Dr. Christopher A. Yeung of the Desert Institute for Spine Care in Phoenix, AZ graduated magna cum laude from the University of California, San Diego and was in the top five percent of his medical class at the University of California School of Medicine. University of Southern California. Dr. Yeung completed an orthopedic residency at the University of California Irvine Medical Center. He then did a spinal surgery fellowship at the USC Center for Orthopedic Spine Surgery/Los Angeles Spine Surgery.
The Desert Institute for Spine Care (DISC) and Dr. Yeung in particular, have played a leading role in FDA research studies focused on low back pain and its treatment. Dr. Yeung has been the principal investigator on many FDA studies, including the Flexicore Lumbar Artificial Disc Replacement, the Cervicore Cervical Artificial Disc Replacement, and the DASCOR Total Core Replacement. Dr. Yeung and the DISC team always strive to be among the first to gain approval for these innovative techniques and make them available to sufferers of debilitating back pain.
Dr. Yeung is currently conducting a research study to evaluate the benefits and efficacy of the Intracept Procedure, a one-hour treatment designed to treat chronic low back pain at its source. The SMART clinical trial is being conducted at several different sites across the country to determine if this one-hour outpatient procedure, in which a probe is advanced into the vertebrae and placed into the basivertebral nerve, is effective in eliminating low back pain with minimal intrusion. to the patient
Radiofrequency energy is sent directly to the nerve, rendering it incapable of producing pain signals. Only those people with low back pain that does not extend to the lower extremities are eligible to participate in the SMART clinical study. This procedure is potentially effective in treating low back pain that is concentrated only in the lower back and does not radiate to the lower body.
We took a few minutes out of Dr. Yeung’s busy schedule to ask him about the Intracept Procedure and how you can be at the forefront of minimally invasive spinal surgery.
Doctor, what motivated you to get involved in the SMART clinical trial and how is this procedure different from other available options?
Doctor Yeung: The Company approached us because of our experience in minimally invasive spine procedures. We do a lot of percutaneous endoscopic discectomy type of work, so they approached us about getting involved in this new study.
I think one of the reasons was because it’s a truly minimally invasive way to treat vertebrogenic degenerative back pain. Instead of a large open surgery, it actually treats pain through a small incision, essentially like a large needle, which allows a probe to enter the vertebral body and basically remove or burn the nerve that carries pain from the body. vertebral.
For us, it was really exciting to be a part of this study and we are honored to be a part of this study because it could revolutionize the treatment of degenerative disc disease and vertebrogenic back pain. It’s very exciting because it’s a huge difference compared to open fusion.
Who would benefit from this procedure and how would anyone qualify? Does this procedure treat all types of low back pain? Is there any type of hospitalization involved and what is the cost to the patient?
Dr. Yeung: There is no cost to the patient. The study sponsor absorbs the entire cost of treatment. Patients who would benefit from this are people with chronic low back pain without sciatica or radiculopathy, they do not have nerve compression. Compression of the nerves would cause pain in the legs; if they have nerve compression, they will be excluded from the study.
People with chronic back pain of the vertebral bodies are the people who would qualify for this. It is often difficult to know where back pain is coming from because there are many structures in the back that may be causing pain. It could be the vertebra and those are the patients that would qualify or it could be the disc itself or it could be the facet joints in the back or maybe the muscles and ligaments.
Sometimes it’s hard to figure out where the actual pain is coming from, but for the study they are using MRI criteria. People who have chronic back pain and on the MRI have inflammatory changes or degenerative changes in the vertebral bodies themselves, those are the people who would qualify.
Those changes we are looking for are called MODIC changes. We want to try to eliminate people who have pain coming from the facet joints and look primarily for people who have pain coming from pressure on the vertebral bodies. As the discs degenerate and collapse, they are no longer an effective shock absorber between the two bones of the vertebral body. This causes more pressure on those bones and they become inflamed and you can see some chronic bone changes and those are the people we’re targeting.
There is a nerve called the vertebral basil nerve that enters the vertebral body and branches off and innervates the weight-bearing surfaces of those vertebral bodies. The study is designed to go in and remove or burn that nerve so that you can basically short-circuit the pain response of those plated vertebral bodies.
Doctor, how long does the surgery take with this procedure?
Dr. Yeung: Typically, if you are treating two vertebral bodies, they would be like an L4 and L5 vertebral body and would be on either side of the L4 or L5 disc. That would probably take about an hour and ten minutes for the procedure. At each level you have to warm up the nerve for about fifteen minutes each. Setup usually takes about an hour. You don’t get general anesthesia, it’s just local anesthesia and some sedation.
Is this technique the future of low back pain treatment? Will this replace other treatment methods for this specific type of back pain?
Dr. Yeung: I don’t think it completely replaces everything. I think it’s another weapon in our fight against back pain. Basically, you can prolong the need for a big merge and also obviate the need for a merge.
If someone has degenerative disc disease and vertebrogenic back pain, the choice right now is to live with it or have disc fusion or replacement surgery. Hopefully this can relieve the pain from the source, from the nerve and then the patient won’t need to have that reconstructive spinal surgery if the pain is relieved.
Let’s hope this works out and is effective. That’s what the study is designed to find out.
How can someone find out if they are eligible for this study? Where would they go to get more information?
Dr. Yeung: The best place would be the website. On the website it shows all participating sites across the country. Hopefully there is someone close to that person who is looking for more information. I think there’s contact information there too. You can contact the company or if you are in Phoenix, Arizona you can contact my clinic directly. DISC has clinics in Phoenix, Scottsdale, and Gilbert, Arizona. There are about fifteen clinics across the country that they can contact.
What are some of the features that set Desert Institute for Spine Care apart from other practices?
Dr. Yeung: One of the things that sets us apart from other clinics is our ability to offer a full range of treatments, from injection treatments to minimally invasive techniques. We can do endoscopic discectomy which not many people know how to do. It’s a seven-millimeter incision that’s kind of like exploring the knee so we can offer that to patients with herniated discs and that’s probably the biggest differentiator for us, not a lot of people can offer that.
We also offer all traditional treatments such as fusion and open laminectomies where appropriate and are not appropriate for minimally invasive techniques. We offer a full spectrum of care, from non-surgical surgeries to larger open surgeries, with all minimally invasive specialized techniques. We are also one of the few clinics that train a lot of people, so we travel a lot to teach.
I’m here in New York to take a course to help train other neurosurgeons here in the technique.
My dad and I and other associates travel all over the place and give lectures on this and help teach it in cadaver labs. We support a lot of research and participate in FDA studies. Some of the newest cutting-edge technologies being studied can be offered here for the right patients.
Doctor Yeung, thank you for your time and for providing information about the Intracept Procedure and its potential benefits.
Dr. Yeung: You’re welcome.
Dr. Christopher Yeung, MD, Desert Institute for Spine Care, can be contacted at 602-944-2900. For more information on the DISC Phoenix, Scottsdale and Gilbert clinics, visit: sciatica.com. For more information about the SMART clinical study and the Intracept procedure, contact the Desert Institute for Spine Care directly at 602-944-2900 or visit http://www.smartclinicalstudy.com.
Kevin Nimmo is a writer and online media strategist. He interviews subject matter experts and educates his readers based on information provided by experts in their respective fields. He is also executive editor of The Western Medical Journal.
By Kevin Nimo