Plano Clinic
2301 Marsh Lane, Suite 300
Plano, TX 75093
transcutaneous lumbar disc resection spine surgery

This minimally invasive spine procedure can be done in place of a complex spinal fusion or laminectomy.

back pain spine specialist

Dr. Richard Marks has provided advanced surgical care to relieve back pain in more than 5,000 discs.

back pain

Dr. Marks has performed more Transcutaneous Lumbar Disc resections than anyone in the U.S.

Common Types of Kneecap Trauma

Kneecap TraumaThere are two main types of kneecap trauma – dislocations and fractures. While these types of injuries are rare, the can be extremely painful and require immediate treatment. Here is some information on each type of trauma and common treatment options.


The kneecap is a bone similar in shape to a triangle that is located at the front of the knee going. It is designed to slide up and down but not sideways. Strong ligaments hold it in place – in fact, the cartilage located at the back of the kneecap (or patella) is the thickest found in the body. When a dislocation takes place, the kneecap is pushed out of its correct location.

This form of kneecap trauma occurs when a great deal of force is applied to the area, such as during a car accident or a severe fall. However, it can sometimes happen when the patella is twisted awkwardly – usually during some sort of sports activity.

A dislocated kneecap needs to be put back in place as quickly as possible. Once that is done, the patient typically experiences a great deal of pain, instability and weakness in the area. Physical therapy is vital to helping a patient to regain strength and stability and to also help prevent future dislocations.


A fracture of the kneecap is usually caused by a fall from a substantial height or a direct blow. In some cases there is a single break but in others the patella can break in to several pieces. There are some instances where a fracture can be treated through non-surgical means. A patient will probably need to wear a brace of about 4-6 weeks and go through a gentle rehab program. If a fracture is severe, however, surgery will be needed. Screws, wires and pins will be inserted to hold the patella in place. Healing usually takes place within three months and patients typically return to full activities within 4-6 months.

If you suffer any sort of kneecap trauma, talk to Plano orthopedic surgeon Richard A. Marks. Call our office at 972-301-2866 or contact us online to schedule an appointment.

When to See a Doctor for Neck Pain

neck painNeck pain is a common occurrence, and can affect many places on the body from the tops of the shoulders to the bottom of the head. In some instances, it can even spread to the arms or upper back. While many types of neck discomfort will not require medical assistance, there are other times a person will need to see a doctor. Here are some of the ways to tell when you may need to seek medical help in order to have your neck problem addressed.

When to Call 911

If neck pain is severe or accompanied by tingling, numbness or arm weakness, then you should call 911. These are other instances where immediate medical assistance will be necessary:

  • Neck pain occurs along with nausea, shortness of breath, chest pain or other symptoms associated with a heart attack.
  • You have suffered an injury in a car accident or a fall and you are showing signs of a spine injury
  • You are unable to move any part of your body.

When to Visit an Orthopedic Specialist

Other instances of neck pain, while not necessarily an emergency, will need to be addressed by an experienced orthopedist. These include:

  • Numbness in the legs or buttocks
  • Loss of bowel or bladder control
  • Long-term neck pain has suddenly worsened for no apparent reason
  • The pain is so severe it wakes you from your sleep

Contact Us About Neck Pain

Please visit the office of Dr. Richard Marks to schedule an examination for any neck pain you may be experiencing. Dr. Marks will thoroughly check to see the possible reasons for your discomfort and then determine the best plan of treatment. Contact us online or call us at 972-301-2866 to set up an appointment.

Tips to Avoid Knee Pain When Running

knee painNo matter how much or run – or how often you run – the risk of developing knee pain is always present. Running is hard on knee joints, whether you’re just out on your daily jog or you’re undergoing intensive training for a marathon. Here are some of the things you can do to reduce the chances of being hurt.

Be Selective in Your Footwear

Choosing the right shoes is critically important when it comes to reducing knee pain when running. Not only is the proper amount of cushioning a must, you also need to find a shoe that fits correctly. Pay special attention to getting the right width of shoe. Also, since many types of running shoes on the market today don’t provide a great deal of support, you should consider buying a quality insert. The best ones are a bit stiff; if you can bend it very easily, that is a sign it won’t give you the support you need.

Don’t Forget to Stretch

You simply cannot underestimate the importance of stretching before your run – not only is it good for your knees, it will help several other areas of your body. In addition to reducing the chance of developing knee pain, it can also help protect against injuries such as shin splints, hip problems and foot cramping.

Know Your Limits

Far too many runners overdo it and pay a significant price as a result. As soon as the weather becomes consistently warm, they immediately start running long distances. Start out slowly and gradually build yourself up to long runs. If you are a serious runner, make sure you rest at least a day or two each week.

Dr. Richard A. Marks is a Plano orthopedic surgeon who has a great deal of experience treating knee pain. If you would like to schedule an appointment, call our office at 972-301-2866 or contact us online.

Staying Active to Avoid Back Pain

back painBack pain can result from both overexertion and leading a sedentary lifestyle. One of the best ways to avoid this problem is by remaining active without overdoing it. These are just some of the best activities that can help you avoid experiencing discomfort.

Get Out and Enjoy

Swimming is a great activity to help people avoid having to deal with back pain. While it may not sound that exciting to swim laps, doing so requires you to use just about all of your muscles – your back muscles especially. Running is also excellent, not just for your overall stamina but for your posture as well; poor posture is one of the leading causes of back issues.

One of the best types of exercises to help reduce the chances you’ll experience back pain is biking. It does not jar the spine like other activities, and stationary biking is very gentle on your spine. Golf is another low-impact activity that can help your posture – as long as you walk the course and don’t ride in a cart. Just try not to play too much or you could develop back issues due to excessive twisting.

Before the Workout

Whatever your activity of choice may be, just make sure you follow the proper warm-up routine first. This will help your muscles get ready for the workout you are getting ready to put them through. Stretch your hamstrings, calves and triceps, and also rotate your back and waist to increase your range of motion. Use simple movements to get the blood flowing and gradually increase the intensity to loosen muscles further. You also want to practice before you play. For example, gently swing the club a few times before you tee it up for real, and try a little “phantom swinging” before you actually dive in the pool.

If you are experiencing back pain, Plano orthopedic surgeon Dr. Richard A. Marks. can help. Our office provides a wide range of both non-surgical and surgical options to treat a variety of conditions. Contact us online or call 972-301-2866 to schedule an appointment.

Arthroscopic Meniscus Tear Surgery – What to Expect

Arthroscopic Meniscus Tear SurgeryArthroscopic meniscus tear surgery is becoming an increasingly popular option to repair torn cartilage. In many instances, it is performed on an outpatient basis using a range of minimally invasive procedures. If you have suffered an injury, here is some information on what you can likely expect should you need to have surgery.

The type of surgery used will often depend on the area of the knee where the tear is located, the size of the tear, and other factors. In addition, your doctor will take your health, activity level and age into account.

How it Works

Arthroscopic meniscus tear surgery uses a thin tube known as an arthroscope that contains a light and a camera. The surgeon makes small incisions in the area and then inserts the arthroscope. Surgical instruments are then inserted through additional small incisions and then the meniscus is repaired using anchors or sutures.

The Recovery Period

There is a chance your surgeon will ask you to move your knee as little as possible for about two weeks after your arthroscopic meniscus tear surgery takes place. Then, you may be somewhat limited for another two weeks before you can get back to your regular, daily activities. However, your doctor may recommend that you begin physical therapy as soon as your surgery is done. Any sort of heavy activity, such as intense exercise or extended running, should be postponed for a few months. In order to heal in the most efficient manner possible, it will be very important that you follow your doctor’s rehabilitation directions to the letter.

In time, arthroscopic meniscus tear surgery should help your knee return to normal. An added benefit is that it could help prevent long-term issues such as osteoarthritis.

Plano orthopedic surgeon Dr. Richard A. Marks has extensive experience in performing arthroscopic meniscus tear surgery. He will thoroughly explain the type of procedure you may need so that you are as well informed as possible before your surgery. If you would like to schedule an appointment, contact our office online or call 972-301-2866.

Physical Therapy for Knee Pain

knee painPeople who suffer from knee pain can either have the problem surgically repaired or pursue non-surgical options. Physical therapy is one way to reduce pain and restore strength, and has proven very effective for a large number of people. If your doctor recommends this alternative, here is some information on what you can expect.

Getting Started

Before you start your physical therapy program for your knee pain, the therapist will probably ask you a lot of questions about your medical history. Your therapist will not just have your knee condition in mind, but your overall health as well. Once your sessions begin, he or she should always be nearby making sure you can get through the exercises – the therapist should not simply assign you an exercise and then leave.

You’ll be shown the correct form in order to perform whatever work your therapist asks you to do. He or she will continue to ask how you feel and what level of knee pain you are experiencing. More than likely, you will attend sessions two or three times a week, and your therapy will probably last anywhere from 3-6 weeks. The more severe your issue, of course, the longer your therapy will likely last.

You may also receive other treatments in order to reduce your pain. These may include ultrasound therapy to stimulate your muscles and increase blood flow, as well as alternating ice and heat treatments.

Extra Help

There is a chance that your doctor will recommend you use a supportive aid such as crutches while you are going through therapy. You may use a cane or you may need to wear a brace in order to provide further support. It’s extremely important that you learn to use whatever type of aid is recommended correctly so that you don’t risk further injury.

The Dallas area experts at the office of Dr. Richard A. Marks can help alleviate your knee pain so you can once again pursue the activities you love. Give us a call at 972-301-2866 or contact us online to learn more.

How to Choose an Orthopedic Surgeon

Tips to Help Make Your Decision Easier

Orthopedic SurgeonEven if your primary doctor refers you to an orthopedic surgeon, that, of course, doesn’t mean you are required to go to him or her. It can be fairly complicated to choose one on your own, but you need to do some research before making a commitment so you can feel as comfortable as possible. Here are some tips that can help make that decision much easier.

Ask Around

Talk to any friends or family members who may have recently treated by an orthopedic surgeon and see if they would recommend that doctor. Ask them what type of experience they had, and whether or not they would trust him or her to perform another procedure. If someone you trust gives you advice, odds are it will be good advice.

Do Some Homework

You can find a great deal of information about the surgeons you are considering just by performing some basic Internet research. You’ll find plenty of sites that offer Internet reviews, and they can give you a good idea of what kind of treatment you will be able to expect. However, don’t take those reviews at face value – many of them could be exaggerated or fabricated, and posted by people who have their own agendas.

Schedule a Consultation

Once you’ve narrowed down your choices to two or three surgeons, schedule a time to get to know each one of them. This is probably the most important thing you can do to ensure you make the right decision. Prepare a list of questions, and bring it with you if necessary. Also, bring a spouse, friend or family member with you to make sure the right questions are asked.

Finally, once you’ve done your research and finished your consultations, trust your instinct and choose the orthopedic surgeon you feel most comfortable with. You’ll find that a little digging beforehand can provide you with a much more confident feeling going into your procedure. If you have any questions concerning the process or you would like to schedule a consultation with Dr. Richard A. Marks, call our Richardson office at 972-301-2866 or contact us online. We’re just a short drive away, whether you live in Richardson, The Colony or anywhere else in the area.

Dr. Marks Pioneers Exciting Spine Procedure

Breakthrough in Spine Surgery

One of the most exciting advances in minimally invasive spine surgery is Dr. Marks’ Transcutaneous Lumbar Disc Resection procedure. It is an advanced method of repairing discs that are injured, whether by trauma or wear and tear. Injured discs may be described as herniated, bulging, slipped, cracked, ruptured, protruding, dessicated, or “dark” on MRI scans.

Richardson Doctor Develops Minimally Invasive Surgery

spine surgery in richardson txThis spine surgery technique was originally developed to allow athletes to return to their sport in the quickest amount of time with the least long-term restrictions or risks. Dr. Marks began using the procedure with its original instrumentation soon after its inception in the mid 1980s, but for more than just the athletic subgroup of patients. He performed the minimally invasive surgery on patients for whom traditional open spine surgery was not an option. Some patients were afraid of risks or complications related to open surgery itself; others were fearful of anesthesia. Some were too sick to undergo a general anesthetic or too osteoporotic to consider spinal fusion.

The reasons varied, but Dr. Marks soon saw this newly available technique was effective in well over 50% of the patients who had exhausted every other option. His indications broadened, and the number of patients seeking his expertise in the emerging field of minimally invasive lumbar spine surgery grew rapidly. It soon became apparent (and futher documented in a paper published in Southern Medical Journal vol. 97, issue 8) that this outpatient procedure was significantly decreasing debilitating back and/or leg pain in at least four out of five patients.

Now, Dr. Marks has performed this surgical procedure on more than 6,000 discs. Using proprietary tools that have been specially crafted for this procedure, his experience represents him having done significantly more of these minimally invasive techniques than anyone else in the United States.

What is Transcutaneous Lumbar Disc Resection?

Transcutaneous Lumbar Disc Resection is a better alternative to spine surgeries such as a complex spinal fusion or a laminectomy. The injured disc or discs are entered through what is known as a lateral extraforaminal approach so that a small amount of the shock absorbing disc, the nucleus, can be removed. This decompression is meant to minimize the painful pressure on the internally cracked disc, as well as the surrounding nerve tissue. This minimally invasive spine procedure is performed in an outpatient setting. The patient is asleep under the influence of IV (intravenous) analgesia, also referred to as “twilight sleep” as opposed to a general anesthetic that requires inserting a breathing tube. Patients often awaken much improved and need only days to fully recover (rather than weeks or months).

Are You a Candidate for Spine Surgery?

While this surgery has had tremendous success, not everyone is a proper candidate. Dr. Marks and his team will want to perform a complete examination to determine if you are a candidate for this surgery.

For more information about transcutaneous lumbar disc resection and other spine surgeries in Richardson, contact us online or call 972-301-2866.