The Spine Pod

You did the responsible thing and gathered multiple opinions, so why did every surgeon tell you something different? You've lived with the neck, back, or leg pain long enough that surgery is on the table, and now you're sitting with a stack of conflicting recommendations, thinking they can't all be right. It's exhausting in a way that's hard to explain to anyone who hasn't been through it.

That's not a failure on your part. It's one of the harder realities of navigating spine care, where the same imaging and the same symptoms can genuinely lead different surgeons to different recommendations depending on their training, their experience, and the philosophy driving their practice.

Dr. Ahilan Sivaganesan offers a way to cut through the noise of conflicting surgical recommendations and find a surgeon whose approach is actually aligned with your best outcome. Beyond credentials or technique, the question worth bringing into every consultation is about where a surgeon starts. Is this a surgeon asking how to get you a durable result without a fusion if at all possible? Or someone working backward from fusion as the assumed answer before they've fully considered the alternatives?

That distinction, he says, is the North Star. If you've been through the opinion carousel and still don't know who to trust with your spine, that's the filter worth applying.

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

How do you know if you got a total disc replacement or a spinal fusion?

"We replaced your disc" and "we gave you an artificial disc replacement" are not the same thing. Some patients leave the operating room thinking they got a disc replacement and find out after the fact that they got a spinal fusion. Not because anyone misled them, but because the language around these procedures is close enough to create real confusion.

Dr. Jason Cuellar walks through why this confusion happens and what it means for patients who are going into a disc replacement conversation without knowing exactly what to ask.

In a fusion, the disc is removed and replaced with a cage, essentially a rigid spacer, packed with bone graft material to encourage the two vertebrae to grow together and permanently lock that segment in place. In a true artificial disc replacement, the disc is removed and replaced with a device that has moving parts, designed to mimic the natural movement of a healthy disc and keep that segment of your spine mobile. One option locks. One option moves.

It's an easy thing to misunderstand, and it isn't always explained clearly up front. So Dr. Cuéllar's advice is simple: ask your surgeon what they plan to replace the disc with, and ask them to show you the actual device going into your spine. If it's a motion-sparing artificial disc, they'll be able to show you exactly that.

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

If you're in the process of finding a spine surgeon for disc replacement, one thing worth knowing before you make that call is that this procedure rewards specialization in a way that not every spine surgery does.

Dr. Ahilan Sivaganesan explains why disc replacement is a procedure where volume and specialization carry real weight. It's a more technically demanding surgery than spinal fusion, with more variables that need to be accounted for to get a good outcome. The difference between a practice that does this every day and one that does it occasionally isn't just about the surgeon. It's the whole team, the familiarity with the details, the institutional knowledge that builds up when a procedure is part of your daily rhythm rather than an occasional one.

That's not a reason to feel anxious about your options. It's a reason to feel empowered to ask better questions when you're evaluating surgeons. How many of these do you do? What does your team look like? Is this a significant part of your practice?

You're allowed to ask those questions. The right surgeon will welcome them.

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

If you're trying to decide between cervical disc replacement (CDA) and cervical fusion (ACDF), the short-term prognosis doesn't always tell you everything you need to know. Most patients do well in the first couple of years regardless of which procedure they have. The part that matters more are the long-term implications of the type of treatment you choose.

Dr. Jason Cuellar gets into what the long-term data shows when you put these two procedures side by side, and the gap between them becomes more meaningful the further out you look. The early recovery window can feel similar. It's the years after that tell a more complete story about mobility, function, and patient satisfaction.

One area of significance where CDA outperforms ACDF is in adjacent segment disease in the years following your initial surgery. Based off published data, ACDF can come with an up to 3-5x greater risk of re-operation due to adjacent segment disease postoperatively. That isn’t a small difference, that’s an increased risk when comparing the two procedures.

If you're in the comparing stage right now, Dr. Cuellar shares some extremely valuable outcomes data that may help you inform your decision. CDA might not be an option for every patient, but it’s worth the discussion with your surgeon to see if a motion preserving option is available to you.

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

Disc herniations are not one size fits all. You might be experiencing back pain, sciatica, muscle weakness or numbness, and each of these could point to a disc herniation. Where your disc herniation is located dictates the type and extent of symptoms you may be experiencing and it can be disorienting when your symptoms don't seem to follow a pattern you can make sense of.

Dr. Sivaganesan shares the breadth of symptoms patients might experience when dealing with a disc herniation. As he notes, some herniations are worth watching and managing conservatively. Others that cause a neurologic deficit may require more immediate treatment. Understanding which situation you're in is one of the most useful things you can get out of an early appointment with a spine surgeon before you've committed to any path forward.

If your symptoms feel hard to explain and you’re looking for answers to your leg and/or back pain, it might be time to meet with a spine surgeon to discuss your possible treatment options.

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

Imaging and a radiology report tell a surgeon what's happening in your spine. It doesn't tell them what your life looks like around it. Whether surgery is even logistically possible right now, what recovery realistically means for your family, or how long you've already been pushing through pain just to keep everything running. Those are the details that don't show up on an MRI but shape everything about what the right next step actually looks like for you.

Dr. Kamal Woods talks about why the listening phase comes before everything else in his practice. What's on the MRI is one piece of the picture. But your life circumstances, your work situation, your recovery window, what's happening around you day to day, those factors shape what a realistic and appropriate treatment plan actually looks like for you specifically.

A recommendation that makes perfect sense for one patient might not be the right call for another, even when the imaging looks identical. Finding a surgeon who takes the time to understand that full picture before making any recommendations changes the entire experience of navigating spine care. Not just the outcome, but how supported you feel getting there. That kind of attention to your specific situation is worth looking for and worth asking about when you're evaluating who you want in your corner.

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

Just because you meet with a spine surgeon, doesn’t mean you’re bound for spine surgery.
A lot of people put off seeing a spine surgeon because they assume walking through that door means walking out with a surgery date. So they wait, they manage, and they hope it resolves on its own.

Dr. Todd Lanman talks through why getting to a spine surgeon earlier in the process can help you along your recovery and treatment journey. Getting in front of a spine surgeon early doesn't mean committing to anything. Most of his patients leave without surgery being recommended as their first option.

The right surgeon isn't in a rush to get you to the OR. They want to understand your specific situation well enough that when surgery is the answer, they know precisely what they're fixing and why.

If you've been dealing with chronic leg and/or back pain but the idea of seeing a spine surgeon feels like a bigger step than you're ready for, that's understandable. Getting in early just to understand what's actually going on and have a plan in place can make a real difference when it matters most.

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

Getting spine surgery doesn’t always have to come with an exhaustive list of restrictions. If you’ve been told that spine surgery is the end of the road and you’ll have to give up things you once loved, it might be time to ask if a motion preserving alternative is an option to get you back to an active and functional lifestyle.

Dr. Jason Cuellar talks through what cervical disc replacement (CDA) can offer to patients. The procedure is designed to restore motion, and his post-recovery restrictions reflect that. His patients have gone back to MMA fighting. Extreme skiing. There's even Air Force research showing cervical disc replacement is safe through the extreme G-force of a pilot ejection.

Compare this with what you’d be likely getting otherwise, an anterior cervical discectomy and fusion (ACDF), which comes with a different recovery protocol and restrictions list. The contrast between CDA and cervical fusion is real, and it's part of why he favors this approach. Recovery tends to be easier on cervical disc replacement patients, and once they're through it, he's not sitting across from them running through a list of what they can't do anymore.

If getting your life back, not a modified version of it, is what you're hoping for on the other side of surgery, that's worth factoring motion preservation into the conversation with your surgeon.

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

Getting a diagnosis that has the word "disease" can be scary. It sounds permanent. It sounds serious. And if you found degenerative disc disease (DDD) on an MRI report before a doctor has a chance to explain it to you, it can cause some stress and panic.

Dr. Ahilan Sivaganesan explains what's actually happening in the disc as it ages and why finding it on an MRI isn't automatically a reason to worry before you've had a real conversation with your doctor.

Finding it on an MRI doesn't automatically mean surgery is the next conversation you need to have. That said, for some people the symptoms and the imaging do match up, and degenerative disc disease can be really painful and debilitating.

If chronic leg and/or back pain has taken over your life and you’re at a point where conservative care is no longer providing relief, it may be time to ask your surgeon if motion-preserving surgery could be an option for you.

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

If you've ever sat in a consult, been told you need a spinal fusion and felt your stomach drop a little, Dr. Kamal Woods says you're not alone. That reaction from patients is what drove him to completely rethink how he treats the spine.

As patients pushed back on fusion conversations, he leaned further into motion preservation as a practice philosophy. Patients told him what they wanted, and he built his practice around it.

If you’ve been dealing with chronic leg and/or back pain, spinal fusion is no longer your only option. Finding a surgeon who specializes in motion preservation is becoming more accessible than it was even a few years ago. If that's the kind of care you're looking for, it's out there, and more and more surgeons are offering it.

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