Vertrae® 360

Kamal Woods
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We take you behind the scenes of a neurosurgery private practice and talk all things spine-related.

  1. Why Chronic Low Back Pain Isn’t Always a Nerve Problem | Vertrae® 360 Spine Talk (Ep. 35)

    2d ago

    Why Chronic Low Back Pain Isn’t Always a Nerve Problem | Vertrae® 360 Spine Talk (Ep. 35)

    For years, many patients with chronic low back pain have been treated as if their pain was nerve-related. But what if the real issue is mechanical? In this episode of Vertrae® 360 Spine Talk, we explore a specific type of chronic axial low back pain that does not shoot down the legs and often does not respond to physical therapy, medications, injections, chiropractic care, or traditional pain management approaches. The conversation focuses on the multifidus muscle, a deep spinal stabilizer that can become inhibited after injury. When this muscle stops firing properly, it may weaken, atrophy, and contribute to a cycle of mechanical instability and persistent low back pain. We also discuss ReActiv8®, an implantable restorative neurostimulation therapy designed to reactivate the multifidus muscle and help restore neuromuscular control over time. Unlike traditional spinal cord stimulation, which is commonly used to modulate nerve pain signals, ReActiv8® targets the motor nerve responsible for activating the multifidus. In this episode, you’ll learn: • The difference between neuropathic pain and mechanical back pain • Why traditional spinal cord stimulation may not be the right fit for some low back pain patients • What the multifidus muscle does and why it matters • How the inhibition-atrophy-pain cycle can keep patients stuck • How ReActiv8® therapy works • What clinical data suggests about long-term outcomes • Why proper patient selection and specialist evaluation are essential At Vertrae® Surgery Center in Dayton, Ohio, Dr. Kamal Woods and his team focus on identifying the true source of a patient’s spine pain and matching the right treatment to the right diagnosis. This episode is for educational purposes only and is not a substitute for medical advice. Always consult a qualified medical professional for diagnosis and treatment options.

    21 min
  2. Which Spinal Cord Stimulator Waveform Fits Your Pain? | Vertrae® 360 Spine Talk (Ep. 34)

    4d ago

    Which Spinal Cord Stimulator Waveform Fits Your Pain? | Vertrae® 360 Spine Talk (Ep. 34)

    Spinal cord stimulation is often described like one single therapy — but in reality, SCS is a family of different waveforms, and each waveform can affect the nervous system differently. In this episode of Vertrae® 360 Spine Talk, we break down the major spinal cord stimulation options patients may hear about: tonic SCS, 10 kHz high-frequency SCS, burst stimulation, and closed-loop ECAP-controlled stimulation. The conversation explains why waveform selection matters for chronic pain, especially for patients with back-dominant pain, leg-dominant pain, mixed back and leg pain, paresthesia intolerance, or a spinal cord stimulator that has stopped working. You’ll hear how traditional tonic stimulation uses paresthesia, or tingling, to help mask pain, while newer options like 10 kHz SCS, burst SCS, and certain closed-loop SCS settings may provide paresthesia-free pain relief. The episode also explores why closed-loop stimulation is different: it listens to the spinal cord’s response and adjusts stimulation in real time. This episode also covers what happens when a spinal cord stimulator fails. A loss of relief from one waveform does not always mean SCS therapy has failed completely. For some patients, SCS rescue therapy, reprogramming, battery replacement, or switching waveforms may still provide meaningful relief before considering explant surgery. Disclaimer: This podcast is for educational purposes only and is not medical advice. Please consult a qualified healthcare professional for diagnosis and treatment recommendations.

    21 min
  3. Failed Spinal Cord Stimulator? DRG-S May Still Help | Vertrae® 360 Spine Talk (Ep. 33)

    6d ago

    Failed Spinal Cord Stimulator? DRG-S May Still Help | Vertrae® 360 Spine Talk (Ep. 33)

    A failed spinal cord stimulator trial can feel like the end of the road — but for the right patient, it may not mean neuromodulation has failed. It may mean the therapy was aimed at the wrong anatomical target. In this episode of Vertrae® 360 Spine Talk, we explore why some patients who did not respond to spinal cord stimulation, or SCS, may still be candidates for dorsal root ganglion stimulation, or DRG-S. Drawing from the clinical framework of Dr. Kamal Woods at Vertrae® Surgery Center in Dayton, Ohio, this conversation explains the difference between broad spinal cord stimulation and precision DRG stimulation for focal nerve pain. Traditional SCS targets the dorsal columns of the spinal cord and may be better suited for broader, multi-region pain. DRG-S targets the dorsal root ganglion, a specific nerve “checkpoint” where pain signals from one defined area enter the spine. For patients with CRPS, focal post-surgical nerve pain, or pain isolated to one foot, knee, groin, or nerve territory, that difference can matter. This episode also breaks down why “failed SCS” is not one single diagnosis. A failed stimulator may reflect a focal pain mismatch, a structural spine problem, outdated SCS technology, or patient-level factors such as unmanaged depression or long-term opioid use. The goal is not to push another implant — it is to understand why the first therapy failed and what the next best step should be. You’ll also hear about DRG-S salvage therapy, the temporary DRG stimulation trial process, and clinical data showing that carefully selected patients with focal neuropathic pain may still respond after a previous SCS failure. Topics covered include: Failed spinal cord stimulator trial Spinal cord stimulator stopped working DRG stimulation after failed SCS Dorsal root ganglion stimulation DRG-S salvage therapy CRPS and focal nerve pain Post-surgical nerve pain Persistent spinal pain syndrome Neuromodulation options after failed SCS Temporary DRG stimulation trial Pain phenotype mismatch Dr. Kamal Woods and Vertrae® Surgery Center in Dayton, Ohio Disclaimer: This podcast is for educational purposes only and is not medical advice. Please consult a qualified healthcare professional for diagnosis and treatment recommendations.

    21 min
  4. Is Your Pain Coming From the DRG? | Vertrae® 360 Spine Talk (Ep. 32)

    Jun 5

    Is Your Pain Coming From the DRG? | Vertrae® 360 Spine Talk (Ep. 32)

    What if your chronic pain is not “unexplainable” — but coming from one tiny, specific structure near the spine? In this episode of Vertrae® 360 Spine Talk, we explore dorsal root ganglion stimulation, or DRG-S, a precision neuromodulation therapy designed for highly localized nerve pain. The conversation breaks down how the dorsal root ganglion acts like a sensory “tollbooth” between the body and spinal cord, and why this small cluster of nerve cells may become hyperactive after injury, surgery, or complex regional pain syndrome. Unlike traditional spinal cord stimulation, which treats broader pain patterns, DRG stimulation targets a specific nerve territory — making it especially relevant for patients with focal pain in areas such as the foot, knee, groin, pelvis, or lower extremity. The episode also discusses the landmark ACCURATE trial, where DRG-S showed strong outcomes for patients with lower-extremity CRPS, including higher responder rates than conventional SCS in the studied population. You’ll also hear why DRG-S is not for every kind of chronic pain, why patient selection matters, what a temporary trial looks like, and why a consultation should be about getting a clear answer — whether that answer is DRG-S, spinal cord stimulation, or another treatment path entirely. Topics covered include: Dorsal root ganglion stimulation, or DRG-S DRG stimulation for CRPS Focal neuropathic pain Post-surgical nerve pain Chronic groin and pelvic pain Foot, knee, leg, and lower-extremity nerve pain DRG stimulation vs spinal cord stimulation The ACCURATE trial Paresthesia-free pain relief Temporary DRG stimulation trials Neuromodulation in Dayton, Ohio Dr. Kamal Woods and Vertrae® Surgery Center Disclaimer: This podcast is for educational purposes only and is not medical advice. Please consult a qualified healthcare professional for diagnosis and treatment recommendations.

    22 min
  5. Is Neuromodulation Right for Your Pain? | Vertrae® 360 Spine Talk (Ep. 31)

    Jun 3

    Is Neuromodulation Right for Your Pain? | Vertrae® 360 Spine Talk (Ep. 31)

    Neuromodulation is often described as a “last resort” for chronic pain — but it is not one single treatment, and it is not right for every patient. In this episode of Vertrae® 360 Spine Talk, we break down Dr. Kamal Woods’ three-family framework for understanding advanced neuromodulation therapies: spinal cord stimulation, dorsal root ganglion stimulation, and ReActiv8® restorative neurostimulation. This conversation explains why the right treatment depends on the specific pattern, location, and mechanism of pain. Broad, burning nerve pain may point toward traditional spinal cord stimulation, while highly localized pain — such as certain cases of complex regional pain syndrome, post-surgical nerve pain, or focal groin and foot pain — may fit DRG stimulation. For deep mechanical low back pain connected to multifidus dysfunction, ReActiv8® works differently by helping restore muscle function rather than simply masking pain signals. The episode also explores what patients can expect from a temporary neuromodulation trial, why patient selection matters, and how clinical research like the ACCURATE trial, EVOKE trial, and RESTORE trial helps guide treatment decisions. If you have lived with chronic pain despite pills, injections, therapy, or prior surgery, this episode offers a clearer way to think about whether neuromodulation may fit your pain — and why getting an honest “yes,” “no,” or “not this treatment” can be the most important outcome of a consultation. Topics covered include: Spinal cord stimulation for chronic pain Dorsal root ganglion stimulation, or DRG-S ReActiv8® restorative neurostimulation Complex regional pain syndrome, or CRPS Focal nerve pain vs widespread nerve pain Mechanical low back pain and multifidus dysfunction Temporary stimulator trials Neuromodulation patient selection Chronic pain after surgery Dr. Kamal Woods and Vertrae® Surgery Center in Dayton, Ohio Disclaimer: This podcast is for educational purposes only and is not medical advice. Please consult a qualified healthcare professional for diagnosis and treatment recommendations.

    21 min
  6. Chronic Back Pain, MRI Limits & Neuromodulation | Vertrae® 360 Spine Talk (Ep. 30)

    Jun 1

    Chronic Back Pain, MRI Limits & Neuromodulation | Vertrae® 360 Spine Talk (Ep. 30)

    What happens when your MRI looks “fine,” your surgery is considered technically successful, but your back pain is still there — or even moving somewhere new? In this episode of Vertrae® 360 Spine Talk, we explore why chronic back pain often requires a deeper diagnostic approach than standard imaging alone. Through the lens of Dr. Kamal Woods’ MotionFirst™ philosophy, this conversation breaks down why an MRI can miss important clues about pain, especially when the spine is only viewed as a static structure rather than a dynamic system in motion. The episode also examines the role of the multifidus muscle, functional instability, the prone instability test, and why some patients continue to experience pain even after a successful spinal procedure. From there, the discussion moves into central sensitization, the connection between chronic pain, depression, anxiety, and the nervous system, and how emerging treatments like neuromodulation may help interrupt amplified pain signals. If you have ever felt dismissed because your pain does not match your imaging, this episode offers a new way to think about chronic back pain — one that looks at movement, muscle function, nerve sensitivity, and the full pain experience. Topics covered include: MRI limitations in chronic back pain Dr. Kamal Woods’ MotionFirst™ philosophy Why pain can persist after spine surgery Multifidus dysfunction and spinal instability Central sensitization and nervous system hypersensitivity Depression, anxiety, and pain amplification Neuromodulation for chronic pain Why chronic pain is not “all in your head” Disclaimer: This podcast is for educational purposes only and is not medical advice. Please consult a qualified healthcare professional for diagnosis and treatment options.

    6 min
  7. Chronic Pain, Depression & Hope Fatigue | Vertrae® 360 Spine Talk (Ep. 29)

    May 29

    Chronic Pain, Depression & Hope Fatigue | Vertrae® 360 Spine Talk (Ep. 29)

    What if chronic back pain is not just about what appears on an MRI? In this episode of Vertrae® 360 Spine Talk, we explore the powerful connection between chronic pain, depression, anxiety, and hope fatigue — and why emotional exhaustion can be deeply tied to the way the nervous system processes pain. Inspired by insights from neurosurgeon Dr. Kamal Woods, this conversation takes a closer look at how chronic pain can physically change the brain. When pain persists for months or years, the brain’s threat detection system can become overactive, while the areas responsible for optimism, planning, and imagining a better future can become quieter. This helps explain why many patients feel like they have reached a permanent ceiling with pain, even when more precise answers may still be possible. We also discuss why depression and chronic back pain often form a two-way cycle, how hope fatigue develops after repeated failed treatments, and why patients should not be pressured into toxic positivity or false hope. This episode also covers advanced pain treatment options such as spinal cord stimulation, neuromodulation, and ReActiv8 therapy, including how these approaches may help target specific pain signals, nerve pathways, or mechanical pain generators like the multifidus muscle. For patients living with persistent spinal pain, failed back surgery syndrome, neuropathic pain, chronic low back pain, or long-term pain after surgery, this episode offers a new way to think about pain: not as a personal failure, but as a complex neurological and mechanical condition that deserves a deeper evaluation. In this episode, we discuss: Why MRI findings may not fully explain chronic back painThe link between chronic pain, depression, and anxietyHow chronic pain can rewire the brain and nervous systemWhat hope fatigue is and why it mattersWhy chronic pain can disrupt identity and daily functionHow precise pain evaluations can reveal overlooked pain generatorsThe role of the multifidus muscle in spinal stabilitySpinal cord stimulation for neuropathic painReActiv8 therapy for mechanical low back painWhy restoring function may matter more than chasing zero pain If you or someone you love feels stuck in chronic pain, this episode is a reminder that the right questions may not have been asked yet — and that a new evaluation may reveal a new path forward.

    6 min
  8. Persistent Spinal Pain Syndrome Is Not Failed Back Surgery | Vertrae® 360 Spine Talk (Ep. 28)

    May 25

    Persistent Spinal Pain Syndrome Is Not Failed Back Surgery | Vertrae® 360 Spine Talk (Ep. 28)

    Pain after spine surgery can be confusing, discouraging, and emotionally exhausting — especially when the surgery was technically successful, but the pain remains. In this episode of Vertrae® 360 Spine Talk, we explore Persistent Spinal Pain Syndrome, or PSPS, the diagnosis that has formally replaced the outdated term “failed back surgery syndrome.” This shift matters because persistent pain after spine surgery is not about blame. It is about understanding the biological, structural, neurological, and emotional factors that can continue driving pain after surgery. Drawing from the clinical framework of Dr. Kamal Woods at Vertrae® Surgery Center in Dayton, Ohio, this episode explains why pain can persist after spine surgery, including causes such as epidural fibrosis, adjacent segment disease, recurrent disc herniation, unaddressed facet joint pain, Modic changes, and central sensitization. You’ll also hear why the length of time someone had pain before surgery can influence recovery, how anxiety and depression affect the nervous system’s response to pain, and why a fresh re-evaluation can help identify what is generating symptoms today. Topics covered include: Why “failed back surgery syndrome” is no longer the preferred termWhat Persistent Spinal Pain Syndrome meansWhy pain can persist after technically successful spine surgeryEpidural fibrosis, adjacent segment disease, and recurrent disc herniationCentral sensitization and chronic nerve painHow preoperative pain duration affects PSPS riskThe role of anxiety, depression, sleep disruption, and emotional traumaWhy fresh evaluation matters after persistent painSpinal cord stimulation for neuropathic leg painReActiv8® restorative neurostimulation for multifidus dysfunctionWhy the next step is not blame, but better diagnosis Seeking a second evaluation after spine surgery is not a betrayal of your original surgeon or an admission that the first decision was wrong. It is an appropriate clinical step when pain persists and a new diagnosis may be needed. This episode is for educational purposes only and is not a substitute for medical advice, diagnosis, or treatment. If you experience sudden loss of bladder or bowel control, new numbness in the groin or saddle area, sudden weakness in the legs, fever with severe back pain, or rapidly worsening neurological symptoms, seek emergency medical care immediately.

    6 min
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About

We take you behind the scenes of a neurosurgery private practice and talk all things spine-related.

Information

  • Creator
    Kamal Woods
  • Years Active
    2025 - 2026
  • Episodes
    35
  • Rating
    Clean
  • Copyright
    © Copyright 2026 Kamal Woods
  • Show Website
    Vertrae® 360

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