The Spine Pod

The Spine Pod Conversations about Motion Surgery
New episodes every other Wednesday

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05/21/2026

If your chronic back and/or leg pain has started shaping how you work, how you spend time with your family, and whether you say yes to things you used to enjoy, it might be time to talk with a spine surgeon about treatment options. Your life shouldn’t be put on hold because of your back pain.

There's a specific kind of stuck that patients live in before they decide. You're managing. Barely. You're still going to work but you're not really there. You've stopped doing the things that used to make your week feel like yours. And the whole time you're measuring yourself against some invisible bar. Am I bad enough yet? Is this enough to justify surgery? The answer to that isn't always on a scan.

Dr. Woods breaks it into two lanes. If there's neurological decline happening (loss of grip, loss of balance, bowel and bladder issues), the answer is more clear-cut. But if it's pain, it comes down to what you’re sacrificing in your day-to-day life.

When you’re no longer living the life you love, or you feel like you are giving up too much, it may be time to talk with a spine surgeon to see what options are available to help get you back on your feet.

This content is for educational and informational purposes only and is not intended as medical advice.

05/20/2026

If your hip doctor told you today that you needed a hip fusion, you'd run out of the office. We can't even imagine that anymore. But when it's the spine, most patients hear "fusion" and assume that's their only option.

Joint replacement is the standard of care for every other major joint in the body. Hips, knees, ankles, shoulders. The spine is the last one we still routinely fuse. Part of that is complexity. But there have been major advancements in motion preservation that are giving patients real options beyond fusion. And just like Sir John Charnley faced when he invented the total hip replacement, criticism is part of how these things progress. He often heard statements from his peers like, “this is just a fad” or “this isn’t going to last.” It's part of the process. It makes the research sharper and the outcomes better. Fast forward 60 years and total hip replacement is one of the most successful orthopedic procedures that exist.

What does that mean if you're a spine patient? That we're not where the other major joints are yet, but we're getting there. The options exist, they're well researched, and they continue to advance. Finding a surgeon who specializes in motion preservation gives you the best opportunity to hear all your options beyond just a spinal fusion.

This content is for educational and informational purposes only and is not intended as medical advice.

05/19/2026

If you've been looking for a surgeon who offers motion preserving spine surgery and you keep hearing "fusion" instead, you're not crazy for wanting to understand all your options. Dr. Jason Cuéllar sat down with us to talk about the challenge many patients experience when seeking spine care.

Sometimes patients who want alternatives to spinal fusion end up seeing three, four, five surgeons trying to find someone who will even have the conversation. That's a lot of appointments when you're already in pain. You shouldn't have to fight through multiple consults just to hear all your options.

Whether you’re looking for disc replacement or other motion-sparing alternatives, it’s important to find a surgeon who performs them regularly. Seeking out the right care for your condition can be hard, don’t be scared to ask your surgeon what options are available for your condition.

This content is for educational and informational purposes only and is not intended as medical advice.

05/16/2026

Is back and leg pain causing you to constantly rethink your simplest daily activities? Asking yourself things like:

How far can I get before the leg pain starts?
Where's the next place to sit?
Can I make it back to the car?

This clip is for you.

There's a real, structural reason for this, it’s called spinal stenosis. Dr. Siva walks through what’s actually going on in your body that’s causing your back and leg pain.

If this chronic pain and/or weakness has started shaping how you spend your day, it’s worth a workup with a spine surgeon to see if spinal stenosis is the cause.

This content is for educational and informational purposes only and is not intended as medical advice.

05/15/2026

PT used to be the thing patients did once they'd recovered enough: typically six weeks out for motion preserving procedures, three months out for a fusion. The thinking has now evolved. Movement at the two- to four-week mark is part of how the body recovers, not what comes after recovery.

Dr. Kamal Woods sat down with us to talk about how the timeline for post-op PT has shifted, and what's actually at stake in those first few weeks. The thing that doesn't always make it into the discharge instructions is that PT isn't just for after the pain is gone. It's part of how the pain gets managed in the first place.

PT in that early window isn't just movement, it's actively cutting down the inflammation, swelling, and stiffness that drag recovery out and make the pain worse. Dr. Woods believes in this so much that he built a full PT clinic inside his spine practice. Every one of his patients goes through it before and after surgery.

If you're heading into surgery, ask your surgeon what their PT plan looks like. If you're already recovering and you've been skipping, this is worth bringing back up.

This content is for educational and informational purposes only and is not intended as medical advice.

05/13/2026

If you're looking for alternatives to spinal fusion, sometimes you don't get the whole story.

Dr. Jason Cuéllar sat down with us and shared the most common misconceptions patients hear when they ask about motion-preserving surgeries: disc replacement is still experimental and doesn't work.

What he wishes surgeons would say instead is the truth. Some version of, "I don't do disc replacement." Or "I'm not trained in it, here's a colleague who is."

The other half of getting the real story is who you go to. Dr. Cuéllar is firm on this: the surgeon who does disc replacements every day is going to give you a different conversation, and a different outcome, than the one doing a couple a month, or none at all. If you're considering a motion-preserving procedure, it's important which consult room you're in.

This content is for educational and informational purposes only and is not intended as medical advice.

05/11/2026

If you're dealing with chronic back pain and your MRI isn't showing a clear culprit for your pain, Dr. Ahilan Sivaganesan sees you. You're not alone. A spine surgeon explains why some of the most painful disc problems don't show up the way you'd expect on a standard lumbar MRI.

It's called an annular tear, a tear in the outer wall of a lumbar disc that causes inflammation and disc fragmentation that doesn't always read clearly on imaging. That feeling of being told nothing is wrong while the pain is wrecking your day? It's not in your head.

Although a lot of back pain does get better with conservative care, if you've already cycled through physical therapy, injections, medications, and a few specialists, and the only thing anyone has offered you is a big fusion or reconstruction, Dr. Siva says it's worth asking a surgeon trained in motion preservation and/or endoscopic spine care whether an annular tear could be the actual source.

This content is for educational and informational purposes only and is not intended as medical advice.

05/07/2026

The goal isn't just back pain relief, it's getting you back to the things you love doing and keeping you from needing more spine surgery down the road. Dr. Sielatycki shares his view on why motion preservation is his whole game.

Dr. Alex Sielatycki out of Steamboat sat down with us and basically gave his mission statement.
Motion preservation and restoration is his game. The whole point, in his words, is to stop funneling people into big lumbar fusions and a lifetime of repeat surgeries, and get them back to what they actually love doing. Skiing. Grandkids. Whatever your version of that is.

He's not saying motion preservation is right for every patient. He's saying patients should know it exists before they commit to a fusion. That's a different conversation than most people are getting in clinic.

Save it for your next consult.

This content is for educational and informational purposes only and is not intended as medical advice.

05/06/2026

Cervical fusion vs cervical disc replacement: what's actually different?

Dr. Ahilan Sivaganesan sat down with us and walked through the side-by-side of cervical fusion vs disc replacement. The goal of either surgery is the same: un-pinch the nerve or spinal cord. The difference is what the surgeon puts back in once the disc and bone spurs are out.

With a fusion, that's a static metal cage with a plate and screws, solid and locked in place. With a disc replacement, it's a mobile implant designed to preserve, and sometimes restore, range of motion.

Per Dr. Sivaganesan, the data has shown fewer re-operations at the next level up or down with cervical disc replacement compared to fusion. Not every patient is a candidate for either, but if you're heading into a consult, this is the kind of question worth bringing in with you.

Save this for your next appointment!

This content is for educational and informational purposes only and is not intended as medical advice.

05/05/2026

If your 2am search on why your back pain isn't healing didn't explain this, Dr. Jeffrey Larson does. You're not alone.

A neurosurgeon explains why disc injuries don't respond like other parts of your body. Discs have no blood supply, so they don’t repair themselves like other muscles and tissues.

That frustration waiting for improvement that never comes? It's not in your head.

Although often times herniated discs can heal on their own, if you feel like your back pain isn’t getting better with conservative care (physical therapy, injections, medications, etc.) it may be because your discs heal differently than the rest of your body does.

This content is for educational and informational purposes only and is not intended as medical advice.

05/04/2026

If you've been told your only options are live with back pain or get a fusion, that's not the whole story.

Dr. Ahilan Sivaganesan sees patients who've been through countless specialists, tried every injection, exhausted PT, and still don't have relief. They're told fusion is the only way forward. But for many, there's a third option: motion preserving devices or ultra minimally invasive endoscopic procedures that address the source with a tiny footprint and same-day recovery.

Not every surgeon offers these alternatives. If fusion is your only recommendation, get another opinion from someone who specializes in motion preservation before you make that decision.

This content is for educational and informational purposes only and is not intended as medical advice.

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