February 27, 2024


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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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, […]
July 2, 2022


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 […]
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 […]
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 […]
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. […]
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 […]
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 […]
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 […]
May 9, 2022

Grade 1 Spondylolisthesis At L4-5 With Severe Lumbar Stenosis

Yesterday I did a terrific case with my trusty orthopedic spine surgeon, Dr. Richard Obedian, with whom I have been working with as a team for […]
May 6, 2022

Severe Stenosis Above Prior Fusion

This next patient was a 54-year-old female who had a long history of low back pain with radiation to both legs. She had a prior L4-S1 […]
May 2, 2022

Lumbar Stenosis

Lumbar stenosis is a fairly common condition I see in my office.  Patients develop lumbar stenosis or narrowing of the spinal canal as a result of […]
April 28, 2022

Lumbar Degenerative Scoliosis Case Study

Lumbar degenerative scoliosis is a tricky problem. In most cases, you are dealing with patients who are 65 and older who often present with concurrent medical […]
April 26, 2022

Cervical Spinal Cord Compression With Myelopathy

This 52 year-old female presents with 4 months of progressive neck pain, numbness of both hands, and difficulty using her hands and buttoning a shirt. She […]