Month: February 2026

Well, one of the niche things that I address in my practice is addressing complications, or bad outcomes from patients that have had prior surgery. Of course, typically with another surgeon. These can be difficult situations and require a fair amount of experience, patience, and critical thinking on the part of the surgeon.

They also require a lot of understanding of the patient’s condition as this is someone who’s undergone usually major surgery that didn’t go as well as they helped.

The important thing is to look for ways to get them better by moving forward, seeing what problems you can address and what problems you can’t, and trying to get them better with the least intervention possible.

One of the most common injections I perform is in the lumbar spine. It’s called a transforaminal epidural steroid injection. That’s a long phrase just to describe a injection of steroid, not in the spinal canal, but next to the spinal canal, where the nerves exit that can be tailored very specifically to the pinched nerve in question.

The steroid medication can then trickle into the spinal canal, in ideal cases provide long-term lasting relief. It’s not uncommon to need more than one to get patients back to their optimal state. And frankly, it’s typically a good thing to try and, and select patients with lumbar problems before considering surgical intervention.

Vertebroplasty is an older procedure that predates kyphoplasty literature on it. Today, really questions its effectiveness as an intervention, and it involves putting a needle into a broken bone and through that needle, pumping liquid cement into that broken vertebrae and fixing the fracture in place.

Its results, at this time are considered questionable.

Kyphoplasty is procedure that’s been out now over 20 years. It involves treatment for fractures in the lower, mid back or low back that are unresponsive to non-surgical treatment. A needle is placed in the broken bone and through the needle. A balloon is passed. The balloon is inflated, and surgical cement is put into the fracture instantly fixing it.

For a while we thought that pretty much everybody with a fracture in these areas needed a kyphoplasty and as quick as a fashion possible. Now we know that it’s been out for a long enough time, has been studied that it’s not a procedure that should be done in everybody, but rather, certain cases that take longer to heal or, or patients with a fracture that collapses worse.