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May 5, 2025
fig 7a
May 5, 2025

WE LIKE TO DO IT ALL

We have had a busy couple of weeks doing all kinds of interesting spine cases. WE LIKE TO DO IT ALL….particularly those cases that are degenerative […]
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March 3, 2025
Fig. 4
March 3, 2025

IT’S ALL ABOUT THE DECOMPRESSION…

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January 6, 2025
Fig 1a,b
January 6, 2025

YOU DON’T HAVE TO GET EVERY MORSEL

The spinal synovial cyst is one of the most interesting expressions of spinal instability. They emanate from the synovial lining of a degenerated facet joint that […]
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August 27, 2024
74518811426__78EB9837-981E-49F7-9023-C319E83C1615 (1)
August 27, 2024

IMPORTANT CONSIDERATIONS IN SPINE SURGERY

I had some time off to contemplate nature and the beauty of Alaska and took a break from neurosurgery. I think it’s very important to take […]
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May 23, 2024
Fig8
May 23, 2024

SOMETIMES YOU HAVE TO CONNECT THE SKULL TO THE NECK

Patients may require an occipital-cervical fusion for both cranio-cervical and atlanto-axial instability, depending on the anatomy. Patients who have long segment posterior cervical fusions can sometimes […]
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February 27, 2024
fig 2 (2)
February 27, 2024

LUMBAR SURGERY CAN BE DONE IN THE MORBIDLY OBESE PATIENT

As a spine surgeon you see patients with all body types. Morbidly obese patients pose a particular challenge. Heavy patients who have lumbar spinal stenosis or […]
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January 11, 2024
Fig 1 Sagittal and axial T2 weighted lumbar and 1B L4-S1 instrumented fusion
January 11, 2024

When Just Enough is Enough

We as spine surgeons can sometimes change our approach in the preoperative planning of a patient’s surgery. Sometimes an approach that is so initially obvious becomes […]
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November 15, 2023
Fig 2a Sagittal and axial T2 weighted cervical MRIs demonstrating large C4 5 herniated disc with spinal cord compression red arrows
November 15, 2023

Spine Cases Where Surgery Is Clearly Indicated

One of the more interesting aspects of neurosurgery is making a decision as to whether a patient should have spine surgery. If a patient has severe […]
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July 24, 2023
hydroxyapatite coated pedicle screw
July 24, 2023

A Good Solution For Patients With Osteoporosis Who Need Surgery For A “Slipped Disc” or Spondylolisthesis

                 I specialize in and am very familiar with patients who have osteoporosis and require spinal surgery for degenerative […]
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April 28, 2023
Fig 4
April 28, 2023

Tale of Two Pathologies Contributing to Lumbar Stenosis with Spondylolisthesis

The actual structural cause of lumbar thecal sac compression can vary in degenerative spondylolisthesis and stenosis. The culprits are commonly thickened ligamentum flavum or severe facet […]
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March 13, 2023
th
March 13, 2023

My Love For Picking Arthritis Off The Dura

After 25 years in practice, I still find it challenging, but quite rewarding: removing degenerative material off the dural membrane in the lumbar spine. Some people […]
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October 6, 2022
fig3 IMG 7141
October 6, 2022

Revision Lumbar Surgery

Revision lumbar spine surgery is amongst the most difficult of surgeries, not just in spine surgery, but of all categories of surgery. I don’t believe many […]
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August 23, 2022
IMG 6060
August 23, 2022

Lateral Disc Herniations

Patients can present with all kinds of herniated discs that occur in many different locations in the lumbar spine. I tell patients that the disc is […]
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July 22, 2022
fig 2 thoracic
July 22, 2022

Thoracic Stenosis

Thoracic stenosis is far less common than lumbar stenosis.  Whereas the symptoms of lumbar stenosis are usually well-defined, thoracic stenosis can act like a great mimicker, […]
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July 2, 2022
figure 2 cysts
July 2, 2022

Cysts

People are obsessed with cysts!  When you think about it, the body likes to form cysts.  Why does this happen? Cysts can form just about anywhere […]
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June 10, 2022
Figure 5 Sometimes WJS
June 10, 2022

Sometimes It Is Obvious And Sometimes It Is Not

Patients sometimes have subtle anatomical abnormalities you discover as you investigate their problem.  And sometimes these findings can answer the why and the how as to […]
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May 27, 2022
IMG 5280 5 1
May 27, 2022

Lateral Recess Stenosis

Nervous tissue is soft. The thecal sac is surrounded by a rigid bony ring which forms the spinal canal. Any mass that fills the very small […]
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May 11, 2022
IMG 5097 768x1024 1
May 11, 2022

72-Year-Old Male With Progressive Neck Pain

Here is a tough case: This is a 72 year-old male who presented with several months of progressive neck pain without symptoms of the arms or legs. […]
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May 11, 2022
IMG 5140 768x1024 1
May 11, 2022

Spinal Cord Compression In Obese Patient

 Patients who are morbidly obese are particularly challenging to manage with spine pathology. When these patients have low back pain and concurrent severe lumbar degeneration, it […]
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May 11, 2022
IMG 5185 scaled
May 11, 2022

Severe Stenosis With A Grade 1 Spondylolisthesis

This week was frantically filled with interesting spine cases that illustrate important biomechanical principles and important common problems that we face as neurosurgeons. The first was […]
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May 10, 2022
IMG 5090 768x1024 1
May 10, 2022

NSPC Mobile Patient

Another patient followed up who I initially had seen on our NSPC mobile van at her worksite. She was 52 years-old and complained of chronic intractable […]
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