"The Headache Line"
(239) 449-3090
Telephone: (239) 566-3434
Fax: (239) 566-2143
1660 Medical Boulevard
Suite 200
Royal Palm Medical Building
Naples, FL 34110

Physicians:

Michael Vickers, M.D.,
Thomas Morell, M.D.,
Joseph Kandel, M.D.,
F. Desmond Hussey III, M.D.,
Igor Levy-Reis, M.D.,
Michael Novak, M.D.,
Dr. John Wilson, M.D.,
Christopher Wey, M.D

In 1996, a group of experience neurologists and neurosurgeons joined together to establish Neuroscience & Spine Associates.

As Southwest Florida's leading practitioners in neurology, neurosurgery, rehabilitation and diagnostics, their combined resources and expertise provide patients with the highest quality, most technologically advanced medical care.

Our medical team has more than 120 years combined experience, and the doctors are board certified specialists in their field. Many of our physicians are also published authors and they are frequently invited to speak at medical conventions and symposia.

Known for the highest quality patient care, the doctors and staff at Neuroscience & Spine Associates treat patients as individuals, listening to them carefully and treating them with compassion and expertise.

Care, compassion and expertise are the hallmarks that have made Neuroscience & Spine Associates Southwest Florida's leading neuroscience specialty team.

Physicians:
Thomas Morell, M.D.,  Joseph Kandel, M.D.,  Mark Gerber, M.D.,  Michael Lusk, M.D.,  Michael Novak, M.D.

At Neuroscience & Spine Associates, we have developed special expertise to ease the pain associated with disorders of the spine.

Our professional staff develops programs to help patients increase muscle strength and the structural integrity of the spinal column. 

The increased strength eases immediate spinal discomfort and reduces the risk for later re-injury. Customized programs may include:

• Initial testing
• Regimented series of therapeutic exercises
• State-of-the-art rehabilitative equipment exclusively at Neuroscience & Spine Associates in SW Florida
• Flexibility training
• Complete diagnostic and rehabilitative procedures by certified professionals
• Comprehensive neurological evaluations and treatment plan
• Safe and effective re-conditioning
• Instruction of proper body mechanics and activities of daily living
• Strengthening exercises with continuous computer evaluation
• Myofascial trigger blocks
• Facet blocks, Epidural steroid injections, rhizotomies
• Educational seminars, books, videos
• Rehabilitation programs
• Surgery

Telephone: (239) 594-8002
Fax: (239) 594-3447
877 111th Avenue North
Suite 1
Naples, FL 34108

Physicians:
Dr. John Wilson, M.D.,
Michael Vickers, M.D.,
Michael Novak, M.D.,
Joseph Kandel, M.D.,
Igor Levy-Reis, M.D.,
Jan Malat, M.D.,
Christopher Wey, M.D.


Not all MRI machines are created equal

MRI (magnetic resonance imaging) 
When protons are placed in a magnetic field, they become capable of receiving and then transmitting electromagnetic energy.  The strength of the transmitted energy is proportional to the number of protons in the tissue.  Signal strength is modified by properties of each proton's microenvironment, such as it's mobility and the local homogeneity of the magnetic field.  MRI signal can be "weighted" to accentuate some properties and not others. 

When an additional magnetic field is superimposed, one which is carefully varied in strength at different points in space, each point in space has a unique radio frequency at which the signal is received and transmitted.  This makes constructing an image possible.  It represents the spatial encoding of frequency, just like a piano.

Neuroscience & Spine Associates has the latest state-of-the-art magnetic resonance imaging technology., featuring:

• Most advanced MRI in Southwest Florida for your peace of mind
• Spacious, wide body open design for the utmost comfort
• Leading high field technology from Philips provides unparalleled speed and an extremely accurate diagnosis
• Expertise of Southwest Florida's leading neurologists for top medical care
• Friendly, professional staff puts you at ease
• Flexible hours to fit your schedule
• Convenient location for easy access just off U.S. 41 in Naples

Telephone: (239) 566-3434
Fax: (239) 566-2143
1660 Medical Boulevard
Suite 200-Royal Palm Medical Building
Naples, FL 34110

Physicians:
Michael Vickers, M.D.,
Christopher Wey, M.D

Some patients describe a balance problem, or disequilibrium, characterized by dizziness, lightheadedness or a sense of being unsteady.

When a feeling of turning or spinning is associated with this condition, it is called vertigo. 

Patients who have these symptoms may have to undergo a series of examinations to determine the
cause.

The sense of balance is maintained by a complex interaction of the following parts of the nervous system:

• inner ears
• eyes
• skin pressure receptors
• muscle and joint sensory receptors
• central nervous system (brain and spinal cord) which process all the bits of information from the four other systems.

Once we have checked for injury or infection, our neurologists sometimes have to investigate further for diseases of the nerves that affect balance: multiple sclerosis, tumors, etc. The physician will examine the patient's ear, nose and throat and then do tests of nerve and balance function. He/she might order skull x-rays, a CT or MRI scan of the head. Recommended treatment will be based on the diagnosis.

Telephone: (239) 449-3090
1660 Medical Boulevard
Suite 200
Naples, FL 33104

Physicians:
Dr. John Wilson, M.D.,
Joseph Kandel, M.D.,
Michael Novak, M.D., |
Christopher Wey, M.D.,
Michael Vickers, M.D.,
Igor Levy-Reis, M.D.,
F. Desmond Hussey III, M.D.

Neuroscience and Spine
Associates has opened Southwest Florida's only full-service headache
treatment center, offering:

• Complete headache evaluation & diagnosis
• Customized treatment plan including drug therapy, nutrition counseling & lifestyle programs
• Emergency migraine clinic therapist available during office hours, evenings & weekends at onset of symptoms
• Botox(TM) Treatments

NASA Licensed Physical Therapists are highly skilled in evaluating and treating patients with neurological dysfunction and other types of disease, injury and illness. 

Treatment may be long or short term depending on your physicians care plan and prescription. 

Our physical therapists work closely with your physician to ensure rapid progress and results you can attest to for better quality of life. 

.  Manual Therapy
.  Joint Mobilization
. Myofacial Release
. Gait and balance training
. Strengthening and Conditioning Programs
. Postural re-education
. Home Exercise Programs
. Modalities including ultrasound, electrical stimulation, heat and cold pack   and paraffin.
  Trigger point massage, vestibular rehabilitation

Physical therapy offers a variety of benefits including:

• Increased range of motion
• Increased strength and stability
• Decreased pain
• Improved mobility and function
• Patient Education

We offer Physical Therapy Services at both our
Naples and Fort Myers Locations.

Telephone:  Ft. Myers (239) 437-1121 ***Naples (239) 514-1708

Massage therapy helps the body to relax and recover from stress and strain.  Our licensed massage therapists may use a variety of massage modalities in a session to achieve the best results.

NASA offers several different types of massage.  The three most commonly used are;

•  Swedish---This type of massage is to relax and energize the body

•  Deep Tissue---Utilized for muscle damage from injury or disease

•  Chair---For the upper body only

Occupational Therapy

Our licensed occupational therapy team is geared toward the physical well being of our patients. 

Our therapists concentrate on physical, psychological, social and environmental factors that are restricting function and a return to normal activities. 

Occupational Therapy offers a variety of benefits:

•  Increased range of motion
• Increased strength and stability
• Decreased pain
•  Increased physical well being
• Increased fine motor skills
•  Patient education

Occupational Therapy is available in our Naples location only
239-514-1708

An electroencephalogram (EEG) is a test used to detect abnormalities related to electrical activity of the brain. This procedure tracks and records brain wave patterns. 

Small metal discs with thin wires (electrodes) are placed on the scalp, and then send signals to a computer to record the results. 

Normal electrical activity in the brain makes a recognizable pattern.  Through an EEG, doctors can look for abnormal patterns that indicate seizures and other problems such as sleep disorders and changes in behavior.

Electromyography, or EMG, involves testing the electrical activity of muscles. 

Often, EMG testing is performed with another test that measures the conducting function of nerves. This is called a nerve conduction study.

Because both tests are often performed at the same office visit and by the same personnel, the risks and procedures generally apply to both tests.

Muscular movement involves the action of muscles and nerves and needs an electrical current.  This electrical current is much weaker than the one in your household wiring. 

In some medical conditions the electrical activity of the muscles or nerves is not normal.  Finding and describing these electrical properties in the muscle or nerve may help your doctor diagnose your condition.

EMG may aid the diagnosis of nerve compression or injury (such as carpal tunnel syndrome), nerve root injury (such as sciatica), and with other problems of the muscles or nerves.  Less common medical conditions include amyotrophic lateral sclerosis, myasthenia gravis, and muscular dystrophy.

What is Med X? How does this work?

Poor muscle function is often cited as a risk factor for back and neck pain. It has been documented that up to 80% of all back and neck pain is caused by weak muscles and not structural lesions. How ever, patients with lower back or neck pain usually avoid activities that cause pain-resulting in disuse atrophy, increased weakness and consequent instability of the spinal column, this often leads to increased pain independent of the original pain stimuli.

Various treatment techniques have been utilized to improve function in the individuals who are plagued with chronic low back and neck pain. However, only one treatment has been branded as effective to treat chronic spine pain. That treatment is aggressive exercise targeting the lumbar and cervical extensor muscles. There is paucity of data to determine the long term effect of this treatment and what type of exercise will produce the highest decrease in pain while improving function with routine daily activities.

The effective assessment and training of the lumbar and cervical extensor muscles require stabilization of synergist muscles in order to isolate the fore mentioned. Through a series of restraints, lumbar and cervical extension machines minimize the contribution of the larger and stronger synergist muscles and site specifically targets the extensors. In addition, standardization of the testing and training position, Correction for the influence of gravitational forces (body weight) during testing and training, and full range of motion measurement are also required for accurate quantification of lumbar and cervical extension strength.

Arthur Jones developed the first exercise machines that accomplished this task. The Medx tool is well documented in the research and is designed to specifically exercise the lumbar and cervical muscles through restraint systems designed to stabilize the pelvis and the torso, respectively. Numerous studies indicate that by strengthening the atrophied and/or injured muscles a reduction in pain will follow. The purpose of this study was to determine the changes in functional ability after 12 weeks of lumbar and cervical reconditioning using the MedX tool to strengthen the spinal extensor muscles.

The lumbar and cervical machines were developed to accurately measure full range of motion lumbar and cervical extension strength. The LEM machine was designed to stabilize the pelvis and standardize positioning of the upper body, thus allowing foe more precise measurement and training of the smaller and weaker lumbar extensor muscles. The CEM machine is designed to stabilize the upper torso, more specifically the upper chest and shoulders, allowing for measurement and training of the cervical extensor muscles. Patient strength capabilities are based on their static (isometric) testing efforts.

Our MedX program combines site specific exercises that are designed to increase strength and ROM of the muscles, resulting in decreased pain and increased function. Functional ability is constantly changing. The body responds to recent demands, so if you don’t use it you will lose it. Unfortunately, after the initial injury occurs (usually because of the soft tissue weakness) the muscles surrounding the initial injury site will contract, holding the body in place. Removing the need for the other muscles to work and there for becoming atrophied. Passive ROM and callisthenic type exercise programs are popular in rehabilitative settings and have been reported to alleviate the symptoms of LBP. Unfortunately, such programs do not provide PRE for the lumbar musculature and thus are limited in their ability to increase lumbar strength.

The MedX reconditioning protocol follows the standards suggested by the University of Florida and the MedX study physicians. Patients are treated on a bi-weekly basis, with a
2-3 day, period of rest and recovery between appointments. During the recovery period the patients are instructed to perform home stretches and use ice for inflammation r soreness. The NASA MedX protocol suggests 16-24 visits over a 12-13 week period. Every 4-5 weeks or 8 visits the patient are re- evaluated to discuss goals and symptoms. The patients are encouraged to follow up with the referring physician every 4-5 weeks to discuss MedX report and progress.

Therapeutic exercise is a very important part of the MedX reconditioning program. Each candidate follows a standardized stretching protocol, under the supervision of our exercise therapist. Patients are instructed to perform stretches 2-3 times daily or as their symptoms and schedule permit. A warm up using a recumbent bike for 8-15, minutes is performed prior to stretching exercises and MedX. The final 8-12 visits the patients are shown strengthening exercises using dumbbells, Lat Pull machine, and ankle weights. The goal is to have our patients prepared for an adult’s fitness program upon completion of protocol.

Post surgical protocols are also in place for lumbar and cervical MedX reconditioning. The patient is placed under strict guidelines for ROM, Strength, and pain tolerance. The goal is to improve movement and restore function.

The MedX reconditioning program is not for everyone. The several visits can cause a increase of muscle soreness, and overall a increase in pain symptoms. However, with the encouragement of the therapy staff, and a positive reinforcement most patients find that the effort was worth it. If your patients are unable to tolerate the MedX program, less aggressive therapeutic exercise program is also available 2-3 times a week. MedX in combination with massage therapy or physical therapy has shown to be more tolerable.

The rehabilitation staff is looking forward to providing you with more therapeutic care options. Under the supervision of our professional therapy staff, the safety and well being our patient’s is our main concern. Please consider MedX reconditioning or therapeutic exercise options in the future.