The Spine Pod

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The Spine Pod A podcast about all things Spine Surgery. For educational purposes only & does not constitute as medical advice.

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10/05/2026

If you've been researching disc replacement as an alternative to spinal fusion, you may have come across the idea that disc replacement is “experimental". You might have even see it in writing, in an insurance coverage decision or a denial letter.

Dr. Alex Sielatycki, an orthopedic spine surgeon, says disc replacement is not experimental. Disc replacement has been around for more than twenty years and has gone through rigorous testing and long-term follow-up. In studies, disc replacement has been found to be at least equivalent, if not superior, to spinal fusion, which is still the standard of care for chronic neck, arm, leg, and back pain.

Not every spine surgeon performs disc replacement, but a surgeon not offering a procedure isn't evidence that the procedure is unproven.

So if you hear that disc replacement is experimental, ask directly why they believe that and whether they have data to support it.

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

10/03/2026

If you've been diagnosed with spinal stenosis, you may have been told to hold off on spine surgery as long as you possibly can. Until the leg pain is unbearable. Until you can't even walk from the front door to the mailbox. Until you're barely sleeping at night because you can't find a comfortable position without constant pain.

Dr. Jason Cuéllar, an orthopedic spine surgeon, explains where the advice came from. Thirty or forty years ago, the treatment options were do nothing or have a large fusion, and those fusions failed often enough that waiting was the reasonable call. Avoiding surgery made sense when surgery was often the harder path.

The good news is that more treatment options exist now, including motion preserving procedures like disc replacement. Dr. Cuéllar still believes surgery should be a last resort. What's different today is that these options are worth considering earlier in the process, because the condition of your spine helps determine which treatments are available to you. Wait too long and some of them can come off the table.

If you've been told to wait, it's worth asking what you're waiting for, and whether waiting could take away any treatment options for you. The answer may still be to hold off, but you'll just be deciding with the full picture.

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

10/01/2026

"How long until I can get back to work after a cervical disc replacement?" If you’re considering a disc replacement for your chronic neck and/or arm pain, this is probably one of the first questions you want answers to before deciding on surgery.

Dr. Alex Sielatycki, an orthopedic spine surgeon, shares what he tells his patients when it comes to recovery time and returning to work. If you work at a desk, he tells patients to come back when they feel up to it, which for a lot of people is a matter of days. If your job is physical, he starts you on light duty and clears you for everything at around four to six weeks.

Recovery comes in stages, not one date on the calendar. There's a point where you can handle lighter work and a later point where you're cleared for all of it, and knowing both makes planning your leave or talking to your employer a lot easier.

One thing that helps: tell your surgeon what your job actually involves. The lifting, the reaching overhead, the hours with your neck down starring at a computer. Your real recovery timeline gets built from those details.

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

09/30/2026

If you’re considering spine surgery, pain relief is probably a big part of what you’re looking for. But Dr. Jonathan Stieber, orthopedic spine surgeon, believes restoring function and maintaining motion are also important goals to think about.

He makes an interesting comparison to other areas of orthopedics. Hips and shoulders are routinely replaced to restore function rather than fused. In the spine, fusion is still commonly used, but Dr. Stieber believes preserving motion is something worth striving for when possible.

For you, that means looking beyond whether a procedure can simply relieve your pain.
How could it affect the way you move? What is the goal for your function after surgery? Are there motion-preserving options worth discussing?

The right treatment is personal, but understanding what your options could mean for your movement and function is an important part of making that decision.

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

09/27/2026

If you’re looking at treatment options for neck pain, you may be trying to understand the difference between cervical disc replacement and cervical fusion. One question worth asking your surgeon: What would you choose if it were your own neck?

Dr. Jason Cuéllar, orthopedic spine surgeon, has a very clear answer. If he were a candidate for both, he would choose cervical disc replacement.

For him, a big part of that decision comes down to what happens after surgery. He points to faster recovery, getting back to activity more quickly, and the long-term impact on the levels above and below the surgery.

If you’re weighing your own options, ask beyond what happens on the day of surgery. How will each procedure affect motion? What does recovery look like? What are the chances you could need another surgery later? And how might that change depending on whether one, two, or more levels are involved?

Not every patient is a candidate for cervical disc replacement, and a surgeon’s personal choice doesn’t automatically make it the right option for you. But understanding what they would choose, why they would choose it, and how those same considerations apply to your spine can help you have a much more informed conversation.

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

09/24/2026

When you’re considering spine surgery, it can be overwhelming to figure out which treatment option is actually best for you.

Part of what makes that decision so complicated is that healthcare doesn’t always measure “value” around the things that matter most to patients.

Dr. Ahilan Sivaganesan, fellowship-trained neurosurgeon, explains that true value in healthcare means looking at outcomes and costs together. Not just whether a procedure works, but what it takes to get you there.

In the example he shares, two different spine procedures could both lead to a good outcome for the right patient. But when you also consider implants, hospital costs, out-of-pocket expenses, recovery time, and time away from work, the total impact of those options can look very different.

For patients, that means the question shouldn’t only be, “Will this surgery work?”
It should also be: What are all of my appropriate options, and what does each one mean for my recovery, my body, and my life?

That may mean asking whether a less invasive or motion-preserving option could address the same problem compared to a spinal fusion. It also means understanding the tradeoffs between the procedures available to you and why one is being recommended over another.

Not every patient will have multiple surgical options. But when you do, the best decision starts with understanding the full picture, not just the procedure itself.

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

09/22/2026

If you’re considering spine surgery, you may have come across total disc replacement and wondered whether it could be an option for you.

There is real data and clinical experience behind both cervical disc replacement and lumbar disc replacement. But one of the most important factors in a successful outcome can get lost when you’re researching procedures online: the right procedure has to be matched to the right patient.

Dr. Jonathan Stieber, orthopedic spine surgeon, believes disc replacement can be an excellent motion-preserving option when a patient is appropriately selected, the indication is right, and the procedure is performed well.

That means the question isn’t simply, “Does disc replacement work?”

It’s: Could disc replacement be the right option for my specific situation?

Preserving motion can be incredibly valuable when it’s possible. But it’s also extremely important that you find the procedure that best addresses the source of your pain, fits your individual circumstances, and gives you the best opportunity to get back to the life you want to live.

That’s why finding a surgeon who understands motion-preserving options and can explain why you are, or are not, a candidate matters.

Know your options. Ask questions. And make sure you understand why a particular procedure is being recommended for you.

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

09/20/2026

If spinal fusion is the only option you’ve been offered, it’s worth asking one more question: Are there other options for me?

Dr. Ahilan Sivaganesan, a fellowship-trained neurosurgeon, talks about something most patients never see. For certain spine procedures, fusion can be more technically forgiving for the surgeon and may reimburse better than motion-preserving alternatives.

His point isn’t that fusion is the wrong choice or that surgeons recommending it are doing something wrong. In fact, he says the opposite. His point is that healthcare systems have incentives, and those incentives can play a role in which treatments become more common.

For patients, that makes asking questions even more important.

Why are you recommending fusion for me? Am I a candidate for a motion-preserving option? What are the benefits and tradeoffs of each? And if an alternative isn’t right for me, why?

Fusion may still be the right answer. But you deserve to understand the options that apply to your specific condition before making a decision that can have a lasting impact on your spine.

If fusion has been recommended, it’s okay to ask what else is possible. Understanding all of your options can help you make a decision you feel confident in.

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

09/18/2026

For a lot of people, fear of spine surgery starts with someone else’s story. A parent who had surgery in the early 2000s. A grandparent before that. A friend who had a rough recovery and never quite bounced back.

Those experiences stick with us. And if you’re living with chronic leg or back pain, they may even be part of the reason you’ve been putting off surgery.

Dr. Jonathan Stieber, an orthopedic spine surgeon, has been operating long enough to see just how much spine surgery has changed over the last twenty years. Smaller incisions, less blood loss, lower infection rates, shorter hospital stays. In some cases, procedures that once meant several nights in the hospital may now mean going home the same day.

That doesn’t make the decision to have spine surgery a small one. It means the experience someone had 20 years ago may not tell you what your experience would look like today.

Ask questions. Understand what your specific procedure involves. Get another opinion if you need one. The goal isn’t to talk yourself into surgery. It’s to make sure you’re making the decision based on the most up-to-date information on spine surgery today.

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

09/15/2026

When you have chronic back pain, figuring out what is causing that pain can sometimes be surprisingly difficult. There are a lot of pain generators in your spine that could be responsible, and for a long time the disc itself wasn't widely counted among them. If you've been told there's no clear source for your pain, that history may be part of why.

Dr. John Peloza, an orthopedic spine surgeon, disagrees with the idea that a disc can't be a source of back pain. Many spine specialists were trained that back pain can only be associated with the compression of nerves. Dr. Peloza’s position is different. He believes the disc can generate pain on its own, that discogenic pain is a common driver of axial back pain, and that spine surgery can treat it successfully.

This is not a debate about whether your pain is real. It's a disagreement that can occur among providers about where the pain is potentially coming from, and whether a damaged disc can be a source of that associated back pain.

If you've been living with chronic back pain that no one can explain, ask directly whether discogenic pain has been considered in your case, and what it would take to confirm or rule it out. If the answer that you keep hearing is that your pain is a mystery, that's a reason to get a second opinion from a spine specialist who may be able to look at your situation from a different perspective.

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

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