarely necessary if there was only a small amount removed from the bone and disc material during surgery to fix a herniated or bulging thoracic disc.

This procedure involves placing small grafts (or a combination of them) of bone over or under the loose spinal bones. The surgeon may use a combination cable, rods, and screws to stop the vertebrae from moving while allowing the graft to heal.

REHABILITATION

What should I expect during my recovery?

Non-surgical Rehabilitation

Even if you do not need surgery, your doctor may recommend you consult a physical therapist. Patients usually see their Physical Therapist once a week for between four and six weeks. The goals of treatment include controlling symptoms, finding positions that relieve pain, and teaching you how to keep your spine healthy during everyday activities. Patients can progress to a series of strengthening exercises as their bodies heal. Aerobic exercises such as swimming or walking can help ease pain and improve endurance.

After Surgery

Recovery after surgery can be complicated. Some patients have to leave the hospital soon after their surgery. Some surgeries require that patients remain in the hospital for a minimum of a few days. Patients who have to stay in hospital for a while may be seen by a Physical Therapist shortly after their surgery. The sessions are designed to help patients move more easily and avoid putting additional strain on their backs.

Patients are advised to follow the surgeon’s advice regarding wearing a brace or support belt during recovery. In the first few weeks following surgery, patients should be careful not to overdo activities.

Many patients who have had surgery need Physical Therapy outside of the hospital. The type of surgery may require them to see a Physical Therapist for a period of one to three years. Physical Therapists can use heat, ice or electrical stimulation to treat pain and muscle spasm. The Physical Therapists then show patients how to move safely and with the least strain for the healing process.

As patients heal, they can gradually take up flexibility exercises for the shoulders and hips, as well as mobility and strengthening exercises for the back muscles. Patients can also meet with the Physical Therapist at a swimming pool. Patients will be able to perform exercises that increase endurance, muscle strength, or alignment of the body. As rehabilitation programs evolve, patients are required to perform more challenging exercises. Safely increasing strength and functionality is the goal. In the ideal scenario, patients can return to their old activities. To avoid future problems, patients might have to alter their activities.

Once treatment is complete, regular visits to a Physical Therapist’s office will be discontinued. Although the Physical Therapist will remain available to help, patients will take responsibility for their exercise routines as part of their ongoing home program.

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Kevin Pauza, M.D.

SPECIALTY

  • Disc Biologics
  • Interventional Spine

EDUCATION & DEGREES

  • Fellowship: Interventional Spine, University of Pennsylvania
  • Residency: PM&R, University of Pennsylvania
  • Internship: Surgery & Medicine, Columbia University College of Physicians and Surgeons
  • Medical Doctorate: Pennsylvania State University College of Medicine
  • Bachelor of Arts: Biology, Lehigh University
  • Bachelor of Arts: Psychology, Lehigh University

CERTIFICATIONS & LICENSES

  • Texas State Medical and Surgical License
  • New York State Medical and Surgical License
  • Florida State Medical and Surgical License

HONORS

  • Lehigh University Four-year Academic Scholarship
  • Magna Cum Laude, Lehigh University
  • Lehigh University President’s Award
  • Lehigh University Tower Society
  • Distinguished Alumnus, Penn State University (selected from 500,000 Penn State alumni)
  • North American Spine Society, Outstanding Paper of the Year, 2003
  • President-Elect, International Spine Intervention Society
  • Founding Partner, Texas Spine and Joint Hospital
  • Commencement Speaker: Penn State University College of Medicine
  • Advisory Board, AMA
    Keynote Speaker, Harvard Pain Center Commencement
  • Founding Chairman, Standards Committee, International Spine Intervention Society
  • Chairman, Spine Committee, Amercian Academy of Physical Medicine & Rehabilitation
  • Appointed Spine Advisor, Japanese Prime Minister
  • Appointed Spine Advisor, Allied Royal Families

EXPERIENCE

  • Founding Partner & Principal, Texas Spine & Joint Hospital

Travis Foxx, M.D. - Premier Anesthesiology & Pain

Kevin Pauza, M.D. - Turtle Creek Surgery Center

Prior to attending Penn State University, Dr. Pauza earned his undergraduate degree from Lehigh University, and furthered his training with a Surgical and Medical Internship at Columbia University College of Physicians and Surgeons. He continued his specialty training at the University of Pennsylvania, followed by an Interventional Spine Fellowship. In addition to his research, philanthropic, and clinical endeavors, Dr. Pauza remains a motivated educator. He established a Spine Fellowship program and continues training physicians from around the world. He heads international committees responsible for establishing standards and educating surgical and non-surgical physicians.

After helping hundreds of patients who failed to experience relief after spine surgery, it became evident to Dr. Pauza that current methods needed to change. This motivated him to seek better ways to help patients, by thinking outside the box.

Dr. Pauza is the first physician in history to pursue FDA approval for using biologics to treat the spine. Millions of patients will benefit from his development of minimally invasive treatments for degenerative disc disease and other more common and serious disorders of the spine.

SPECIALTY

  • Disc Biologics
  • Interventional Spine

EDUCATION & DEGREES

  • Fellowship: Interventional Spine, University of Pennsylvania
  • Residency: PM&R, University of Pennsylvania
  • Internship: Surgery & Medicine, Columbia University College of Physicians and Surgeons
  • Medical Doctorate: Pennsylvania State University College of Medicine
  • Bachelor of Arts: Biology, Lehigh University
  • Bachelor of Arts: Psychology, Lehigh University

CERTIFICATIONS & LICENSES

  • Texas State Medical and Surgical License
  • New York State Medical and Surgical License
  • Florida State Medical and Surgical License

HONORS

  • Lehigh University Four-year Academic Scholarship
  • Magna Cum Laude, Lehigh University
  • Lehigh University President’s Award
  • Lehigh University Tower Society
  • Distinguished Alumnus, Penn State University (selected from 500,000 Penn State alumni)
  • North American Spine Society, Outstanding Paper of the Year, 2003
  • President-Elect, International Spine Intervention Society
  • Founding Partner, Texas Spine and Joint Hospital
  • Commencement Speaker: Penn State University College of Medicine
  • Advisory Board, AMA
    Keynote Speaker, Harvard Pain Center Commencement
  • Founding Chairman, Standards Committee, International Spine Intervention Society
  • Chairman, Spine Committee, Amercian Academy of Physical Medicine & Rehabilitation
  • Appointed Spine Advisor, Japanese Prime Minister
  • Appointed Spine Advisor, Allied Royal Families

EXPERIENCE

  • Founding Partner & Principal, Texas Spine & Joint Hospital

Brandon Tolman, D.O. - Nashville Spine Institute

Boris Terebuh, M.D. - Regenerative Spine & Joint Center

Boris Terebuh, MD specializes in providing personalized nonsurgical solutions for spine problems that interfere with the function patients desire and the independence they deserve. Dr. Terebuh completed his Physical Medicine & Rehabilitation residency training at The Ohio State University in 1997 and has been in solo practice in Ohio since 2001 because he is committed to providing accessible, individualized and attentive care to his patients. His regenerative approach to solving spine problems enhances the body’s natural ability to heal itself. His guiding principle is integrity – doing what is right for patients in a conscientious manner with the motivation of helping them become fully functional, independent and satisfied. Dr. Terebuh is a very unique Medical Doctor because he has earned seven Board Certifications in the field of musculoskeletal medicine and nonsurgical spine care. Boris Terebuh, MD is delighted to be a Discseel® provider because this revolutionary new technology aligns perfectly with his preferred regenerative treatment approach and patient care philosophy. Dr. Terebuh is also grateful to Discseel® developer, Kevin Pauza, MD, for all the years of diligent and meticulous research to create this innovative, paradigm-shifting intervention, which will certainly spare countless individuals the prospect of avoidable spine surgical procedures.

Thierry Bonnabesse, M.D. - Champlain Spine and Pain Management

Gregory Lutz, M.D. - Regenerative Sportscare Institute

Dr. Gregory Lutz is the Founder and Medical Director of the Regenerative SportsCare Institute (RSI). In addition, he currently serves as Physiatrist-In-Chief Emeritus at Hospital for Special Surgery (HSS) and a Professor of Clinical Rehabilitation Medicine at Weill Medical College of Cornell University. Dr. Lutz is one of the world’s leading experts in the field of regenerative interventional orthopedic medicine, appearing annually on Castle Connolly’s and New York Magazine’s “Top Doctors” lists.

Janet Pearl, M.D. - The Boston Stem Cell Center

Dr. Janet Pearl has been in practice since 1999 and is the Medical Director of The Boston Stem Cell Center. She is also the Medical Director of  Complete Spine and Pain Care  an interventional integrated Pain Management practice, both located in Framingham, Massachusetts. Dr. Pearl is Triple Board Certified in Regenerative Medicine, Pain Medicine and Anesthesiology and has over 20 years experience in doing these procedures.

Previously, Dr. Pearl was the Co-Director of the Pain Management Center at St. Elizabeth’s Medical Center, where she was also the Director of the Pain Management Fellowship program.

After graduating from Harvard College with an A.B. in Applied Mathematics with Economics, Dr. Pearl received a M.Sc. in Health Planning and Financing at the London School of Hygiene and Tropical Medicine. She then received her M.D. from the Columbia College of Physicians and Surgeons, where she represented the Medical School as a senator in the Columbia University Senate.

Watch Dr Pearl give an introduction to The Boston Stem Cell Center

Dr. Pearl completed her internship in Internal Medicine at New England Deaconess Hospital, her residency in Anesthesiology at the Massachusetts General Hospital, and her fellowship in Pain Management at the Brigham and Women’s Hospital. Dr. Pearl was the first resident ever to serve on the Accreditation Council for Graduate Medical Education (ACGME)’s Residency Review Committee for Anesthesiology. She is a Joseph Collins Scholar and a Rotary Scholar and was awarded the AMA/Glaxo Welcome and AMA/Burroughs Welcome Resident Leadership Awards.

From 2004 to 2010, Dr. Pearl served on the University of Massachusetts Board of Trustees. While there she chaired the Committee on Science, Technology and Research, was a member of the Committee on Academic and Student Affairs and the Governance Committee and also served as Vice Chair of the Advancement Committee, and as a member of the Committee on Athletics.

Dr. Pearl is Board Certified in Regenerative Medicine, Pain Medicine and Anesthesiology with the American Board of Regenerative Medicine and the American Board of Anesthesiologists.

Memberships:

  • The American Pain Society;
  • The Massachusetts Medical Society;
  • The Massachusetts Society of Anesthesiologists;
  • The Massachusetts Society of Interventional Pain Physicians;
  • The American Society of Anesthesiologists;
  • The American Society of International Pain Physicians;
  • The American Institute of Ultrasound in Medicine; and,
  • The American Board of Regenerative Medicine.

PUBLIC SERVICE:

  • Member, Massachusetts Department of Industrial Accidents, Health Care Services Board 
  • Member of the Association of Harvard College Class Secretaries and Treasurers
  • Past Member of the Board of Directors of the Harvard Alumni Association
  • Former Member of the Board of Trustees University of Massachusetts. (10/2010 – 10/2014) 

Mark Reecer, M.D. - Fort Wayne Physical Medicine

Dr. Mark Reecer is board certified in Physical Medicine & Rehabilitation and Pain Management. He has over 20 years of work comp experience, and he routinely provides Independent Medical Examinations (IMEs) for the Indiana Workers’ Compensation Board. Dr. Reecer has lectured extensively and has authored multiple publications that promote his specialty and the use of treatment modalities to eliminate pain, improve function and avoid surgery.

Dmitry Buyanov, M.D. - IV Infusion Treatment Center

Dr. Buyanov is originally from Kiev, Ukraine. He received his training in Anesthesiology and his Interventional Pain Management Post-Doctoral at Penn State Medical Center, PA. Dr. Buyanov moved to San Antonio in 2003 at which time he was part of a multi-specialty group before he founded Premier Pain Consultants in 2004. His practice has over 5000 active patients in his practice. Dr. Buyanov treats his patients in a cost-effective manner although giving them the best care with interventional pain treatments/procedure to help each patient improve their quality of life. Dr. Buyanov strongly believes in an individualized and multidisciplinary approach to pain management, he believes in the Buddhist saying: “pain is inevitable but suffering is optional”. He works closely with the area internists, physical therapists, chiropractors, psychiatrists, neurologists, and spine surgeons to insure that each patient has the most optimal individualized treatment plan. Dr. Buyanov enjoys spending his spare time with his children.

Desmond Hussey, M.D. - NASA Neuroscience and Spine Associates. P.L

Dr. Hussey earned his undergraduate degree from Dartmouth College, and proceeded to earn his Medical Degree from The University of Miami School of Medicine. He then attended Northwestern University Internal Medicine Program, followed by a Neurology Residency Program at Emory University. Dr. Hussey continued his specialty training at John Hopkins University pain clinic. A member of The Spinal Injection Society and The American Academy of Neurology and Psychiatry.

Haley Burke, M.D. - Colorado Rehabilitation and Occupational Medicine

Dr. Burke is board-certified in both Interventional Pain Management and Neurology and has completed an accredited Pain Fellowship with the Department of Anesthesiology at MD Anderson Cancer Center, one of the nation’s most prestigious hospitals. Dr. Burke completed her residency in Neurology at the University of Colorado, where she received the department’s ‘Excellence in Teaching’ award during her year as Chief Resident. Her Doctor of Medicine degree was completed at the University of Texas Health Science Center, where she was elected to the ‘Gold Humanism Honor Society.’

Maxim Moradian, M.D. - Interventional Spine Care & Orthopedic Regenerative Experts

Dr. Moradian is triple-board certified in Physical Medicine and Rehabilitation (PM&R), Sports Medicine and Pain Management. Dr. Moradian’s clinical practice is devoted to the comprehensive care of spine, joint, muscle, tendon, ligament, and peripheral nerve disorders. He is proficient in performing advanced, minimally-invasive procedures under fluoroscopic and/or ultrasound guidance in the entire spine. Dr. Moradian performs electrodiagnostic testing (EMG/NCS) for the accurate diagnosis of muscle and/or nerve disorders. He has a special interest in regenerative medicine, sports concussions, neuromuscular ultrasound, medical education, and clinical research. His true passion is to treat his patients like his family and friends.

Wendi Lundquist, D.O. - Active Life Physical Medicine & Pain Center

Dr. Lundquist is the Medical Director and founder of Active Life Physical Medicine & Pain Center, Innovative Surgery Center, and Regena Spa. She is dual board certified in Physical Medicine and Rehabilitation along with Pain Management and a diplomat with the American Board of Pain Medicine. She completed her training at Loyola University in Chicago, Illinois in July of 2005. During her time there, she served as Chief Resident and was involved in several research projects. Prior to, she completed medical school at Midwestern University at the Arizona College of Osteopathic Medicine campus in Glendale, Arizona and internship at Doctors Hospital in Massillon, Ohio. She also has a Bachelor of Science in Biology and minor in Chemistry from the University of New Mexico in Albuquerque. She has a special interest in sports medicine, pain and spine. With 17 years experience, she has great enthusiasm towards regenerative medicine.

Yasuyuki Nonaka, M.D. - Nonaka Lumbago Clinic

Haley Burke, M.D. - Colorado Rehabilitation & Occupational Medicine

Dr. Burke is board-certified in both Interventional Pain Management and Neurology and has completed an accredited Pain Fellowship with the Department of Anesthesiology at MD Anderson Cancer Center, one of the nation’s most prestigious hospitals. Dr. Burke completed her residency in Neurology at the University of Colorado, where she received the department’s ‘Excellence in Teaching’ award during her year as Chief Resident. Her Doctor of Medicine degree was completed at the University of Texas Health Science Center, where she was elected to the ‘Gold Humanism Honor Society.’

Haley Burke, M.D. - Colorado Rehabilitation & Occupational Medicine

Dr. Burke is board-certified in both Interventional Pain Management and Neurology and has completed an accredited Pain Fellowship with the Department of Anesthesiology at MD Anderson Cancer Center, one of the nation’s most prestigious hospitals. Dr. Burke completed her residency in Neurology at the University of Colorado, where she received the department’s ‘Excellence in Teaching’ award during her year as Chief Resident. Her Doctor of Medicine degree was completed at the University of Texas Health Science Center, where she was elected to the ‘Gold Humanism Honor Society.’

Matthias H. Wiederholz, M.D. - Performance Pain and Sports Medicine

Founding Partner, Triple Board Certified – Physical Medicine & Rehabilitation; Sports Medicine; Anti-Aging, Regenerative & Functional Medicine

Dr. Matthias H. Wiederholz is cofounder of Performance Spine & Sports Medicine, LLC. He is a fellowship-trained interventional pain physician whose clinical interests include: Interventional Pain Management, Sports Medicine, Musculoskeletal Medicine, Minimally-Invasive Spine Surgery, Non-Surgical Orthopedics, and Anti-Aging / Functional Medicine.

He received his specialty training in Physical Medicine and Rehabilitation at Baylor College of Medicine in Houston, Texas where he served as chief resident. He completed fellowship training in Interventional Pain Management in Marietta, Georgia. He is board-certified in Physical Medicine & Rehabilitation and Sports Medicine. He also received advanced fellowship training through the American Academy of Anti-Aging Medicine and is board-certified in Anti-Aging, Regenerative & Functional Medicine.

Dr. Wiederholz performs a myriad of interventional pain procedures including, but not limited to the following: epidural steroid injections, facet joint injections, radiofrequency ablation, sacroiliac joint injections, discography, percutaneous disc decompression, epidural lysis of adhesions spinal cord stimulator implants, and minimally-invasive discectomies. Endoscopic spine surgery is a very unique and valuable tool in his armamentarium and makes Dr. Wiederholz one of the most specialized physicians in the field of Pain Medicine.

Dr. Wiederholz uses musculoskeletal ultrasound in the diagnosis of musculoskeletal injuries. He incorporates ultrasound for precise injection therapy including cortisone injections, prolotherapy, and PRP (platelet rich plasma). This technology is also utilized to perform the Tenex procedure, a percutaneous procedure for treating chronic tendon pain (tennis elbow, rotator cuff, plantar fasciitis, etc).

Dr. Wiederholz is the fellowship director for the sports and spine fellowship at Performance Spine & Sports Medicine. Dr. Wiederholz holds an affiliation with Capital Health System and JFK Johnson Rehabilitation Institute.

Being advanced fellowship trained in Anti-Aging, Regenerative & Functional Medicine means that Dr. Wiederholz has the most advanced training in Anti-Aging Medicine available. He is a leading expert in Bio-Identical Hormone Restoration and helps patients achieve wellness through nutrition, lifestyle, and hormone therapies.

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Michael Wolff, M.D. - Southwest Spine & Sports