Minimally Invasive Procedures

Interventional Spine Physicians Finally Get the Memo on Bupivacaine

It would be hard for most people to believe that we’ve known for more than a decade that a long-acting anesthetic called Bupivacaine is toxic to cartilage and yet in interventional pain management, it’s still the most widely injected anesthetic into joints. Why that disconnect exists says much about the problems in modern medicine, but…read more

Is an In-Office Orthobiologics Lab a Good Thing?

There has been an explosion of in-office labs these past several years which like many things in orthobiologics, is something Regenexx pioneered. Sometimes doctors place pictures on Linkedin and I see stuff that’s glaringly bad. This brings up a point. If I can see things in the background of a Linkedin glamor post, what else…read more

What Dual Axis C-arm Fluoroscopy Can Teach Us About Image Guidance

At our Colorado HQ site, we recently brought in dual-axis fluoroscopy. What’s that and what can that teach us about the critical importance of imaging guidance in interventional orthobiologics? Let’s jump in. What is Fluoroscopy? Fluoroscopy is a live x-ray technology. It’s part of the one-two punch of imaging guidance technologies that are required equipment…read more

Big Procedures, Big Problems. Little Procedures, Little Problems

I’ll never forget my brother-in-law’s comments when our kids were young. Having older kids at the time, he told us, “Little kids, little problems. Big kids, big problems”. Today I’ll modify his advice to “Big procedures, big problems. Little procedures, little problems”. Let’s dig in. The Trend Towards Minimally Invasive Care Minimally invasive in medicine…read more

Minimally Invasive and Maximally Destructive

One of the things that I am increasingly uncomfortable with is the new and manifold ways my colleagues are finding to permanently destroy tissue using minimally invasive procedures. What I mean is that there is a trend to take destructive surgeries and turn them into procedures that can be performed by pain management physicians using…read more

Torn Ankle Ligament Surgery: The Hammer and the Nail Effect

Do you really need torn ankle ligament surgery? Most of the time the ligament isn't as torn as you were lead to believe...

Treating Rotator Cuff Tears with Stem Cells, Not Surgery

I love treating shoulder rotator cuff tears with precise injections of bone marrow concentrate which contains stem cells. This patient was a weightlifter with a high-grade tear who wanted to avoid surgery and get back to powerlifting. He just sent us a video of his progress, lifting more weight without surgery than most can ever…read more

Radiology Instructions for X-ray Based CCI Imaging

Dear radiology tech, This patient may have craniocervical instability and needs a specific set of images. These are broken into two types: Flexion-extension radiographs at the maximum range of motion Open mouth lateral bending views with a maximal ear-to-shoulder range Instructing the patient to look down slightly and look up slightly or to slightly bend…read more