Is Trauma the Cause of Cervical Radiculopathy?
As a practicing orthopaedic Spine Surgeon, I am constantly asked about the cause of cervical radiculopathy. From the patients, I am asked ” Doc, do you know why I developed this pinched nerve in my neck?”. And, since we are now in this environment of medical cost evaluation, the insurance companies then ask ” Doctor, […]
Prescription Drugs, Driving and Machinery
In Florida, you can be prosecuted for Driving under the Influence even while taking prescribed narcotic drugs and muscle relaxers. In Florida, many employers perform random drug testing of it’s employees, and require drug testing, for employment. Most companies now require drug testing when accidents occur with the use of heavy machinery. Why do I […]
Latest on Why Discs Herniate
The above image is taken from August 1, 2013 Spine. It is the title of the ISSLS Prize winning article by Dr. Rajasekaran. As you can see, it was a prospective study microscopically analysing disk material retrieved from 181 subjects, who underwent lumbar discectomy surgery. Patients selected for surgery met the criteria of being younger than 60 […]
Loss of Cervical Lordosis
As a practicing Orthopaedic Spine Surgeon, I often get back x-ray reports indicating “Loss of Cervical Lordosis”. As most of my patients are highly educated, they often will read that report, and will come to discuss the finding. So, I thought I would share my comments on the topic. As some of you may know, […]
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 […]
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 […]
