News and Events

Here is the latest news from Non-Surgical Spinal Decompression

January 2009: Mark Daugherty obtains advanced Continuing Education credits...

December 2008: Acute Spine Pain Educational Clinic Implemented...

November 2008: Dr. Fudala lectures at Board Symposium...

September 2008: Brian Riesenberg attends Advanced Core Stability Seminar...

April 2008: Post-surgical Rehabilitation services implemented...

January 2008: Brian Riesenberg attends "Disc Decompression" seminar...

Nov. 2007: Dr. Fudala lectures at Advanced Spine Symposium...

July 2007: Internal Statistical Analysis of Lumbar Disc Herniations Treated Conservatively Yields Impressive Results...

June 2006: Dr.'s Jonathan Borden (neurosurgeon) and Ron Fudala (Chiropractic Neurologist) speak on surgical and non-surgical options for care...

January 2006: The SpineCenter at Riverhills Healthcare introduces non-surgical treatment option of low back and neck disorders...


January 2009: Mark Daugherty obtains advanced Continuing Education credits:
Mark, who works primarily in our post-operative rehabilitation department, recently returned from an advanced program discussing novel equipment and methodology for spinal core training and general physical conditioning. Upon returning, Mark mentioned, "Within each program are nuggets of information that could be of potential use for our patients. We recognize that we cannot purchase each new piece of equipment, or implement every new technique. But, after returning from these programs, all of us sit down, review the relevant information, and determine if anything would work within our paradigm. If so, we implement it. If not, we are at least aware of what is being done elsewhere."

December 2008: Acute Spine Pain Educational Clinic Implemented:
To address the needs of of both the patients and primary care providers, Dr. Fudala and Staff have just introduced an educational clinic to provide patient's suffering from spinal disorders timely and appropriate information on how to best manage their conditions in the early phase of their illness. Although not taking the place of a thorough evaluation, this program helps to educate patients on proper spinal function, common causes of injury, and ways in which simple everyday measures can be implemented to prevent further injury and to help one recover more quickly. Dr. Fudala stated, "There is a great deal of misinformation when it comes to disorders of the spine, and it is well known that the best way to prevent situations from becoming chronic is to address them at their earliest stage, with effective information and reasonable home measures. Our patients have told us that seeing and being taught, in person, has been much more beneficial to them than simply having them read a pamphlet. We also recognize the tremendous time constraints on family physicians and felt that we could help them address their patient education needs in a more comprehensive manner." These programs are held weekly, and are at no charge, being offered as a community service. Appointments are required and can either be made by the patient, or by the treating physician's office.

November 2008: Dr. Fudala lectures at Board Symposium:
Dr. Ron Fudala has just returned from Daytona, Florida, where he was a guest presenter at the advanced symposium sponsored by the International Board of Electrodiagnosis. His primary topic involved the discussion of cases from his practice in which he had encountered some unusual, and often rare neurologic disorders in patients who were initially referred in for the assessment of a suspected spinal condition. In this discussion, Fudala stressed the importance of an accurate history, clinical examination, and supplemental testing such as EMG/NCV to arrive at an appropriate diagnosis prior to initiating treatment. Dr. Fudala stated, "It is not entirely unusual for uncommon conditions to present with seemingly common or benign symptoms. As such, when one is involved in the advanced management or work up of these patients, a high level of suspicion needs to be maintained to insure that important disorders are not overlooked."

September 2008: Brian Riesenberg attends Advanced Core Stability Seminar:
Mr. Riesenberg, an exercise physiologist offering "Non-Surgical Spinal Decompression" at Riverhills Healthcare, recently completed 12 hours of training on the current research regarding the mechanics of spinal stability. An additional emphasis of this program was learning how to incorporate techniques patients can do on their own, often without the need for expensive equipment. Riesenberg noted; "To provide the best care, all of us need to be familiar with newer research as it emerges, and to be willing to incorporate this into our efforts in a practical and affordable way. In doing this, we find that patients are much more compliant with our recommendations."

April 2008: Post-surgical Rehabilitation services implemented:
Mark Daugherty recently joined The SpineCenter at Riverhills Healthcare and will be involved in the development and instruction of post surgical rehabilitation procedures for patients who have undergone spinal surgery. Mr. Daugherty, a Certified Fitness Trainer, has extensive experience having served as a fitness and training consultant with the Cincinnati Reds. Daugherty stated that, "Although working with individuals who are not professional athletes may be somewhat different, in a sense we are all athletes in that our bodies still need to perform acceptably to meet the demands imposed upon them. In working with the neurosurgical staff, and with Dr. Fudala, we will devise programs designed to help patients reach the highest level of physical function possible. Also, having experience with athletes who have been injured will help me to better understand the needs and concerns of those who have had surgery." Speaking on behalf of the neurosurgical department, Dr. P. R. Schwetschenau stated, "We believe that, for a surgery to have lasting success, patients need to buy into the idea of being a part of their recovery. We now have the capability to help them accomplish that, and to customize programs that are not only unique to each individual's needs, but also to the type of surgeries we perform."

January 2008: Brian Riesenberg attends "Disc Decompression" seminar.
Brian Riesenberg, exercise physiologist, recently attended a course titled "Advanced Decompression and Active Therapy" which emphasized how to categorize and position patients to achieve optimal outcomes, and also how, and when to implement various forms of rehabilitative exercises. Brian stated that, "Even though we had already incorporated many of these techniques into our practice, we always come away with several ideas of how others treat their patients and will often implement and then evaluate these to see if they will work effectively for us."

Nov. 2007: Dr. Fudala lectures at Advanced Spine Symposium:
Dr. Fudala recently participated in the program "Bridging the Gap in Spine Care," held in Cleveland, OH sponsored by the American Academy of Spine Physicians (link) as a part of a distinguished multi-disciplinary panel of surgeons, radiologists, physiatrists, and chiropractic physicians. Fudala's topic was the Epidemiology of Lumbar Disc Herniations, in which he reviewed the recent research illustrating how large lumbar disc herniations often resorb without surgical intervention. Fudala pointed out that, "While surgery remains a viable and often necessary intervention, and each case needs to be considered on an individual basis, there is current evidence that strongly supports the fact of biochemical processes occurring which can lead to the "self-repair" of these lesions. More recent papers have also addressed that there are factors on a patient's MRI scan which can be predictive of whether or not a patient's disc has a chance of 'self-repair' or shrinkage."

July 2007: Internal Statistical Analysis of Lumbar Disc Herniations Treated Conservatively Yields Impressive Results:
An initial review of 100 consecutive patients, suffering from lumbar disc herniation with radicular pain (leg pain), who had undergone conservative care with-Surgical Spinal Decompression has shown that over 50% of these patients achieved a pain-free status, another 25% reached a level of improvement of greater than 75%, with the remaining patients having lesser levels of improvement, or no improvement at all. No patients were made worse, and 15 of the original 100 did ultimately require surgery. Three factors were predictive of a successful outcome: (1) Symptom duration of less than 6 months, (2) The ability to attain a normal range of spinal extension or with repeat spinal extension producing a centralization of pain, and (3) A baseline Oswestry Index (functional outcome questionnaire) of less than 50%. Although outcomes were better in those with a shorter duration of symptoms, it was impressive to see that over 50% of the patients having symptoms for greater than one year also categorized their response as acceptable. The presence of absence of a neurologic deficit had no bearing on the outcome in this initial series. Long-term follow-up on these patients has not yet been completed. Dr. Ron Fudala, director of the department, stated,"Many of these patients had originally come in to see one of our surgeons for a second opinion, having been advised previously that surgery was their only option. Our SpineCenter is designed to provide a range of options in accordance with a patient's desires, as long as their safety and integrity of neurologic function is not compromised. We do not look at one form of treatment as necessarily being more superior to another but rather look at a spectrum of treatments with the intent on offering conservative care as an initial approach."

June 2006: Dr.'s Jonathan Borden (neurosurgeon) and Ron Fudala (Chiropractic Neurologist) speak on surgical and non-surgical options for care.
Presenting at a dinner seminar, Dr.'s Borden and Fudala recently addressed a combined group of Medical and Chiropractic Physicians. Dr. Borden spoke on Dynamic Stabilization, a recently developed surgical option designed to preserve spinal segmental motion and theoretically reduce the incidence of adjacent level disc degeneration often seen as a complicating factor with standard spinal fusion surgery. Dr. Fudala spoke on The Fact's, Fallacies, and Fancy, of -Surgical Spinal Decompression addressing the many inconsistencies between what manufacturers or overly aggressive physician/marketers state, and what is actually supported by scientific inquiry. Dr. Borden stated that; "These programs are important on two fronts. First, I am able to discuss a new technique that I have found to be helpful. Secondly, and just as important, I am able to learn about alternative forms of care such as chiropractic to get a better idea of when to refer and for which conditions it is most beneficial."

January 2006: The SpineCenter at Riverhills Healthcare introduces non-surgical treatment option of low back and neck disorders.
Recognizing that many patients referred into a surgical practice are not immediate surgical candidates, The SpineCenter has implemented an option for conservative treatment under the direction of Dr. Ronald D. Fudala, a Board Certified Chiropractic Neurologist. With Riverhills, Dr. Fudala's role has been in the preliminary triage of potential surgical patients, consulting for many of the area's Chiropractic Physicians, and performing specialized electrodiagnostic testing for the surgical department. Dr. Schwetshenau, one of the practice's neurosurgeons, and president of Riverhills Healthcare, stated that, "For years we have recognized the need for conservative care yet did not have the facilities to offer this. Having this department allows us to develop and monitor the success of this form of treatment while maintaining continuity of care within our practice." Dr. Fudala further noted that; "It is not uncommon for patients to be referred to me to address the benefits of our program versus other treatments such as standard chiropractic care. In many instances, I either see patients who are being managed effectively with spinal manipulation, or whose condition may warrant this form of care as compared to the conservative measures we employ. The surgeons have placed great trust in me to utilize our service, if that is in the patient's best interest, or to refer for other forms of conservative care if that were felt to be more beneficial. In doing this, we can continue to meet the needs of our patients, their referring physicians, and make sure we implement or consider all of the different resources available in our local healthcare community."

We have designated our service known as "Non-Surgical Spinal Decompression" which combines very gentle and controlled intermittent forces targeting the spine to alleviate irritation on pain sensitive structures. Brian Riesenberg, an exercise physiologist, has joined us to assist in the development and implementation of core stability training with the goal of not only alleviating pain, but in helping patients to achieve a greater level of functional spinal fitness hoping to prevent recidivism, which remains a large problem of the spinal pain population. Dr. Fudala has further stated that, "There is much to learn about how to best manage spinal conditions and no treatment is perfect. We have developed basic treatment protocols and we intend to keep data on all of the patients we treat, regularly monitor our outcomes, and make any necessary changes based upon our data or newer information that becomes published."