Prehab – Optimizing Surgical Outcomes

“Prehab” is refers to a patient engaging in a rehabilitation process before surgery. There are well-documented factors that affect pain and surgical outcomes. It’s important to implement treatments to address all of them prior to undergoing a procedure with significant risks. Chronic pain infiltrates every aspect of life. You have … Read More

Eight-Level Spine Fusion? No!

A seventy-three-year-old woman—let’s call her Dorothy for the sake of this story—was understandably apprehensive. She had just been told that she needed an eight-level spine fusion from her tenth thoracic vertebra to her pelvis, so she came to me for a second opinion. Dorothy was a retired National Guard armed … Read More

Are You Kidding Me?

Patients and physicians are not making logical or reasonable decisions regarding spine surgery. I have watched this phenomenon for almost 30 years and it’s getting disturbingly worse.     To solve a problem in the mechanical realm you must specifically identify it before you can fix it. The same holds … Read More

Am I Operating on Your Pain or Anxiety?

My surgical decision-making has become a clearer over this last couple of weeks – but in an unexpected way. I have noticed this year that many patients with significant structural anatomic problems will improve or resolve their symptoms without surgery after engaging in a self-directed structured approach. It appears that … Read More

How Many More Neck Surgeries?

One middle-aged patient sought me out in Seattle from the East Coast for a second opinion regarding his neck. He had been disabled since 2001 with chronic pain over most of his body. He had at least 10 additional NPD symptoms of burning, aching, stabbing, and tingling that would migrate throughout … Read More

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