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Nano Back Institute
Nano Back Institute is an organization that is quoted with providing non-traumatic spine surgery, that which results in zero damage to the spine. This is compared to what would be described as traditional spine surgery that includes minimally invasive spine surgery, spinal fusion, laminectomy, percutaneous discectomy, spinal disc herniation, and tessys method. According to the organization, the fundamental approaches to non-traumatic spinal disc removal were invented at the institution and much of the technology used by the institute is advanced compared to other surgeons. Since 1986, the institution has been authoring peer reviewed publications and is quoted with teaching their techniques around the world.

About the Founder: Dr. David Ditsworth
A board certified neurosurgeon, Dr. Ditsworth developed the non-traumatic Discectomy for treating herniated and bulging discs in the spine. Dr. Ditsworth has been on staff at Cedars Sinai Medical Center, in Los Angeles, California, since 1983. He has written more than 40 peer reviewed abstracts, articles, and book chapters and is a member of the Congress of Neurological Surgeons. Dr. Ditsworth completed an accelerated program for his bachelor's degree and his medical degree from the University of Utah, School of Medicine Honors Surgery Program. He then completed an internship at University of Miami, Jackson Memorial Hospital. Dr. Ditsworth went on to complete a fellowship in neurosurgery at the Yale University School of Medicine. He did his residency in neurosurgery at the University of California, Irvine School of Medicine.

Locations
The Nano Back Institute has four locations in the United States. These locations include: Beverly Hills, California; New York City, New York; Los Angeles, California; and Philadelphia, Pennsylvania.

Procedures
Non-traumatic Lumbar Spine Procedure and Non-traumatic Cervical Spine Procedure

The Nano Back Institute performs non-traumatic discectomy. At the institute, this is an outpatient procedure, requiring no over-night stay by the patients and is performed in an operating room. Patients receiving the procedure are administered local anesthesia, an IV sedation, which is given by one of the on staff anesthesiologist.

The technique for the procedure includes using an x-ray fluoroscopy and a magnified video for guidance. A small, specially designed nano probe is inserted through the skin, between the vertebrae and into the problem disc location. Nano tools are then used through the hollow center of the probe to push the bulging disc back into place and/or to remove disc fragments and small bone spurs. The average procedure time is 45 minutes to an hour, according to the Nano Back Institute. According to a range of patient testimonials, there is typically no pain post surgery. Upon completion of positioning the bulging disc back into place and removing disc fragments, if necessary, the probe used is then removed and a small band-aid is placed over the incision. There are no stitches used after surgery due to the access route to the disc in non-traumatic procedures consisting of only the probe's small puncture site that is centimeters in size.

In addition to no suturing being preformed during the discectomy, there is no muscle dissection, no bone removal, and no large skin incision throughout the entire procedure.

The approach of using a small endoscope that is nano size, the smallest workable size, to be able to direct the probe completely through the foramen, and to be able to work anywhere inside the spinal canal to remove disc fragments, is a fundamentally different approach from other spine operations performed. The non-traumatic discectomy is a type of procedure that is unique when it comes to operations called "minimally invasive," because no incision by cutting is made into the spine with the non-tramatic discectomy. Minimally invasive operations are inherently invasive and involve some sort of surgical cutting, bleeding, and scarring.

Doctors and Staff
There are three board certified neurosurgeons on staff at the Nano Back Institute. In addition to the neurosurgeons, the staff includes three anesthesia/pain management doctors, three anesthesiologists, one orthopedic surgeon, and three internists.

Publications

 * Nano Endoscopic Approach for Central Lumbar Disc Herniations. Poster presentation. The International Society for the Advancement of Spine Surgery in Boca Raton, FL USA | April 12 - April 14, 2017.
 * Removal of Disc Fragments from the Lumbar Spinal Canal Without Normal Anatomy Disruption. Spine Summit 2016. The 32nd Annual Meeting of the Section on Disorders of the Spine and Peripheral Nerves, March 2016. Orlando Florida.
 * Paramedian, Zero Trauma Approach Through the Ligamentum Flavum for Extruded Disc Herniations in the Lumbar Spine. Contress of Neurological Surgeons Annual Meeting, Sep 2015. New Orleans, Louisiana
 * Endoscopic Anterior Cervical Discectomy Without Fusion Through a Two Millimeter Opening. The International Society for the Advancement of Spine Surgery Annual Meeting, May 2014. Orlando Florida.
 * Non-Traumatic Approach Through the Ligamentum Flavum for Extruded Disc Herniations in the Lumbar Spine. 30th Annual Meeting of the AANS/CNS Section on Disorders of the Spine and Peripheral Nerves, Orlando, FL, March 5-8, 2014.
 * Book Chapter - Decision Making in Spinal Care - Chapter 61; Copyright 2013 by Thieme
 * Successful Unifactorial Treatment of Multifactorial Spinal Stenosis. The Society for Minimally Invasive Spine Surgery, Annual Meeting. September 2012, Miami, Florida.
 * Multifactorial Lumbar Stenosis Treated Successfully with Primary Factor Treatment Only. The 2012 AANS/CNS Section on Disorders of the Spine and Peripheral Nerve Annual Meeting, Mar 2012. Orlando Florida.
 * "Lumbar Fusion Candidates" Avoid Fusion: Long Term Follow-up. The Congress of Neurological Surgeons 2011 Annual Meeting, Oct 2011.
 * NON-TRAUMATIC, TRANS-LIGAMENTUM FLAVUM APPROACH FOR L5/S1 EXTRUDED DISC HERNIATIONS. Annual Meeting of the AANS/CNS Section on Disorders of the Spine and Peripheral Nerves, Feb 2010.
 * Double Approach Non-traumatic Lumbar Spine Surgery in Central and Paracentral Lumbar Disc Herniations: No Access Surgical Trauma, Better Results and No Failed Back Surgery Syndrome. IITS 2009, Phoenix
 * Treatment of central and paracentral lumbar disc herniations with a transforaminal double access non-traumatic discectomy: safe and with better results. WCMISST June 2008
 * 7 cases with previous surgeries and free fragments: 100% success with average of 16 weeks follow-up. IITS 2007 France
 * "Lumbar Fusion Candidates" Avoid Fusion (Long Term Follow-up). Minimally Invasive Surgery of the Spine 2007, San Diego
 * Book Chapter - Decision Making in Spinal Care - Chapter 63; Copyright 2007 by Thieme
 * Non-traumatic Transforaminal Endoscopic Approach to the Lumbar Spinal Canal for Removal of Migrated Free Fragments. IITS 2006, Phoenix
 * Outpatient Small Non Traumatic Discectomy In L4/5 Lateral Recess Lumbar Disc Herniations: Successful And Surgically Conservative. 2005 March
 * Enhanced Discography (Pre-Operative Mapping) A Prelude to Small Guided Non Traumatic Discectomy. IITS 2005, San Diego
 * Double Approach Small Non Traumatic Discectomy in L4/L5 and L5/S1 True Central Disc Herniations: No Access Surgical Trauma, Better Results. CNS 2004 San Francisco
 * Paramedian Small Endoscopic L5-S1 Discectomy. CNS 2002 Philadelphia
 * Preparative Analysis for Precision Lumbar Endoscopic Disc Surgery. CNS 2001 San Diego, California
 * Endoscopic Lumbar Discectomy: Small, Soft Scope Technique. Spine & Peripheral Nerves Section 2001
 * IDET and PED: Benefits of Combination Treatment Los Angeles Metropolitan Hospital. Spine & Peripheral Nerves Section 2000
 * Paramedian Percutaneous Non Traumatic Discectomy: New Surgical Technique and Initial Clinical Results. CNS 1998 Seattle, Washington
 * "Contrast Disc Analysis and Mapping as a Prelude to Endoscopic Lumbar Discectomy." The 14th Annual International Intradiscal Therapy Society Meeting. Phoenix, Arizona. May23-27, 2001.
 * IDET and PED: Benefits of Combination Treatment (Joint Section meeting Feb. 2000).
 * American Association of Neurological Surgeons and Congress of Neurological Surgeons abstract compilation.
 * "Endoscopic Transforaminal Lumbar Discectomy and Reconfiguration: A Postero-lateral Approach Into The Spinal Canal" Surgical Neurology. Volume 49, Number 6. pp.588-598 June 1998.
 * "The Development of Percutaneous Lumbar Endoscopic Microdiscectomy (This Author's Twelve Year Experience)" The Eleventh Annual International Intradiscal Therapy Society Meeting. San Antonio, Texas. May 1998
 * "Endoscopic Transforaminal Percutaneous Discectomy for Recurrent Lumbar Disc Herniation," The Tenth Annual International Intradiscal Therapy Society Meeting. Naples, Florida. May 28-31, 1997.
 * "True Transforaminal Endoscopic Percutaneous Lumbar Discectomy," The Tenth Annual International Intradiscal Therapy Society Meeting. Naples, Florida. May 28-31, 1997.
 * "Non Traumatic Discectomy," Faculty, International Intradiscal Therapy Society Meeting. Amsterdam, the Netherlands. May 9, 1996.
 * "Endoscopic Spinal Surgery," Invited Faculty (taught seminar), The American Association of Neurological Surgeons. Minneapolis, Minnesota. April 30, 1996. Commended for presenting "the surgery of the future".
 * "Endoscopic Transforaminal Disc Removal and Reconfiguration," The 12th Annual Meeting of the Joint Section of Congress of Neurological Surgeons and American Association of Neurological Surgeons on Disorders of the Spine and Peripheral Nerves. Lake Buena Vista, Florida. February 28 - March 2, 1996.
 * "Endoscopic Transforaminal Disc Removal and Reconfiguration," Selected by Joint Section of American Association of Neurological Surgeons and Congress of Neurological Surgeons as best paper for publication.
 * "Percutaneous Transforaminal Non Traumatic Discectomy," North American Spine Society. Washington, D.C. October 18-21, 1995.
 * "A New Superior Technique for Removal of Herniated Lumbar Discs," The Canadian Journal of Neurological Science. Volume 22, Number 2. May 1995.
 * "A Safer, Effective Alternative to Laminectomy," Presentation at International College of Surgeons. San Diego, California. April 1, 1995
 * "Comprehensive Percutaneous Endoscopic Spinal Surgery," Presentation, The American Association of Neurological Surgeons. Orlando, Florida. April, 1995.
 * "2.8 mm Endoscopic Comprehensive Percutaneous Lumbar Disc Surgery," Presentation at International Intradiscal Therapy Society. La Jolla, California. March, 1995. Taught Discectomy Workshop - Faculty - UCSD OrthoMed Facility.
 * "A New and Superior Technique for Removal of Herniated Disc: Endoscope and Nucleotome Combination," Presentation to the Joint Section of The American Association of Neurological Surgeons and The Congress of Neurosurgeons. Phoenix, Arizona. February, 1995.
 * "A New Technique for Intra and Extra Discal Percutaneous Endoscopic Lumbar Surgery," Presentation, Annual Symposium and Call for Papers: Techniques in Spinal Surgery. New York City, New York. December, 1994.
 * "Percutaneous Discectomy in the Older Patient (Improved Results with Nucleotome/Laser Enhancement)," Presentation, Seventh Annual Intradiscal Therapy Society Meeting. Aberdeen, Scotland. May, 1994.
 * "New Comprehensive Percutaneous Discectomy Using a Working Channel Scope and Nucleotome," Presentation, Seventh Annual Intradiscal Therapy Society Meeting. Aberdeen, Scotland. May, 1994.
 * "Percutaneous Discectomy Over Age Sixty (Nucleotome With Laser Enhancement)" Presentation, Joint Section on Disorders of the Spine and Peripheral Nerves (A Joint Section of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons). Tenth Annual Meeting. Ft. Lauderdale, Florida. February, 1994.
 * "Percutaneous Discectomy in the Older Patient," Presentation, Second Annual Symposium, Techniques in Spinal Surgery. New York, New York. December, 1993.
 * "Percutaneous Discectomy- Lasers and Fiberoptics," Continuing Medical Education Lecture, National Scientific Conference, (Westside Hospital). Hawaii. July, 1993.
 * "Percutaneous Discectomy- Recent Advances," Continuing Medical Education Lecture, National Scientific Conference, (Westside Hospital). Hawaii. July, 1992.
 * Back Pain and Alternatives to Back Surgery: Percutaneous Discectomy, Lecture Series, Beverly Hills Medical Center, 1989.
 * Back Pain and Alternatives to Back Surgery: Percutaneous Discectomy, Lecture Series, Beverly Hills Medical Center, December 1988.
 * Arachnoiditis, Presentation, Congress of Neurological Surgeons' Annual Meeting, October 1980, Houston, Texas.
 * Benign Brain Tumor, National Critical Care Inst. Journal, Vol 5, Number 11, Nov. 1978.
 * Subdural Hematoma, Chronic, National Critical Care Institute Journal, Volume 5, Number 9, September 1978.