Patient Safety

Blogging from the Caymans Again after 2 Years!

For many years, every three months I would have a blog where I announced being down in the Caymans. However, due to the pandemic, I haven’t been down here in 2 years as of this month. So let’s dig into what Cayman is all about when it comes to Orthobiologics. Closed for Two Years? It…read more

What Is Procenta? What Is Human Tissue Therapy (HTT)? Why Is a Former Employee Mixed Up in This?

This week, I had a colleague send me information about yet another birth tissue company selling a product for use in treating orthopedic injuries. The sales rep claimed to my colleague that this product, called Procenta, was “FDA Approved” for that purpose. Let’s dig in. What Is Procenta? Procenta is a placental tissue sold by…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

CCI and DMX: Can You Still Have Instability with a Normal DMX? What Is a False Negative?

You can’t beat movement-based imaging for finding Cervical Instability. However, all imaging has a false-negative rate. Let’s discuss that and learn about instability in the process. Let’s dig in. What Is Instability? If you had to choose a single concept of what goes wrong in the spine as the most important thing you should know,…read more

Antidepressants and Back Pain

One of the hot topics in treating chronic pain is that we doctors should prescribe antidepressants. Why? Well as I used to say, many doctors view patients with chronic low back pain as crazy or lazy. Let’s dig into how well antidepressants work for back pain and dig in a bit more about why your…read more

The Steroid and Anesthetic Trick or Treat

I’ve discussed more times than I can count that the high-dose corticosteroids used every day by physicians in joints, tendons, and spinal injections are like a Halloween trick. This morning we’ll go over a survey that shows just how widespread these injections are these days. Let’s dig in. The Survey A survey was taken of…read more

Low Dose Naltrexone and Anesthesia

Over the last 5 years, there has been a HUGE trend towards treating chronic pain patients with what’s called low dose Naltrexone. While some patients find this helpful, it presents a challenge for interventionists like myself, as the increased anesthesia requirements for these patients enhance the risk of procedures. So let’s explore what’s happening and…read more

Is R3 Stem Cell Really an Award Winner?

R3 is a marketing company run by a defrocked orthopedic spine surgeon that has gained lots of attention for flaunting FDA regulations and claims about its private-labeled stem cell products that can’t be verified. Not to be dissuaded, they have now created a host of artificial awards and press releases or what I called the…read more