Author: Dr. Shim:

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Neck Pain

Do you have Neck Pain? Unfortunately, neck pain affects a large number of people, and the causes do not always seem obvious.   Most of the time,  it will be a self limiting process and will improve with time. Explanations of neck pain include arthritis, which is a degeneration of the bones and joints in […]

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HIgh Intensity Zone

What is a High Intensity Zone? In relationship to the spine,  it is a term that has been used on and off for the past 20 years. Initially described by Drs’ April and Bogduk in 1992,  it is a  MRI finding  identified on a specific sequence called T2.  A High Intensity Zone (HIZ) is defined […]

Disk Degeneration in 21 Year Olds

During my training,  it was assumed that the average adolescent or teenager should have normal disc anatomy. It was assumed that  disc herniation/degeneration was a rare occurrence in that population.  But,  at that time,  technology such as a MRI scanner was relatively new, rare and expensive.  We did not have the capability to test to see […]

Dermatome Patterns

Dermatomal Patterns help physicians define nerve radiculopathy patterns.  Most neurologists/spine specialists  accept certain associated sensation, muscle strength, and reflex changes patterns to specific nerve roots. L5 radiculopathy is typically associated with weakness of the extensor hallucis longus muscle.  That is the muscle that allows the great toe to point upwards.  L5 radiculopathy also follows a […]

Artificial Disk Replacement

  Have you been told you need an Artificial Disk Replacement?  Usually,  it means you have had neck or back pain, and have not improved with conservative treatments.  Assuming you have had appropriate treatments, but still have significant pain, artificial disk replacement may be an option for you. But,  there are certain questions you need […]

Epidural Steroid Injections

  Should you get Epidural Steroid Injections?      It depends on the rationale for the treatment.  In my practice,  I use Epidural Steroid Injections for both treatment as well as diagnostic purposes.  The research for these injections have been significant, but the conclusions by the various authors have been very different.  If you must […]

Did the Accident Cause the Disk Herniation?

That is a frequent question asked by many patients.The answer is, a definite maybe the accident caused the disk herniation. As a practicing orthopaedic spine surgeon,  I have seen many patients with complaints of pain after an auto accident.  In my community,  I have also been asked to evaluate patients in Auto accidents by attorney […]

Does my Doctor Own his Private Practice?

  Does my Doctor own his Practice?  This may or may not be important to you.   When you are hurting, and need help, it is probably the last thing on your mind.  But,  if you are carefully weighing your options, and seek a solution to a chronic condition,  perhaps you should answer that question.  Is […]

Do Not Smoke!

  80 % of people will have back pain sometime in their life.  Often, I am asked how can I avoid having back pain.  Unfortunately,  we cannot avoid the natural wear and tear to our bodies.  Just by living,  you will wear out your joints, bones and ligaments.  In addition,  some of us will cause […]

Laser and Back Surgery

What the deal with laser and back surgery? This is a common question we are asked by patients. Our answer to this question is “not much” . The laser is a tool that has been used in surgery for over 35 years. Many associate the use of the laser as ultimate fix all as its […]

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