Webinar Episode 7. September 2023

Welcome to the seventh live webinar with Joel Proskewitz.

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

01:00 Maintaining bone health.

02:40 Bone mass and osteoporosis post 50 year old spine patients (Chin et al 2007).

04:45 Pedicle screws and bone health for fusion patients.

09:00 Do all or what % of back pain suffers end up in surgery somewhere down the line? No definite number on this. Many people suffer for decades without being a surgical candidate. Joel discusses the difference between back pain and leg pain patients.

16:00 How many injections can you have for Scoliosis and Stenosis. Joel describes both conditions, some of the reasons for both and the differences across age groups. In Joel’s experience and the surgeons he has worked with, they do not go beyond three to four injections per year.

26:05 Do injections just mask the pain? Clinician injection skill level is very important. There are many types of injection variations.

34:55 The Jefferson Curl. Firstly, lower back and cervical discs are not the same. Basing surgical and rehabilitation decisions on empirical evidence only is limited. Joel talks through the lumbar spine structures with a focus on disc function and structure.

Joel also describes a disc bulge and directional changes during spinal flexion, rotation and flexion & rotation simultaneously. 

52:10 - Cumulative loading and trauma over time NOT sudden.

54:20 - Clinical reasoning and pattern recognition come from extensive experience. Practitioners need a lot of experience.

57:35 If a patient has neural deficit what is your view on when or if to proceed with surgery?