Spine Surgery

A Video Blog on Neck and Back Surgery Causing Instability

I saw a patient this week who has evidence of severe neck and back instability due to surgery. The issues were better explained with a video than a blog, so here’s that video case presentation:

The Artificial Disc Replacement Hustle

Medicine is often more about marketing than reality. One area where masterful marketing has overtaken reality is the promise of an artificial disc. Let’s explore the hype and the reality today. The Promise of the ADR Both fusion and disc replacement surgery are performed in patients with DDD (Degenerative Disc Disease). DDD is when the…read more

The Curious Case of the Bad Artificial Disc

I often write about what I experience day in and day out in the clinic. The case this morning is of a patient who had an Artificial Disc placed and developed new pain. After a few in-clinic x-rays, a problem with the disc was discovered. So let’s use this opportunity to review the concept of…read more

Does Low Back Surgery Cause Damage to the Fascia? What Is the Fascia?

Your muscles are surrounded by something called fascia. This structure commonly gets injured in low back surgery. What is fascia and why should you care if yours is injured? Let’s dig in. What Is Fascia? Fascia covers our muscles and contains them. Look at the diagram above. The muscle is surrounded by a thick fascia.…read more

When IPM Is Worse than Spine Surgery

I’ve blogged a few times on the idea that some Interventional Pain Medicine clinics are becoming as bad as the surgeons they have long criticized. Case in point this morning is an x-ray shared by a radiologist. If a picture is worth 1,000 words, this one is worth 1,001. Let’s dig in. IPM IPM=Interventiopnal Pain…read more

Why Are Interventional Pain Physicians Becoming Spine Surgeons?

We’ve all started attending in-person conferences again while some are still virtual. Having not been doing this for two years, one of the things that startled me was the number of booths selling percutaneous fusion devices to interventional pain physicians. So what’s up? Is this a good or a bad trend? What Is an Interventional…read more

Do You Really Need that Low Back Fusion?

Low Back Fusion has become one of the most common surgical procedures performed in the US, despite very poor evidence that it’s better than not doing any surgery. One of the big issues that often comes up for patients who have a condition called Degenerative Spondylolisthesis is whether they need a Fusion or can just…read more

Surgery for Tethered Cord in Adults?

One of the trends I have seen these past few years is a number of people getting diagnosed with a tethered cord and getting surgery for this issue. So what is this and why would surgery be needed? Are these patients getting needed procedures or exposing themselves to serious risks they don’t need to take?…read more