Dr. Steven Shoshany, Manhattan's spinal decompression specialist contact www.drshoshany.com
W. Robert Hudgins, MD Neurosurgeon Neurological Surgeons of Dallas Dallas, TX
In this interview, W. Robert Hudgins, MD, explains what motivated him to choose the DRX9000 for his practice, his experience using the equipment, as well as patient outcomes.
Dr. Hudgins, why did you opt to try the DRX9000 in your practice? I’d have to say, it had a lot to do with the failure of general traction, and sometimes physical therapy, in the treatment of back pain. General traction has been used for many years as a conservative back pain therapy. The drawback to general traction is it cannot exert adequate pull on the lumbar spine to really do much good. When the DRX9000 was introduced to me, I was intrigued by the science and technical aspects of its controlled spinal decompression therapy.
Unlike conventional traction, the DRX9000 exerts adequate forces to distract vertebrae to create negative pressure within disc spaces to decompress the spine. It simply makes sense and the DRX9000 was the equipment I found to have worked out a complete system out to accomplish spinal decompression.
Why do you say ‘sometimes physical therapy’ fails? I’m not discrediting physical therapy by any means, but some back pain patients are not compliant with the demands of a PT program. Unfortunately, for some, physical therapy is not successful. There are many reasons besides issues related to pain that prevent patients from doing well in PT. Some back pain patients need rest to help alleviate symptoms, which the DRX9000 provides. The DRX9000 does not replace physical therapy, but is an adjunctive treatment. Patients learn how to exercise to build strength and flexibility, as well as biomechanics for injury prevention.
What is involved in DRX9000 treatment? In treating a low back problem, such as a bulging disc, the patient is positioned on the table, secured into place by means of a vest with under arm support to prevent the body from sliding downward. A belt is affixed about the waist. The treatment duration, amount of pull (in pounds), and decompression angle are entered into the computer. The computer uses the data to calculate a slow progression to maximum pull while alternating pulling and relaxing. A typical treatment lasts 20- to 30-minutes. Varying the angle of decompression (pull) adjusts the force through the target disc level. Angle variation cannot be effectively accomplished by means of conventional traction.
The amount of pull, or pounds; how is that calculated? It depends on the patient’s condition. Generally, I start with one-half of the patient’s weight minus 20-pounds. For example, a 200-pound patient would start therapy at a maximum of 80-pounds of pull. As treatment is tolerated, the amount of pull may be gradually increased to half the body weight plus 10-pounds. As a rule, I start with the lower amount of pull and gradually increase. Do patient’s experience immediate or gradual pain relief? It is variable. A few patients have reported after 3 or 4 treatments they already feel much better. However, for the treatment to be most effective, a full 3 to 4 weeks is recommended.
Are other treatments combined with DRX9000 therapy? Yes. Patients receive electrical stimulation and mechanical massage after each treatment to prevent or reduce stiffness and muscle spasm. Depending on the patient’s spinal disorder, they are instructed to wear a brace, which is discontinued after the program.
What spinal disorders do you treat using the DRX9000? It is interesting and perhaps self-defeating that many of the patients referred to me for spine surgery, are successfully treated with spinal decompression. These patients include those with bulging and herniated discs and degenerated discs. Certain spinal problems such as spondylolisthesis, stenosis, and arthritis are not appropriate for decompression. The key is careful patient evaluation and selection.
I’m a strong believer in nonsurgical therapy before approaching surgery. Of course, some patients, such as someone with drop foot, may require immediate surgery.
Is the patient’s age a factor? Generally, no. Two cases come to mind. The first is an active male in his early 30s who enjoys golf and tennis. He presented as a surgical referral with a herniated disc. However, he didn’t want surgery. The second case is an older female, a hospital tech who suffered back pain for 3 years. Both patients wanted to try the DRX9000 instead of surgery. Both continue to do well years after decompression treatment and without surgery.
Does this mean results are permanent? I’ve used the DRX9000 since 2000 and have followed my patients. In general, 2 out of 3 low back pain and 3 out of 4 neck pain patients obtain excellent relief. About 75-80% of my patients continue to do well. I estimate 20-25% return with pain and ask to be treated again; a few may require surgery. In my experience, the majority of patients are pleased with their outcome.
What is the learning curve to use the DRX9000? About 3 days of training is necessary. When my practice obtained its first DRX9000, my PA and I administered therapy to all patients. Once we were familiar with the equipment, and the number of patients grew, we hired a dedicated tech to administer DRX9000 therapy. Belt placement to prevent slippage during treatment is an art, but not difficult to learn.
We’d like to know how many patients your practice has treated using the DRX9000? To date, nearly 800. Patient evaluation and selection is important to treatment success using the DRX9000. Just as every patient is not a surgical candidate, not all patients with a back or neck problem are candidates for spinal decompression. www.drshoshany.com