Dr. Nugent is a licensed, board-certified spine and orthopedic surgeon specializing in consultation, evaluation, and management of spine and orthopedic injuries. He has been in practice in Fresno since 1991. He established the Spine & Orthopaedic Medical Center in 1998. Dr. Nugent has admitting and surgical staff privileges at the Fresno & Clovis Community Hospitals, Saint Agnes Hospital, and the Fresno Surgery Center.

Dr. Nugent received a Phi Beta Kappa and Summa Cum Laude Bachelor of Arts undergraduate degree in Biology from the University of California in Los Angeles, California. He received his medical degree from the University of California in Los Angeles, California. He completed his internship in general and orthopedic surgery at the University of California Medical Center in Los Angeles, California. He completed his residency in orthopedic surgery at the University of California Medical Center in Los Angeles, California. He is a Spine Surgery Fellow with the Johns Hopkins Hospital in Baltimore, Maryland. He completed a research fellowship on Joint Replacement at the University of California and the Sepulveda Veterans Administration Medical Centers in Los Angeles, California.

Dr. Nugent published, "Surgical Treatment of Spinal Tumors" in Spine Care. He also authored "Results of Core Decompression for Femoral Head Osteonecrosis," "Comparison of In Vivo Cementless Acetablular Fixation," and "Results of Cemented to Cementless Revision Total Hip Arthroplasty" in Orthopedic Trans. He also co-authored "Intertransverse Process Lumbar Arthrodesis with Allogeneic Fresh-Frozen Bone Graft" in Clinical Orthopedics, "Degenerative Spondylolisthesis" in Current Opinion in Orthopedics, "Electromagnetic Metal Localization for Removal of Retained Hardware in Children" in Journal of Pediatric Orthopedics, and "Hip Anthroplasty with Clinical Implications" in Orthopedic Clinicians of North America.

Dr. Nugent has given presentations on "Osteoporosis Testing in Orthopedic Practice" at the North American Spine Society in Kemeula Hawaii, "Treatment of Adult Idiopathic Scoliosis with Cotrel-Dubousset Instrumentation" at the American Academy of Orthopedic Surgeons in San Francisco, California, "Electromagnetic Metal Localization for the Removal of Retained Hardware" at the 25th Annual Western Orthopedic Association Meeting in Dana Point, California, "Results of Cemented to Cementless Revision of Total Hip Arthroplasty" at the American Academy of Orthopedic Surgeons Residents Conference in Rochester, New York, "Results of Core Decompression for Femoral Head Osteonecrosis" at the American Academy of Orthopedic Surgeons in Atlanta, Georgia, "Comparison of In Vivo Cementless Acetabular Fixation" at the Orthopedic Research Society in Atlanta Georgia and "Results of Core Decompression for Femoral Head Osteonecrosis" at the American Academy of Orthopedic Surgeons in Salt Lake City, Utah.

Dr. Nugent is a member in good standing of the American College of Surgeons, the American Academy of Orthopedic Surgeons, North American Spine Society, Western Orthopedic Association, California Orthopedic Society, Sequoia College of Orthopedic Surgeons, Fresno Madera Medical Society, Johns Hopkins Medical and Surgical Association, and California Society of Industrial Medicine and Surgery.

Dr. Nugent is currently serving on the following committees: "Coding and Practice Management Educational Task Force" for the North American Spine Society, "Infection Control" for the Saint Agnes Medical Center, and "Practice Management" for the Fresno Madera Medical Society. He has served on the following committees: "California Advantage", "Finance" and "Membership" for the Fresno Madera Medical Society.

Christine Helsby, N.P.

Ms. Christine Helsby is a Licensed Nurse Practitioner.  She received her Bachelor of Science Degree in Nursing from California State University, Fresno, and her Masters Degree of Science in Nursing also from California State University, Fresno.    Ms. Helsby joined the Spine & Orthopaedic Medical Center in early 2008 and is accepting referrals for spine related issues.  Specializing in the evaluation and treatment of osteoporosis and general orthopaedics, she provides an emphasis on services such as pain medication management and physical therapy.

Russell S. Biggers, DPT

Mr. Biggers is a licensed physical therapist and a certified ergonomics assessment specialist. He specializes in evaluation, management, and treatment of spine and orthopedic disorders. He emphasizes body mechanics, and posture training utilizing manual treatment techniques with multiple modalities. Mr. Biggers joined the Spine & Orthopaedic Medical Center in 1999.

Mr. Biggers received a Magna Cum Laude Bachelor of Science degree from the California State University Fresno, California. In addition to holding national certification with the APTA as an orthopedic certified specialist (OCS), he has also received his Doctorate in Physical Therapy from California State University, Fresno. He is a member in good standing with the American Physical Therapy Association.

Mr. Biggers has taught advanced orthopedics for over five years at the Masters level at California State University Fresno. Previous teaching experience includes instruction of Health Nutrition at University of Phoenix.

Mr. Biggers has completed continuing education in "Cumulative Trauma and Ergonomics" at the Back School of Atlanta, in La Jolla, California, "Evaluation and Rehabilitation of the Shoulder, A Multidisciplinary Approach" at the California State University, in Fresno, California, "Training the Patient with Low Back Dysfunction" and "Evaluation and Management of the Cervical Spine" at the Folsom Physical Therapy and Training Center, in Folsom, California. He has completed the year long orthopaedic course "Foundation of Manual Therapy" at Spitzer's Physical Therapy Training Center in Clovis, California.

Mr. Biggers has conducted research and given presentations on "Role Specific Skills and Job Satisfaction in Common Physical Therapy Settings" at the 13th Annual Congress of World Confederation for Physical Therapy in Yokohama, Japan and "Osteoporosis Testing in Orthopedic Practice" at the North American Spine Society in Waikoloa, Hawaii. Publications include The Spine Journal regarding osteoporosis in the orthopedic setting.

Nina Perez, Certified Massage Therapist.

Mrs. Perez attended Golden State College, graduating in 2003 in massage therapy with outstanding knowledge of the human body. She is experienced in Shiatsu, Jen Shin Do, deep tissues, sports massage, reflexology and anatomy. Since graduating, Mrs. Perez has extensive experience in various settings including physician facilities, where she has mastered her techniques of helping patients to overcome their pain.