Introduction: Spondylolisthesis is a common disorder in lumabar vertebras and consist of more than 30% of lumbar fusions are diagnosed. Degenerative spondylolisthesis is seen more in women at level L4-L5 however isthmic spondylolisthesis is seen in men at level L5-S1. MRI is used commonly as first paraclinic test for evaluation of patients with back pain with or without radiculoapthy. It is use...

Lumbar synovial cyst arises from the facet joint and can lead to back pain, radiculopathy, neurogenic claudication or even cauda equina syndrome. Although most surgeons would consider surgery to be the treatment of choice, the natural history of the disease process remains unknown and uncertainty still exists regarding optimal management of this controversial entity. We illustrate a case of lar...

Introduction Lumbar fusion has proven to be an accepted treatment for a variety of indications. Pedicle screw fixation has historically been the gold standard for providing stabilization to the lumbar motion segment while the fusion matures. However, numerous studies have reported high complication rates, increased pain, and juxtalevel degeneration due to the size of the pedicle screw instrumen...

Among the multiple causes of chronic low back pain, axial and discogenic pain are common. Various modalities of treatments are utilized in managing discogenic and axial low back pain including epidural injections. However, there is a paucity of evidence regarding the effectiveness, indications, and medical necessity of any treatment modality utilized for managing axial or discogenic pain, inclu...

BACKGROUND Chronic, recurrent neck pain is common and is associated with high pain intensity and disability, which is seen in 14% of the adult general population. Controlled studies have supported the existence of cervical facet or zygapophysial joint pain in 36% to 67% of these patients. However, these studies also have shown false-positive results in 27% to 63% of the patients with a single d...

The prevalence, costs, and disability associated with chronic pain continue to escalate. So too, the numerous modalities of treatments applied in managing these patients continue to increase as well. In the period from 2000 to 2011 interventional techniques increased 228%. In addition, analysis of utilization trends and expenditures for spinal interventional techniques alone from 2000 to 2008 i...