Spine Conditions

Should We Be Cementing Fractured Back Bones?

This is an interesting blog for me to write. On the one hand, I have colleagues that perform vertebroplasty to treat thoracic compression fractures and say that it can be amazing, older people get rolled in and walk out. On the other hand, the idea of bone cement, an artificial substance to glue bones back…read more

Don’t Expect to Toss the Opioids After Spinal Fusion

Most patients I speak to who are contemplating a spinal fusion for low back pain believe that their pain will be solved and that they will be able to stop using narcotics. However, what if that wasn’t remotely true? Would they still sign up for this invasive and potentially dangerous surgical procedure? New research suggests…read more

Treating the Functional Spinal Unit: Time to Get Rid of the Pain Generator

Interventional pain medicine teaches us that we need to find what I call “the magic pain generator.” Meaning we have a whole specialty of physicians (which used to include me) whose focus is trying to find one structure in the spine that’s causing most of the patient’s spinal pain. However, while sometimes this can be done,…read more

This Is SO Wrong: Neck Fusion Gone Bad

I have had about enough of my spine-surgery colleagues who perform a single fusion that doesn’t work and then keep digging the proverbial hole deeper and deeper by performing more fusions. Case in point this morning is a poor middle-aged woman with her whole neck fused! Now she’s miserable and has complications related to the…read more

Fusion Surgery No Better than No Surgery

Does fusion surgery work? I have blogged before about the research showing that this surgery is often no better in the long-run than no surgery. However, I’ve also pointed out that surgeons have a way of interpreting data in studies that benefit their preconceived notions of efficacy. Today’s blog is about one such study which…read more

Our New C0–C1 Facet Injection Paper

This past decade, a big change has occurred in neck facet-joint treatment. The art of injecting something into a facet joint has become slowly extinct, while the procedures to perform nerve ablation of painful neck joints have ramped up. This has caused a real problem as newer regenerative-medicine techniques involving stem cells and platelet rich…read more

An Update on Our Novel Alar and Transverse Ligament Injection Procedure

Way back when my career was just starting, I got a job with a physician who was involved in auto-accident managed care. This meant that there was a steady stream of neck-injured patients. While many of these patients could be helped, some couldn’t. While it would be attractive to say that these few had psychological…read more

How to Avoid Discography Side Effects: Biologic Discography

Frankly, until we became the first in the world to inject stem cells into discs, discography never made much sense to me. I would tell patients, “I’m going to poke a hole in your disc to see if there’s a hole in your disc.” However, when we began to see that platelet rich plasma and…read more