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Monthly Archives: December 2017

Ryan Shazier Injury

Spinal Injuries in Football

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A Closer Look at Ryan Shazier’s Injury

By: Dr. Michael Rimlawi, Board-Certified, Fellowship-Trained spine surgeon and founder of Minimally Invasive Spine Institute in Dallas

Concussions and football are (and will continue to be) hot topics – especially in youth football. However, it’s important to note the other risks associated with the sport. Take for example the Pittsburgh’s linebacker Ryan Shazier who made a head-first tackle in Monday’s game against Cincinnati. Shazier was taken off the field, seemingly unable to move his legs at the time.

On Dec. 7, a press announcement was issued, “Last night, UPMC neurosurgeons and Pittsburgh Steelers team physicians Drs. David Okonkwo and Joseph Maroon performed spinal stabilization surgery on Ryan Shazier to address his spinal injury.”

While the exact type and extent of the injury and subsequent procedure has not been made public, from the video it appears as if Shazier hyper-extended his back. As noted by the grabbing motion to his back immediately after the hit, he may have also fractured, broken or possibly dislocated one or more bones in his lumbar spine. The injury likely centered in his lumbar spine region because he was seen moving his upper extremities immediately after the injury. If the injury extended to his cervical (neck) region, he likely wouldn’t be able to move either his arms or his legs.

When this type of injury occurs, the key concern is the stabilization of the patient’s spine. In cases where the spine is broken and unstable, even the slightest movement can cause the spine to shift, putting pressure on the spinal cord. Pressure on the spinal cord increases the risk of permanent paralysis.

One way to stabilize a spinal break is to fuse the spine together using instrumentation (also known as spinal screws and titanium rods). In laymen’s terms, let’s assume L2 is the injured area, the surgeon will fuse L1 to L3 with screws and rods to hold it in place, creating spinal stabilization. Prior to the fusion, the surgeon will examine the spinal cord for loose bone fragments that could be pressing on spinal cord nerves and remove them. This procedure is called decompression.

Will Shazier recover fully? No one can know the answer right now. His recovery is dependent upon the size and severity of the bone or tissue damage that may have impacted his spinal cord.

It is important to note that not all spinal fractures require spinal stabilization surgery. Various non-surgical treatments are available, depending on the type of spinal fracture. For less serious spinal fractures, non-surgical treatments can include bracing, pain management, physical therapy, medication therapy, activity modification and rest.

If you would like to learn more about minimally invasive spinal procedures to treat spinal fractures, contact us today.


Michael Rimlawi

Minimally Invasive Spine Surgeon, Board Certified, Fellowship-Trained

Spine Surgeon Dr. Michael Rimlawi is director and founder of the Minimally Invasive Spine Institute’s team. Dr. Rimlawi is a board-certified, fellowship-trained spine surgeon who completed unique training in both orthopedic-spine and neurosurgery-spine at the renowned University of California San Diego. Dr. Michael Rimlawi treats all aspects of spinal disease including degenerative and traumatic conditions of the cervical, thoracic and lumbar spine. More than just a back doctor, he is a leader in the field of minimally invasive spine surgery and a pioneer in endoscopic laser spine surgery.

Pain medication dependence avoidance

Tips for Avoiding Pain Medication Dependence

By | Pain Relief | No Comments

By: Dr. Mike Shah, Interventional Pain Specialist & Pain Management Board Certified Physical Medicine & Rehabilitation, Minimally Invasive Spine Institute in Dallas

At the Minimally Invasive Spine Institute, the majority of our patients come to us because they are in pain. And contrary to popular belief, many of those patients don’t need surgery to relieve their pain. Through innovative interventional pain management procedures, nonsurgical therapy and rehabilitation, pain relief is possible with no incisions at all. However, sometimes medication is also needed.

Addiction and substance abuse in America have increased significantly and pain medication misuse has become a dangerous problem. It is safe to say the United States is in the midst of an opioid addiction epidemic. Often times medicine that is intended to help becomes a source of pain for many because of its misuse.

How can patients take steps to heal without the fear of misuse? We have developed four tips to help ease the fear of misuse when a pain medication is prescribed for proper pain management.

1. Follow doctor’s orders

Pain Medication Dependence DoctorsClosely following dosage and the doctor’s orders can help ensure patients are taking the proper amounts to aid with pain relief but not more than is prescribed. 

2. Know the signs of substance misuse

The National Institute on Drug Abuse describes a person who misuses drugs as someone who takes drugs at a higher dosage than prescribed, combines drugs with alcohol or other drugs, and someone who takes drugs through different forms of administration such as snorting pills. Being aware of these signs can be vital to understanding substance misuse. Noticing a personal change in the frequency or dosage of medication you’re taking can be a red flag.

3. Stay alert for early signs of trouble

If you notice you’re not taking the drug as prescribed, or if you begin missing school, work, etc., see your doctor immediately and inform him that you are concerned you may be developing a dependency on your pain medication. 

4. Upon doctor’s orders, stop taking pain medication once the pain has stopped

Stopping pain medicationOnce the injury has healed and the pain has subsided or decreased to a tolerable level, it is important not to lean on pain medication as a crutch. If you experience withdrawal symptoms after ending medication, seek medical attention immediately.  It is important not to leave pain medication unattended where it can be used by anyone else.  You can return unused medication to your pharmacy to keep your family members safe and avoid misuse.

Not everyone who misuses prescription medication becomes dependent. But any misuse must be addressed so it doesn’t develop further.

Substance misuse affects many people and families every single day. Knowing how and what to watch out for and how to handle any issues that may arise can make all the difference.


Dr. Mike ShahMike Shah

Interventional Pain Specialist & Pain Management Board Certified Physical Medicine & Rehabilitation, Minimally Invasive Spine Institute

Dr. Shah is a Harvard-trained physician in Physical Medicine and Rehabilitation who has been dedicated to the eradication of pain in the Dallas area since 2003. He received a Bachelor of Science in Biology from Duke University and his medical degree from Tulane University School of Medicine in New Orleans, Louisiana. Dr. Shah also received a master’s in Pharmacology from Tulane and a Master of Public Health from Tulane University School of Public Health. Following this, he completed his Physical Medicine and Rehabilitation residency at Harvard’s Spaulding Rehabilitation Hospital in Boston, Massachusetts, consistently recognized as one of the Top 5 Pain Management Hospitals in the country by U.S. News and World Report.

Back Pain Myth Busters

Back Pain Myths

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Common Myths About Back Pain

By: Dr. Michael Rimlawi, Board-Certified, Fellowship-Trained spine surgeon and founder of Minimally Invasive Spine Institute in Dallas

Back pain is bad enough, and myths about the issue can make it worse. Roughly 8 out of 10 people in America will experience back pain at some point in their life, and being able to separate fact from fiction can be important in dealing with it and knowing when to take it easy for a while or when to get help from a spine specialist.

Back Pain MythsMyth 1 – Rest heals back pain

While rest is important and recommended for back pain, it is not always the key to a healthy recovery. Some instances require more extensive recovery methods, and rest can actually be harmful to recovery. When experiencing severe or prolonged back pain, you should always consult a doctor.

Myth 2 – Sitting up straight can prevent back pain

Back Pain and PostureWhile slouching is bad for the back, sitting up straight for too long can strain the back. Lean back in your chair occasionally to create a curve in your back, and walk around during the day as much as possible. If you sit at a desk for long periods of time, chairs that allow you to place your weight on you legs and knees can help remove pressure from your spine. Below is a video of a few key preventative stretches from the Minimally Invasive Spine Institute that you can easily do at the office to help avoid back or neck strain.

Back StretchesMyth 3 – I’m active, so I won’t have back pain when I’m older

Active Back PainAnyone can experience back pain, regardless of their lifestyle. Being active can decrease the likelihood of back pain, but no one is immune from pain regardless of their lifestyle. Excessive weight gain can increase or lead to back pain so maintaining a healthy weight through regular exercise will help ensure a healthier spine.  However, excessive or improper exercise can put extra stress on our spine.  Using proper form and techniques when exercising can help protect you from injury.

Myth 4 – My spine is fragile, so I need to take it easy to avoid hurting my back

The spine is surrounded by muscles and tendons, which give it strength and flexibility. A spine without fractures is strong, and activities like walking or aerobics can strengthen it even more.  If your doctors instructs you to avoid specific activities, it is important to follow his or her instructions.

Myth 5 – Since I have back pain, I must have torn something

Back Pain from TearPain does not always equate to damage. Sensitivity from overuse can often cause pain in the back area. However, if you are experiencing intense or chronic pain, contact a spine specialist immediately.

Myth 6 – The only way I can fix my back pain is with surgery

Many of our patients at The Minimally Invasive Spine Institute don’t need surgery to relieve their pain. Through innovative pain procedures, non-surgical therapy, and rehabilitation — pain relief is possible with no incision at all.

At the Minimally Invasive Spine Institute our goal is helping patients find relief. In many cases, that means assisting them in determining the exact cause of their pain through testing and diagnostic imaging so we can accurately treat the source of their pain.  Pinpointing the cause of their pain can often allow us to avoid unnecessary procedures or large surgeries.

When I opened the Minimally Invasive Spine Institute, my goal was to build a patient centric center that incorporates a team of patient care advocates, therapists, chiropractors, pain management specialists, radiologists and fellowship-trained spine specialists to work as a team to help care for our patients. No patient is ever treated the same because each patient has their own specific conditions and symptoms. Each patient’s pain is unique to them. Each one of our patients has had a customized treatment plan specific to their condition, symptoms and needs.

If you are suffering through pain and chronic symptoms contact us today to speak with one of our compassionate patient care coordinators and learn more about our effective treatment process.


Dr. Michael RimlawiMichael Rimlawi

Minimally Invasive Spine Surgeon, Board Certified, Fellowship-Trained

Spine Surgeon Dr. Michael Rimlawi is director and founder of the Minimally Invasive Spine Institute’s team. Dr. Rimlawi is a board-certified, fellowship-trained spine surgeon who completed unique training in both orthopedic-spine and neurosurgery-spine at the renowned University of California San Diego. Dr. Michael Rimlawi treats all aspects of spinal disease including degenerative and traumatic conditions of the cervical, thoracic and lumbar spine. More than just a back doctor, he is a leader in the field of minimally invasive spine surgery and a pioneer in endoscopic laser spine surgery.