This is the power point for Morocco for Spinal Decompression

1. Spinal Decompression
Improving Lives One Disc at a
Time

2. Introducing Spinal Decompression
The Non Surgical Path to Pain Free Living

3. Our Purpose
To offer more permanent, affordable
treatment options to help local
patients suffering from neck and
back pain that are:
•Non-surgical
•Non-invasive
•Have no side effects

4. Our Goal
• Improve the cost and effectiveness of
treating low back and neck pain
• Improve the quality of life for neck and
back pain sufferers
• To make Moroccan doctors world
recognized specialists in back and neck
pain

5. Back Pain Statistics
• Up to 75% of population will have back
pain at some time in their life
• Billions are spent trying to treat back pain
• Billions spent on drugs and surgery that
don’t provide effective, long-term solution

6. Getting Worse: Sitting
• Poor Posture
• Sitting at Computer
• Sitting all day long
• Sitting at dinner
• Sitting in the car

7. Text Neck- An Actual Diagnosis
Prevalent among kids
• Texting, video games,
Computer, poor posture

8. Too Much Weight
• 2/3 of population is overweight
• 1/3 is obese
• Every extra pound of weight
can add up to 8 extra pounds
of force on the joints

9. Back Pain and 18-34 Year Olds
“The lifestyles of young people in the UAE could lead to years of
back pain and medical problems, according to new research. A
recent study from the UK indicates that two-thirds of people
between 18 and 34 years old regularly suffer from spine and back-
muscle complaints. Now, experts in the UAE fear that the severity
of this problem could mean thousands of young men and women
are destined to spend the rest of their lives with chronic back
pain.”
http://www.thenational.ae/lifestyle/well-being/victims-of-lower-back-pain-are-get
Bob Kemp

10. Are We On the Right Track?
• Why are incidents increasing
despite new drug and surgery
options?
• Is it possible we are not doing
the right thing?

11. The Discs - #1 reason for back pain
Many specialists think 75%-
80% of back and neck pain
come from the discs

12. Treatments Specific to the Discs
• Physical therapy – No
• Chiropractic – No
• Exercise – No
• Drugs – No
• Acupuncture – No
• Massage – No
• Surgery – Yes, can
cut out part of the
disc (risks, side
effects, scar tissue,
invasive)

13. Disc Related Causes #1 Reason for Back Pain
2 Main Causes of Disc Problems
• Disc Degeneration
• Disc Herniations , Disc Bulging, Slipped Discs

14. Discs 101
• Direct blood supply to the discs dies off at
12-14 years old
• No direct circulation
• Blood supply outside the disc
• Force inside through specific movements to
maintain its health

15. Imbibition - Nutrients In, Waste Out
 No direct blood supply into the disc
 Pressure squeezes out water and waste
 Grabs Oxygen, nutrients
 Discs maintain health, hydration

16. After Injury or With Age
• Patients stop moving
• No imbibition occurs
• Waste products build up
• Discs dry out
• Discs thin and degenerate

17. 1) Degenerated Discs

18. 1) Degenerated Discs/Arthritis
• Disc degenerates - no shock absorption
• Transfers 75% of weight bearing off the
discs and onto facet joints
• Causes bone spurs around facet joints and
in the spinal cord canal
• Nerve and Cord compression

19. Disc Degeneration

20. 2) Disc Herniations – (Bulging/Slipped Discs)
• Chronic poor posture
• Long periods of sitting
• Improper lifting (same as up to 4x force)
• Loss of Cervical Curve
*** Most Common ***
Lifting with twisting (pick up a golf ball,
child, suitcase etc.)

21. How Back Pain Has Been Treated
• Pills- Muscle relaxers, pain pills
• Surgery- cut out disc material
• Epidurals - temporarily numb nerve
• Physical Therapy - strengthens
muscles
• Exercise
Only Surgery addresses the Discs

22. Pain Killers
Side Effects
• Addiction - more die than
from car accidents
• Seizures
• Constipation
• Unusual fatigue, bleeding, bruising
• Decreased sex drive

23. Anti-Inflammatories
“There’s an epidemic of adverse drug reactions to NSAIDs.
The Food and Drug Administration believes anywhere
from 10,000 to 20,000 deaths each year are the
result of severe bleeding caused by NSAIDs. It’s a big
problem.”
Quoted from Dr James F. Fries, one of the country’s
leading arthritis experts and professor of medicine
at Stanford University School of Medicine

24. Ibuprophen, Aleve, Celebrex
Side Effects Include:
• Nausea, vomiting
• Headaches
• Constipation, diarhea
• Kidney failure
• Liver failure
• Ulcers

25. Physical Therapy – Pros and Cons
Pros
o Great to stretch & strengthen spine
o Increases flexibility
Cons
o Doesn’t specifically treat discs
o Often makes disc problems worse

26. Laser Spine Institute – “The Next Big Thing”
• Some experts warn is ineffective, expensive and
potentially dangerous
• Lack of independent research to show that their
variations lead to better outcomes than
traditional surgery
• The institute has had trouble recruiting
academics to examine “Success Rates”
• Charges $30,000 for each procedure

27. Laser Spine Surgery – “The Next Big Thing”
• Insurances don’t cover–”lack of research to
confirm safety and effectiveness”
• Up to 2X the malpractice rates than national
averages for surgeries
(Zurich North America)
• Has Doctor Investors– “increases surgeries
performed by up to 87%”
(Journal Health Affairs)

28. “Alarming Rate of Failed Back Surgeries”
• "The world of spinal medicine, unfortunately, is
producing patients with failed back surgery
syndrome at an alarming rate…Despite a steady
stream of technological innovations over the past
15 years—from pedical screws to fusion cages to
artificial discs—there is little evidence that
patient outcomes have improved.”
(The BackLetter, vol.12, no. 7, pp.79 July, 2004.
The BackPage Editorial, The BackLetter, pp. 84, vol. 20, No. 7, 2005.)

29. “On average about 53% of L5-S1 surgeries
fail to produce relief of symptoms.”
(Radin, E.L. "Reasons for failure of L5-S1 intervertebral disc excisions."
International Orthop 1987; 11:255-259.)

30. Patient Dissatisfaction with Surgery
Among spinal surgery patients, 1 out
of every 4 patients is dissatisfied with
their surgery two years post-op.
(Surg Neuol 1998 Mar; 49(3): 263-7)

31. Surgery Success Rates
Eugene Carragee MD, of Stanford University performs
spinal surgery on only a select group who he
carefully screens.
His conclusions:
 Less than 25% will be completely successful (even after
careful screening)
 For the majority of the patients, the surgery does not have
a dramatic impact on their pain or mobility
 A patient’s prospect for a future free from back pain is
“fairly poor”

32. Post Surgery - Less Likely to Return to Work
• After two years, just 26 percent of those who had
surgery returned to work. That’s compared to 67
percent of patients who didn’t have surgery.
• 41% increase in the use of painkillers, specifically
opiates, in those who had surgery.
(University of Cincinnati College of Medicine)
(Failed Back Syndrome: The Disturbing Statistics
By Lisette Hilton : Special To DG News)

33. Surgery Leads to More Surgery
• Dr. Belanger, a skilled surgeon, recognizes that
even “successful” surgeries might require
follow-up surgery in the future. “Revision
surgery,” as it is called, is according to him also
“highly likely to be ‘successful.’”
• 72% of patients may need further
surgery (April 8, 2002. New Yorker online)

34. Treatments Specific to the Discs
• Physical therapy – No
• Chiropractic – No
• Exercise – No
• Drugs – No
• Acupuncture – No
• Massage – No
• Surgery – Yes, can
cut out part of the
disc (risks, side
effects, scar tissue,
invasive)

35. Are We Doing the Right Thing
Looking at those statistics
is it possible we are not
doing the right thing?

36. Spinal Decompression
How Back Pain is
NOW Being Treated!

37. Spinal Decompression - THE Back Pain Solution
• Until Now, Drugs & Surgery Were the ONLY
Options for Back Pain
Today Spinal Decompression is Emerging as a
Leading Solution for Your Back & Neck Pain

38. Current Medical Model
• 8000+ spinal decompression tables in
the USA and Canada
• 1,000,000+ successfully treated
• Recently Introduced into Russia,
Singapore, England, Mexico and
more
• 10+ Research articles

39. Everyday Pressures on Disc

40. Astronauts and NASA
• Even astronauts knew when there was no pressure
on the discs their back pain went away
• Doctors and researchers looked for a way to
decrease the pressure inside the discs
• This lead to specialized tables which are today
known as
Spinal Decompression Therapy!!

41. Decompression Produces Negative Pressure
In a Study Published by The Journal of
Neurosurgery, Researchers Placed a
Pressure-Sensor in a Disc creating spinal
decompression forces
 Found that the Disc Pressure Dropped to
-100 mm hg

42. What Spinal Decompression Treats
• Herniated Discs
• Degenerated Discs
• Facet Syndrome
• Sciatica
• Chronic Neck and Back Pain

43. Typical Treatment Protocol
• Treatment is 12-15minutes
• Comfortable, safe
• Patients into 80s
• Up to 350 lbs
• Everyday for 2 weeks
• 3x week for 2 weeks

44. Contraindications
• Pregnancy
• Cancer in the spine
• Abdominal Aortic Aneurysm
• Surgical Fusion

45. How It Works - Herniations
• Creates negative pressure inside discs
• Negative pressure acts like a “vacumn”
• Draws in herniations and bulges

46. Sciatica

47. Reduction In Disc Herniation Size
Journal of Neuro Imaging 1998 Volume 8 Number 2
Subjects Condition
• Herniated Discs, Degenerated Discs,
Torn Annulus
Prior to Treatment
• Pain in back and down the leg
• Numbness in legs, weakness
• 5 week protocol
• 20 treatments

48. Reduction In Disc Herniation Size
Journal of Neuro Imaging 1998 Volume 8 Number 2
• Up to 90% reduction of nucleus herniation in 71% of patients
• Torn annulus repair is seen in all
• Virtually all subjects have sufficient relief to return to work.
• 71% had significant pain relief and complete relief of weakness
• 90%+ had numbness in the leg disappear
• 86% had “good” to “excellent” relief of Sciatic and back pain
• 28% had rapid relief in as few as 3 treatments
• 85% improved clinically
• Only 6% recurrence rate at 1 year

49. Reduction In Disc Herniation Size - Case Report
European Musculoskeletal Review: Management of Low-back Pain with a Non-surgical Decompression System (DRX9000™)
Post Treatment
• Pain went from a 10 on a scale of 1-10 down to a 1
• No longer felt the burning sensation in the buttocks or legs
• Improvement in muscular strength
MRI revealed
• Decreased herniation size
• Increased disc height at multiple lumbar
levels

50. Reduction In Disc Herniation Size – Case Report
Size of Herniated Disc
Pre-Tx MRI Post-Tx MRI
4 Oct 2007
28 Jan 2008
L5–S1 2.5 (left) 2.0 (left)
5.1 (centre) 2.2 (centre)
2.5 (right) 1.6 (right)
L4–5 4.5 (left) 3.3 (left)
5.1 (centre) 4.1 (centre)
4.8 (right) 3.5 (right)
L3–4 5.0 (left) 3.2 (left)

51. How It Works – Disc Degeneration
Specialized traction forces
• Create negative pressure inside discs
• Draw in Blood, Oxygen, Nutrients
• Rehydrate and promote repair
Causing
• Discs to become taller
• Pressure to be taken off nerves

52. Disc Degeneration

53. Research Shows Increase in Disc Height - Case Report
Management of Low-back Pain with a Non-surgical Decompression System (DRX9000™)
Pre- and Post-treatment MRI
Measurements
Pre-Tx MRI Post-Tx MRI
4 Oct 2007 28 Jan 2008
L5/S1 10.2 mm 11.9 mm
L4/L5 3.3 mm 5.1 mm
L3/L4 6.4 mm 8.4 mm
L2/L3 6.1 mm 8.1 mm

54. Research Summary
7 Week Protocol - 22 Treatments
Post Treatment
• Pain went from a 10 on a scale of 1-10 down to a 1
• No longer felt the burning sensation in the buttocks or legs
• Decrease in the frequency of burning in the right inguinal region
• Improvement in muscular strength
MRI revealed
• Decreased herniation size
• Increased disc height at multiple lumbar levels

55. The Journal of Neurological Research (April 1998)
• 778 Patient Cases
• 40 Month Avg. Time of Symptoms
• Avg. Pain was 4.2 out of 5
• Success Considered a 0-1 out of 5
(little or no pain whatsoever).
• Overall, Treatment was Successful
with 71% of the Patients

56. Mayo Clinic Study
PRESENTED AT : American Academy of Pain Management AAPM 18th Annual
Clinical Meeting
Prior to Treatment:
• Average pain score was 6.4 out of 10
• Pain for more than 6 months
• 20 Treatments were given over 6 weeks
Sept 27-30, 2007 | Las Vegas, Nevada and New York State Society of Anesthesiologists - 61st Post Graduate
Assembly in Anesthesiology December 7-11, 2007 | New York, NY

57. Mayo Clinic Study – Post Treatment
• Significant pain relief in 88.9% of patients
• Average pain decreased from 6.4 to .8 Out of 10
• Required fewer analgesics after treatment
• No Safety Issues
• No Adverse Effects

58. Non-Surgical Spinal Decompression for
Chronic Discogenic Low Back Pain
As Reported at the American Academy of Pain Management Sept 7-10, 2006 Orlando, FL
• Patients reported a mean 90% improvement in back pain, and
better function as measured by activities of daily living.
• On a 0 to 10 scale patients rated the DRX9000 an 8.98.
• No patient required more invasive therapies (e.g. surgery)
• 100% would Recommend Decompression to someone else
• Require fewer analgesics after treatment
• Achieve better function after treatment
• No patients contacted required surgery

59. Non-Surgical Spinal Decompression for
Chronic Discogenic Low Back Pain
As Reported at the American Academy of Pain Management Sept 7-10, 2006 Orlando, FL
Subjects had a mean pain
score 5.99 on a 0 to 10 scale
(0= no pain 10=worst pain)
at time of initial presentation
that decreased to 0.87 after
last treatment

60. A Study in The Orthopedic Technology Review (Nov 2003)
• 219 Patients with Herniated and
Degenerated Discs
• 86% Showed Immediate Improvement
• 92% Improved Overall
• Only 2% relapsed within 90 Days

61. But Will The Results
Last?

62. Long Term Results – 4 Years Later
• 91% resumed Normal, Daily Activities
• Over 80% showed 50% or Better Pain
Reduction at the End of the 4 Year study.
• Greater than 50% Still Had a Pain Level of Zero!
The Anesthesiology News (2003)

63. Long Term Results – 4 years later
More than 50% of
Patients Still Had a
Pain Level of
Zero!

64. Comparison
• No Side Effects
• Long-Term Results
• Fixes the Problem rather than Masking It
• 71-86% vs. 25-50% Success Rate
• 10% the Cost of an Average Surgery
• Little Risk of Making Condition Worse
Decompression
vs.
Drugs
Decompression
vs.
Surgery

65. A Pain Management Doctor in Pain
“I was amazed at the results. I was
astounded. I have now treated hundreds
of patients including myself and am
continually impressed with the results.”
Dr. Donald Bailey, M.D., Pain Management,
Savannah, GA

66. An Orthopedic Surgeon Talks…
“As an orthopedic surgeon and peer reviewer, I
see many patients who are significantly
worse after back surgery. In many cases I
believe that if they had been treated with
spinal decompression before surgery they
would have resolved completely.”
Dr. Howard Berkowitz, M.D., Orthopedist, Atlanta, GA

67. “Before Surgery…”
“Manipulation, acupuncture, steroid injections,
anti-inflammatory agents and muscle relaxants
all fall short of addressing the underlying
problems associated with intervertebral disc
lesions. “Spinal” Decompression should be
utilized in all patients who are poor surgical
candidates and before surgery is undertaken
except in the emergent conditions.”
Dr. Gustavo Ramos, M.D., Neurosurgery, McAllen, TX

68. “More Effective Than Surgery…”
“Spinal decompression is a more effective
treatment than surgery, is a safer
treatment than surgery, has fewer side
effects than surgery and may have
beneficial side effects.”
Dr. David Duncan, M.D., Anesthesiology, Tulsa, OK

69. Ancillary Services
• Class IV Laser - Speed Up Healing time
• Supplements - Provide disc with nutrients
• Rehabilitation - Stretch and strengthen for
longer lasting effectiveness
• Weight Loss - Take pressure off discs
• Itrac- Fix the cervical curve for best long
term results

70. Does Not Increase Doctor’s Time
• A technician can do all the work
• Unattended therapy
• Doesn’t require a lot of
space, consumables
• Little ongoing expenses

71. Gives You a Distinct Marketing Advantage
• Technology
• Computerized
• “Wow” factor
• Safe, comfortable
• Research proving its effectiveness
• 1000s of patient and doctor testimonials

72. “Neurologists Like Myself…”
“Neurologists like myself have long known that we should
do everything possible to help our patients avoid back
surgery. Now with Non-Surgical Spinal Decompression,
we finally have a very effective way to treat back pain
without surgery. The vast majority of even our worst
cases experience significant, long-lasting relief if they
complete the entire treatment regimen.”
Dr. Orlando Maldonado, MD

73. “Treats Not Just the Symptoms…”
“The addition of spinal decompression to my practice
has been a most impressive and rewarding
experience…..treats the underlying etiology of
common causes of acute/chronic low back pain,
and not just the symptoms … should be tried prior
to undergoing surgery in all chronic low back pain
patients who meet the inclusion/exclusion criteria.”
Dr. Gerald Weiss, M.D., Neurologist, Norwalk, CT.

74. Saves Doctor’s Hands, Neck & Back
• No “hands on” work
• No bending, twisting, lifting
• Table does all the work
• Many physical therapists and
chiropractors are physically “burned out”
• Saves the doctor’s hands, neck, back and
shoulders

75. Successful Clinics Usually Have
• The Right Equipment
• The Right Training
• The Right Marketing

76. With the Right Training
• 75% to 85% Success Rate
• In 12-20 visits
• Dramatic results
• Happy Patients who refer their friends
• Patients come from all over to see the
“Morocco Back Pain Specialists”

77. The Right Training
• 10+ hours of videos
• 350 Power Point Slides
• Ongoing Phone Support
• Seminars/ On Site Training

78. The Right Training
• Contraindications - What patients can’t do decompression
• Proper patient set up and technique
• “Disc Herniation 101” - Everything you need to know
about the discs
• Annular Tears- When would a ruptured disc not
benefit?

79. The Right Training
• The 5 things to look for on a MRI to determine a
patients chance for success.
• How long before I should start seeing results on a
patient? At what point will I know they are most
likely not going to respond
• Which Orthopedic tests will give me the most
amount of useful information to determine my
treatment parameters?

80. The Right Training
• What supplements should all decompression
patients be on to ensure the best results? How
Much? Which Ones? Vit D? Magnesium? Fish Oils?
Multi vitamin? Antioxidants? Glucosamine Sulfate?
• Rehabilitation Exercises- When, how often, how
many
• What daily activities should patients avoid while
doing spinal decompression treatments?

81. The Right Training
• Back braces – which ones, for how long, how often
• What about Cold Laser and Ultrasound?
• Which therapies benefit disc patients the most?
What about MedX? What about the ATM2? What
about the SpineForce? What about vibration
therapy?

82. The Right Marketing
Ensure a Steady Stream of New Patients
• Websites
• Newspaper Ads
• Commercials
• Clinic Brochures
• Research Pieces
• Phone Scripting

83. The Right Marketing
• Front Desk Training
• Consultation
• Exam
• Seminars for patients
• Referral Packets

84. 1 Spinal Decompression Table
• Treatment time = 12 minutes
• 4 patients per hour
• 32 patients per day per table
• 32 X $150 treatment = $4,800 daily
• Imagine if you had several tables

85. Some Clinics that we consult with
• Have 10-12 tables per clinic
• Treat 100 plus patients daily
• Easily making more than
$1 million dollars per year in
cash
• In a bad economy who
consistently enroll and
change the lives of 20-30
new decompression patients
per month

86. “X-Rays showed I had Degenerative Disc Disease”
“I have had physical therapy, epidurals and
cortisone shots for neck and shoulder pain
in the past, but the pain always came back,
along with daily headaches. X-rays showed
that I had Degenerative Disc Disorder,
bulging discs and stenosis in my neck….
After just a few Spinal decompression
treatments, I felt much better. After 17
sessions, I feel like a new person!”
~ Mardy S.

87. “I had burning, stabbing Sciatica pain down my right leg…”
“When I started this program, I had burning, stabbing,
sciatica pain down my right leg and numbness
and tingling in my foot. Doctors told me my
Sciatica was caused by Degenerative Disc Disease. I
tried chiropractic and physical therapy with only
minimal relief. Sometimes the physical therapy
actually made it worse. After beginning the spinal
decompression treatments the pain is now gone. My
back was always sore and stiff. Now it feels much,
much better. Overall, this program worked
wonders for me and I hope it will for everybody.”
~ Tim S.

88. “I was diagnosed with a Lumbar Disc Herniation…”
“I was diagnosed with a Lumbar Disc Herniation after
a weight lifting injury….On a scale of 1 to 10,
the pain was a 7. I tried Chiropractic care, pain
meds, exercise and an inversion table. Seriously,
nothing helped. I decided to take matters in my
own hands, and found Spinal Decompression
online… My recovery process has been both fast
and enjoyable. As a result of my treatment, I
now enjoy daily exercise, time with family and
can finally sleep soundly at night!”
~ Chase G., Age 17

89. RenuvaDisc
• Prone/Supine
• Lateral Flexion/Rotation
• “Workhorse”
• Very reliable
• Most Effective table
• Easy to ship, install, fix

90. RenuvaDisc
• Treats Supine AND Prone
• Treats Lateral Flexion AND
Rotation
• Patient Entertainment
System
• Pre-Programmed Protocols
• Separate Cervical and
Lumbar Motors

91. RenuvaDisc Elite
• “Cadillac” of
decompression
• 10 Way Cervical
• 10-Way Lumbar
• 9+ Pre Programmed
Protocols

92. RenuvaDisc Elite
• Only table in the world
to treat by distance