Webinar Episode 4. April 2023

Welcome to the fourth live webinar with our Founder Joel Proskewitz.

The questions addressed and their respective time stamps were as follows:

01:02 - Why a fusion? This is an end of a road procedure. Conservative intervention, discectomy or decompression has already been tried. Often not back pain indicated. A fusion tends to be major instability with neural deficit and or a spinal fracture. How does the surgeon approach the disc space to execute the procedure?

05:56 - Joel discusses the ALIF procedure, the surgery process and he demonstrates an actual cage. Joel also explains the cage placement, the screws used and the bone process that follows. He concludes with the additional metal rods and pedicle screws used to stabilise the cage and fusion process.

15:16 - A TLIF and ALIF fusion comparison physically. What can a TLIF restore? Spine landmarks and facet joint removal specifically. The TLIF as a minimally invasive procedure. The bone graft difference between the ALIF and TLIF.

22:02 - Lateral Lumbar Interbody Fusion and how these are executed. Joel highlights a common psoas muscle attachment comment. 

25:12 - Cage body structure and similarity to real bone material.

26:50 - Why did Joel have a further fusion?

29:50 - A TLIF minimally invasive procedure and exercise. If you specifically exercised previously (i.e. cycling) your return to that specific movement may be faster as long as gradual. Remember NO bending, lifting or twisting at the surgical site must be respected. Walking is recommended as soon as possible.

Vitamin levels, smoking, alcohol consumption and general fitness can determine your fusion speed.

35:00 - How often do you see discogenic pain pattern referral in hips? Joel discusses pain differences between disc level and nerve type irritation. Remember everyone is different. 

38:58 - Pain medication with respect to movement and general health. Reducing pain would seem advisable to regain movement to maybe help tissue and structural adaption. Periodising pain medication is a route forward and Joel advises a further conversation with all associated consultants. 

43:55 - Pattern recognition, pain pathways and mechanisms. Spinal flexion, movement and pattern recognition.

46:05 - L4 Radiculopathy indication, movement and hypothesis building.