The rate of ambulatory surgery for lumbar intervertebral disc disorders and spinal stenosis increased dramatically between 1994 and 2006 based upon a National Survey of Ambulatory Surgery. That's progress, due to the use of minimally invasive, same-day lumbar disc operations. However, another study has shown that the rate of lumbar disc operations that were combined … Continue reading Outpatient Spine Surgery?
Laser Spine Surgery
The Laser Spine Institute, a startup in many large U.S. cities, folded in March of last year declaring bankruptcy, according to the Tampa Bay Times. As a neurosurgeon who taught laser neurosurgery for several years, I can say first-hand that the laser has no place in HNP surgery, Often a spine surgeon needs to tease … Continue reading Laser Spine Surgery
NEW INVASIVE TREATMENT FOR CHRONIC BACK PAIN and FDA CLEARANCE vs APPROVAL
. IF pain nerves emanate from a spot in the center of a vertebra (?), a way to "kill" those nerves could relieve chronic back pain. A surgical procedure has recently been given FDA Clearance to do just that. It involves inserting a large needle under X-ray guidance, usually under anesthesia, into the center of … Continue reading NEW INVASIVE TREATMENT FOR CHRONIC BACK PAIN and FDA CLEARANCE vs APPROVAL
Telemedicine
During this pandemic trips to the doctor are difficult to impossible, so consulting a doctor by video from home has become more common and now many insurance plans are helping patients to pay for these online sessions of "telemedicine". I think this makes the use of the LOBAK app more valuable, by letting you know … Continue reading Telemedicine
Testing for HNP or Coronavirus
The Predictive Value Curves I developed in the 1980's for herniated disc diagnoses in LOBAK are now called ROC (Receiver Operating Characteristics) Curves, as shown. These curves have been used to gauge the value of tests for Coronavirus. Turns out that a positive test is quite predictive, but a negative test can be a false-negative … Continue reading Testing for HNP or Coronavirus
An Ominous Sign of a Lumbar HNP
When an intervertebral disc extrudes through the capsule, it won't go back and often surgery is the only way to relieve the pain. Some extruded fragments go into the "armpit" (the axilla) of a nerve root. In those cases straight leg raising of the "well leg" (A), as illustrated, increases pain in the painful leg … Continue reading An Ominous Sign of a Lumbar HNP
Future Surgery Will Be “Intelligent”
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”
CIDP
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
Reading Your Radiology Report
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
PREDICTIVE VALUE (PV) CURVES
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
