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Stay in touch with developments in the world of nerve and spine health with NerveMed News. We publish a monthly newsletter, which you can sign up for free of charge; the form is in the right column of this page. We never divulge your personal information and you may unsubscribe at any time by clicking the "unsubscribe" link contained in each email.


March 2013 Case Study: 14-Year-Old Female with Pelvic Pain

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Thursday, 28 February 2013 08:01

This month’s case features a 14-year-old female with reports of burning, stinging, shooting, pain and numbness in the pelvis.

The patient reports that the symptoms initially began after her 7th grade school year when she was participating in an extracurricular gymnastics competition. After a fall on the balance beam, she initially had pubic pain with frequent urination. The frequent urination resolved on its own after a few months. However, she continued to experience pain in the vaginal area, left greater than right.

She has been in physical therapy for almost a year with no improvement. For pain and inflammation, topical and ingested medications have provided no relief. A newly obtained MR Neurography study does demonstrate significant irritation in the pudendal nerve elements starting with the ischial spine and extending into the upper portion of the obturator internus muscle. Also, there is some mild vein dilatation and pudendal branch irritation. There is normal appearance of the S2 and S3 spinal nerves as they traverse the piriformis muscle.

Her pain is aggravated with activity, so she has had to reduce her tumbling and gymnastics squad participation. Due to increased pain with prolonged sitting, she was unable to complete her final week at school before the summer break. She has experienced significant change from being an active young person, and since January 2013, has developed worsening numbness/tingling symptoms which have no specific aggravating factors.

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Treating Young Patients: Pediatric Protocols

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Thursday, 28 February 2013 08:00

The Institute for Nerve Medicine is pleased to announce a new medical program designed to minimize risk and to enhance the recovery of young patients.

Successfully treating patients 18 years of age or younger can be a daunting task. Doing so requires specific clinical protocols and safety measures that some medical facilities simply do not possess.

However, the fact remains that many young people suffer from issues related to sports injury, orthopedic injury, and soft tissue nerve damage.

To better serve the widest possible range of patients, including young people, the medical team at INM has created new pediatric protocols in association with Image Based Surgicenter of Santa Monica.

With many adult patients we see soft-tissue injuries that have developed into chronic, long-term pain. But with young patients, they are more often seen as traumatic injuries. The sooner we identify the nerve damage and correct the problem, the higher the likelihood the young patient will avoid long-term or even permanent nerve loss.

It doesn't matter what the injury; from pelvic pain to pudendal nerve injury or even piriformis bi-lateral pain — speed to diagnosis and treatment is key for the young patient.

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London Clinic: January 21-23, 2013

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Tuesday, 30 October 2012 08:02

For all our European patients, we are pleased to announce the latest London clinic with Dr. Aaron G. Filler, MD PhD FRCS, medical director of the Institute for Nerve Medicine, at our Harley Street offices, this upcoming January 21-23, 2013.

If you are in the United Kingdom or continental Europe, this clinic may be of great interest to you. You will have a private consultation with Dr. Filler, and if deemed necessary, be scheduled for a nerve scan study at our London imaging center.

All interested patients should contact us by email at This e-mail address is being protected from spambots. You need JavaScript enabled to view it at your earliest convenience. Space is extremely limited during these clinics, so don't delay - let us know your interest as soon as possible, and we will schedule you during our January presence in London.

 

The Latest from the Front Lines: Continuing Our Insurance Discussions

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Tuesday, 30 October 2012 08:01
Part of our ongoing series of discussions with patients regarding the Medical Insurance Industry and our efforts to help ensure as much reimbursement as possible for individuals

This October, the Institute for Nerve Medicine's medical director Dr. Aaron G. Filler, MD PhD FRCS attended the national meeting for the Congress of Neurological Surgeons in Chicago. This is an annual event in which board certified neurosurgeons meet to discuss healthcare standards in their field. Dr. Filler also is a member of the Peripheral Nerve task force committee, where he and his peers discussed the recent negative impact of insurance plans. The task force is committed to changing the insurance plans' recommendations from a focus of what makes the plan money to a focus of what is in the best interest of the patient.

Major plans such as Blue Cross and Aetna are appointing non-specialty, non-certified doctors, nurses and other industry-paid medical consultants to render medical policy determinations based on fiscal models and outdated medical research. The confusing assignments of “not medically necessary” or “experimental treatment” and even “beyond the usual and customary” cause patients to have to pay out of pocket for any medical service given these labels by their insurance plan. Naturally, many patients choose to refuse medical services that are beneficial to them, simply because their insurance plan will not cover the service. But the fact is that these services actually are medically necessary, they have peer and clinical support and they exceed the standards of care which are all good things for patients seeking quality medical services.

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New Book from Dr. Filler: The Smart Guide to Patents

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Tuesday, 30 October 2012 08:00

Institute for Nerve Medicine medical director and MR Neurography co-inventor Dr. Aaron G. Filler, MD PhD FRCS is the author of a new book entitled The Smart Guide to Patents, published by Smart Guide Publications.

This important new book tackles the complex and confusing world of invention and the patent process, explaining every step of the process in simple, easy-to-understand language from the perspective of someone who has already successfully navigated the US patent process.

The book covers a wide variety of subjects, including complete coverage of the new 2011 America Invents Act.

For more information on the book, please visit the dedicated book website by clicking here.

For the book's complete table of contents, please click here.

To download a free excerpt of the book, please click here.

To order your own copy of the book from Amazon.com for more than 20% off the suggested retail price, please click here.

 

New Video from Dr. Aaron Filler: Piriformis Syndrome - Advancements in Treatment

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Friday, 24 August 2012 16:01

The Institute for Nerve Medicine is pleased to announce the release of a new video program by our medical director, Dr. Aaron Filler, MD PhD FRCS.

Entitled Piriformis Syndrome - Advancements in Treatment, the program includes a comprehensive explanation of piriformis syndrome and "sciatica," an examination of ineffective treatment strategies, and successful treatment techniques pioneered by Dr. Filler and regularly used with our patients here at the Institute for Nerve Medicine.

We hope you'll take a few minutes to learn more about piriformis syndrome and the new techniques now in use by Dr. Filler to help achieve high success rates with our patients who entrust their health to the Institute for Nerve Medicine.

 

August Case Study: Piriformis Syndrome Follow-Up

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Friday, 24 August 2012 15:56


ABOVE: Open MR interventional scan of the case study patient depicting the MRI needle delivering injectate medication to the piriformis muscle based on MR Neurography targeting. Click the image for a larger view in your browser.


Welcome to the August 2012 edition of the Institute for Nerve Medicine's Case Study Newsletter.

This month’s case study continues with the success story of a 2008 Piriformis patient who contacted us last month with updates on his progress. This patient has been suffering from right lower extremity neurologic symptoms. Physical exam and imaging indicated involvement of the piriformis muscle and obturator internus muscle.

Based on MR Neurography findings, it does appear the patient would benefit from additional MR guided interventional procedures. The patient has had several injections in the past with little success and is reluctant to have additional injections and prefers to go straight to surgery. However, Dr. Filler explains the benefits of the procedure and the differences in accuracy versus more traditional injection methods.

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London Clinic with Dr. Filler September 1-4, 2012

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Friday, 24 August 2012 15:54

The Institute for Nerve Medicine is pleased to announce our next London Clinic, this September 1-4, 2012, at our Harley Street offices.

This clinic will be for patients wishing to have a private consultation with Dr. Aaron G. Filler, MD PhD FRCS, without having to travel to Santa Monica, California. It's perfect for European, Middle Eastern and African patients.

Patients will be seen at this clinic after they have obtained an MR Neurography study. This will allow Dr. Filler to personally review the MRN findings in person. These consultations will include a complete neurological consultation and image review.

If you are interested in a consultation with Dr. Filler in London, please click here to contact us for complete information and next steps.

 

London Clinic with Dr. Filler September 1-4, 2012

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Friday, 29 June 2012 15:17

The Institute for Nerve Medicine is pleased to announce our next London Clinic, this September 1-4, 2012, at our Harley Street offices.

This clinic will be for patients wishing to have a private consultation with Dr. Aaron G. Filler, MD PhD FRCS, without having to travel to Santa Monica, California. It's perfect for European, Middle Eastern and African patients.

Patients will be seen at this clinic after they have obtained an MR Neurography study. This will allow Dr. Filler to personally review the MRN findings in person. These consultations will include a complete neurological consultation and image review.

If you are interested in a consultation with Dr. Filler in London, please click here to contact us for complete information and next steps.

 

July Case Study: 23-Year-Old Female with Distal Plexus Pain after Plastic Surgery

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Friday, 29 June 2012 15:10

Welcome to the July 2012 edition of Case Studies from the files of the Institute for Nerve Medicine in Santa Monica, California.

In this issue, we focus on a 23-year-old female patient referred by her plastic surgeon for consultation and possible treatment. The patient recently completed surgery for breast augmentation, and shortly thereafter, experienced pain symptoms.

She initially presented to her plastic surgeon with concerns about possible injury. Following general post-operative exams, she was relieved to find that this is likely not the issue. Now that her surgery global period is complete, her plastic surgeon would like to obtain more information about the pain symptoms.

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Answers to Your Questions Encore

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Friday, 04 May 2012 14:48

Here's a popular item from last year - so popular, we decided to re-run it this month because it addresses many questions asked by patients just like you.

Each month, The Institute for Nerve Medicine receives hundreds of emails from people all around the world, many asking questions about our medical practice and Dr. Aaron G. Filler, MD PhD, in particular.

Here are a couple of questions recently asked and answered:

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May Case Study: 58-Year-Old Male with Ischial Tunnel Syndrome

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Friday, 04 May 2012 14:38

Welcome to the May 2012 case study from the Institute for Nerve Medicine and Dr. Aaron G. Filler, MD PhD FRCS, in Santa Monica, California.

This month's case study focuses on a 58-year-old male that presented with right buttock pain that was aggravated with exercise and walking for a distance of approximately 1-2 miles. He would develop weakness with right dorsiflexion and eversion.

Approximately four years ago, the patient re-started cycling and began developing right-sided symptoms. He has had significant workup with multiple muscle biopsies, IVIG, and polyneuropathy with no significant findings. The patient reports that he has the sensation of sitting on a golf ball with paresthesias to the lateral calf. The patient has a history of piriformis resection on the left. The patient reports that his pain level is a 4 out of 10 and is continuous.

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Online Medical Reviews: Consider the Source

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Friday, 30 March 2012 12:55

During the last few years, there has been an increase in online medical reviews. In an effort to encourage patient education, we would like patients to complete due diligence and research their healthcare options and medical providers. Most importantly patients should Consider the Source. Instead of relying on anonymous online reviews, there are many legitimate resources for checking medical credentials.

State medical associations offer membership after a rigorous background and educational review. In order to maintain in good standing, a physician must meet annual renewal requirements which include reporting malpractice awards. www.cma.org California Medical Association is one example but you can also check registration and active membership for a doctor with your respective state medical organizations such as The Peripheral Nerve Society (www.pnsociety.com).

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April Case Study: 60-Year-Old Female with Lower Left Extremity Problems

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Friday, 30 March 2012 12:49

Welcome to the April edition of the Institute for Nerve Medicine's Case Study Newsletter.

In this example, we look at the case of a 60-year-old woman suffering from left lower extremity neurologic symptoms. Previously she had experienced some longstanding problems with back pain and ultimately had a lumbar fusion surgery carried out during 2008 and she did obtain good relief of her back pain from that surgery. However the patient continued to experience pain in her buttock and lower leg area.

Through online research she began to consider that she might have Piriformis Syndrome and sought consultation with a local orthopedic doctor. She has had an epidural injection with no effect at all. She has had physical therapy which gives her some very short-term relief over a period of an hour or so with immediate recurrence. The pain has required high doses of narcotic medications. At this point she has come to seek treatment with Dr. Filler at the Institute for Nerve Medicine.

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Article on Diagnosis and Management of Pudendal Neuralgia by Neurography Institute medical director Aaron Filler

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Sunday, 19 February 2012 09:28

Neurography Institute medical director Dr. Aaron G. Filler, MD, PhD, FRCS, authored an article in April 2007 entitled Diagnosis and Management of Pudendal Neuralgia.

Please click here to read an abstract on the article, originally published in the Journal of Neurosurgery.

 
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NerveMed is a free online resource dedicated to helping patients worldwide with information about spine and nerve health issues. NerveMed is powered by the Institute for Nerve Medicine in Santa Monica, California, home to Dr. Aaron G. Filler, MD PhD, a leading neurosurgeon specializing in minimally invasive treatments for spine and nerve issues. Click here to learn more.

Dr. Aaron G. Filler, MD PhD

Dr. Aaron Filler is the world’s leading expert in treatment of nerve and spine pain, having revolutionized treatments by inventing several new technologies, including MR Neurography. Dr. Filler has also pioneered minimal-access surgery methods to treat complex nerve and spine problems with outpatient surgeries.   Click here to learn more.