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Can you cure thoracic facet pain ?Can you cure thoracic facet pain ? In my experience, the most aggravating facet pain to deal with is thoracic facet pain that doesn’t respond to manipulative, conservative or injection therapy. This pain usually originates from the...

What three items does the hospital or ASC administrator want to know ?What three items does the hospital or ASC administrator want to know ? When you approach the administrator or director of an ASC or hospital to support your endoscopic spine practice, they will want...

Is there a finding on the physical exam that might suggest the need for a discogram ?Is there a finding on the physical exam that might suggest the need for a discogram ? Yes, there is, particularly with the “right” history.  Typically, I don’t think that the physical...

Wolf Scopes - Where is this water coming from?As a car enthusiast of older cars, I can tell you that a small (and inexpensive) part can cause big problems. In the motor vehicle example, if there is not adequate fuel or electricity reaching the engine, it won’t start...

Cervical Facet Syndrome - The Lateral Corner Cervical Facet Syndrome - The Lateral Corner  Cervical facet syndrome is a painful and “invisible” condition that can significantly restrict range of motion.  The problem with traditional cervical rhizotomy is that it...

In the Beginning...In the beginning I thought that the most difficult thing about implementing endoscopic spine surgery was going to be learning how to use the instruments after relearning the anatomy. I recall the transition from doing open knee surgery...

If not you...then who?If not me, then who ? If not now, then when ? I’m not sure where I first heard these two questions but I always can hear them in the background when I’m considering a change or feeling the need to “step up to the plate” for a new  topic or issue....

Why you should insist on oblique views of the Cervical Spine MRILook at why you should insist on oblique views of the Cervical Spine MRI You should insist on oblique views of cervical MRI’s because they really tell the story. Typical axial slices are oblique to the...

Why use methylene blue ?Why use methylene blue ? How can methylene blue assist with endoscopic spine surgery ? Endoscopic spine surgery is, in many ways,  a self-taught skill set. Especially as one advances from beginner to expert. Of course this steep learning curve...