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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 […]

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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 […]