The Flex-Bar Retractor Kit The set, except for the table attachment (black handle), is sterilized. At the appropriate time during micro-diskectomy, the large, solid retractor bar, is passed through a small slit in the drapes to a non-sterile nurse, who affixes it to the table attachment and tightens it into the position held by the … Continue reading Microdiskectomy for Lumbar HNP, Part 4
A Periosteal Elevator - its width is the length of the incision. With the patient asleep and turned prone, a metal marker is placed over the intended level and a portable X-ray is taken to verify. The small vertical midline skin incision is deepened to the tops of the spinous processes above and below the … Continue reading Microsurgery for Lumbar HNP – Part 1
When you need not wait for lumbar HNP surgery
Left - X-ray showing balance line created by lordosis. Right - MRI scan of normal lumbar spine; T = thoracic (w 12 pairs of ribs not shown). L = lumbar, S= sacral (a solid bone w rudimentary disc spaces) The intervertebral discs have three components that enable them to flex and twist while bearing lots … Continue reading What are the Lumbar Discs?
Health Care Executives recently held a symposium on Intelligence in Surgery. They named three components; smart instrument systems, human understanding, and digital insights. Surgeons already have a lot of understanding about what they do, particularly in the O.R. My App LOBAK is an example combining human understanding with digital insight. It's a way of coding … Continue reading Future Surgery Will Be "Intelligent"
This is a rare kind of nerve disorder that can begin with numbness or weakness in the legs, or even one leg, and may have associated reflex losses. It could simulate nerve irritation from changes in the lower back, such as disc protrusion or spinal stenosis. I didn't include it in my list of other … Continue reading CIDP
You can get your report emailed, faxed, via the doctor's web site or sent by regular "snail" mail. This website (LOKAKAPP.com), under FAQ's describes when to get an imaging study for low back pain and how to evaluate the result. A full description of a report is at http://www.RadiologyInfo.org. The report should say what you … Continue reading Reading Your Radiology Report
PV Curves for the Diagnosis of a Herniated Lumbar Disc After an Imaging Test. The predictive value calculation for a test that can only be interpreted as positive or negative tells you the likelihood that the result, either positive or negative, is true and not false. With LOBAK you can find your pre-test probability (p) … Continue reading PREDICTIVE VALUE (PV) CURVES
Rats that walk upright on two legs Why Humans Have So Much Back Trouble? Rats without front legs learn to walk upright and develop the inward (lordotic) spine curves in the neck and lower back seen in all humans. That puts more weight on the spine and tends to pinch out the discs toward the … Continue reading Why Do Lumbar Discs Protrude?
After the patient has had an MRI scan with markers on the skin surface for localization, the data could be processed and viewed through "virtual reality" glasses as shown above. The patient is asleep on their stomach and the surgeon can "see through" the body to view the spine. No incision has bern made. Here … Continue reading “X-ray Vision” – Surgery of the Future?
Outcomes after micro-lumbar discectomy (MLD), done as described in this blog, were surveyed by questionnaire. Patient were asked to check one of four options for their present symptoms: Excellent - no pain and able to resume normal activities, Good - some pain but not requiring medication and most activities resumed without limitations, Fair - pain … Continue reading Outcomes After Surgery for Herniated Lumbar Disc
An L4 radiculopathy, the signs of which were explained in a previous blog, is a much less common finding. It is due to a HNP at L3/4, which occurs much less frequently than HNPs at either L4/5 or L5/1, where 85-90% of lumbar disc herniations occur.. Because the L4 root exits at L4/5, a far-lateral … Continue reading The Significance of an L4 Radiculopathy
One of the two most common radiculopathies found with lumbar HNP, an L5 radiculopaty is present when one, two or all three of the findings of weak big toe extension, decreased pin prick sensation over the big toe, or a decreased posterior tibial reflex is found. My study, as shown in the LOBAK app, found … Continue reading The Significance of an L5 Radiculopathy