Author: Dr. Shim:

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Time to Get off the Couch!

You all know that excess weight does lead to more spine complaints.      At the same time,  it takes more than weight control to keep your spine strong and functional.  It takes EXERCISE. In the December 15, 2015 Spine Journal,  a paper by Physical Therapist,  Ulrika Aasa, et al  (Physical Activity Might be a Greater Importance of […]

Poor Surgery Outcomes with Narcotics

In the June 2014 issue of the Journal of Bone and Joint Surgery (American edition),  Dennis Lee, MD and colleagues submitted a Paper titled  “Preoperative Opiod Use as a Predictor or Adverse Postoperative Self-Reported Outcomes in Patients Undergoing Spine Surgery”.  The paper discussed an investigation performed at the Vanderbilt Medical Center in Nashville Tennesee. 583 patients,  […]

Weather and Back Pain

Winter is just around the corner,  and the cold weather is definitely here.  My patients all complain that they have more pain with the cooler temperatures.  While everyone believes cold weather,  and stormy weather contributes to worsening arthritis pain,  the scientific data can be conflicting at times. In relationship to work activities,  some population studies have […]

Why we have Disk Herniations

Today,  I saw a very rare patient.  Why?  Because he is 40 years old,  and his MRI report read “Normal Lumbar Spine.”   After looking at his MRI,  I came to the same conclusion.  There was no evidence of any disk narrowing,  disk dehydration, or bone spur development.  But he had back pain,  from a […]

Still having Pain after Spine Surgery?

Statistically,  most people do improve with spine surgery.  Unfortunately,  some people do not improve,  and a few are worsened. As a Spine Surgeon,  I know many patients want a guarantee of improvement after surgery.   The truth is, THERE CAN NEVER BE A GUARANTEE.  Surgeons can only give chances of success.  As I tell my […]

What is Radiculopathy?

Often times,  physicians use a lot of terms freely with patients,  assuming the patients know what the word means.  Radiculopathy is one of those terms.  In the most simplest terms,  it does mean a pinched nerve in the spine.   It is important to know that radiculopathy really means pinching of the nerves as the […]

Pinched Nerve

Think you have a pinched nerve? A pinched nerve is a common experience for most people over the age of 35.  Usually, it is associated with pain,  burning, or a tingling sensation to either the arms or legs.   While the pinching can occur out the spine, in conditions such as carpal tunnel syndrome, most […]

What is Minimally Invasive Spine Surgery?

Here in Tampa,  we are in a media war over Spine Surgery Services.  It has become a very competitive business,  with many Centers or Institutes deploying expensive marketing teams touting expertise in Minimally Invasive Spine Surgery.  It does sound great.  But what does Minimally Invasive Spine Surgery mean? About 30 years ago,  spine surgery was […]

Does Lumbar Spondylolisthesis and Stenosis need Fusion?

Conventional wisdom says  that patients with known spinal stenosis,  and associated spondylolisthesis should have fusion if having decompression surgery.  The often quoted 1991 paper from Herkowitz and Kurz identified a clinical advantage to perform lumbar fusion for patients undergoing laminectomy for spondylolisthesis with lumbar stenosis. Much research has been geared towards the types of fusions that would give […]

The Chance of Lumbar Discectomy Reoperation

In general appropriate properly selected patients do well with lumbar discectomy surgery.  By definition,  a properly selected patient is one who has a well defined disk herniation on diagnostic testing,  with corresponding physical examination findings of neurotension  (straight leg raise findings), and identified loss of sensation,  reflex changes and/or weakness that follows a specific nerve […]

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