Alexander Taghva, MD

Board-certified neurosurgeon. Spine surgery. I write about the upstream fixes for your spine that most people never get

[Alexander Taghva, MD @DrTaghva]

My patients got tired of hearing me drone on about the spine, so I wrote it down.
UPRIGHT. Fall 2027. Penguin Life.

[Alexander Taghva, MD @DrTaghva]

I wrote a deep dive on this, including why we don't stimulate the substantia nigra, what four major studies actually show, and why directional leads might change how we think about targeting within the STN. https://t.co/ZtJwTy2cjK

[Alexander Taghva, MD @DrTaghva]

Most people think of Parkinson's as a motor disease. It's not. It's a circuit disease that happens to present most visibly through movement.

[Alexander Taghva, MD @DrTaghva]

But here's what most people miss: the cognitive effects are selective, not global. Some domains decline. Others improve. That's not what brain damage looks like. That's what circuit modulation looks like.

[ABC News @ABC]

BREAKING: The FBI has warned police departments in California that Iran wants to retaliate for American attacks by launching offensive drones against the West Coast, according to an alert reviewed by @ABC News.

Read more: https://t.co/LNR2dkGK8T

[Alexander Taghva, MD @DrTaghva]

Patient had a failed spine fusion. Back pain, sciatica, scoliosis. I planned revision surgery.

Then I put a piece of foam in his shoe.

He canceled the surgery.

A $2 heel lift fixed what a fusion couldn't — because nobody checked his leg lengths.

[Alexander Taghva, MD @DrTaghva]

“You have arthritis” is not a diagnosis. It’s a category. Osteoarthritis and inflammatory arthritis have different causes, different treatments, and different trajectories. If no one told you which kind, ask. It changes everything. Full discussion in my substack and YouTube channel.

[Alexander Taghva, MD @DrTaghva]

The algorithm rewards confidence. Medicine rewards calibration. That's the gap. New post on why the loudest voices in medicine belong to people who don't practice it.

[Alexander Taghva, MD @DrTaghva]

Unfortunately, as most practicing physicians know, the steepest learning curve comes from the accountability you have for patients after residency. I don’t doubt *some* of what Casey Means talks about is good general health advice, and certainly mainstream medicine has its blind spots, but nominating her as Surgeon General is a stretch for me. It’s another example of tearing down institutional norms to further degrade our barometer of what expertise and truth mean.

[Alexander Taghva, MD @DrTaghva]

A patient asked me what I listen to in the OR while operating on spines. The answer is unapologetically yacht rock. Steely Dan. Hall & Oates. Michael McDonald. It’s the perfect surgical soundtrack — mellow enough to keep the room calm, smooth enough to let my brain focus on what matters. Like a warm, yachty blanket draped over a very serious situation.
What do you want your surgeon listening to? Surgeons, what do you listen to in the OR?

[Alexander Taghva, MD @DrTaghva]

@timshuwy Thanks Tim, glad you are doing well. My office can also provide some guidance!

[Alexander Taghva, MD @DrTaghva]

Medicare Advantage is not Medicare. The insurer gets paid a fixed amount per patient. Every dollar they don’t spend on your care is a dollar they keep. I had a patient with broken hardware and documented nerve compression get denied. The denial letter read like no one looked at the chart. We requested a peer-to-peer. They called our office on a Saturday. We called back Monday. “Sorry, you missed the window.”

[Alexander Taghva, MD @DrTaghva]

The chin tuck is the most commonly prescribed neck exercise and most people are doing it wrong. "Pull your chin back" jams the upper cervical joints and recruits the exact muscles you're trying to bypass. The better cue: grow tall. Big difference. More on this soon.

[Alexander Taghva, MD @DrTaghva]

Quick tip I give patients all the time: when you’re sitting, try to keep your knees slightly below your hips. Most chairs put your knees at or above hip level, which tilts your pelvis backward, flattens your lumbar curve, and loads the discs. Drop the knees below the hips and your pelvis naturally tilts forward into a more neutral position. Your spine stacks the way it was designed to. You don’t need an expensive ergonomic chair to do this — a seat wedge or even sitting on the front edge of your chair can get you there. The 23-hour rule: small positional changes during the hours you’re not exercising matter more than the exercises themselves.

[Alexander Taghva, MD @DrTaghva]

I published a paper in Frontiers in Pain Research using Karl Friston's variational free energy framework to explore why spinal cord stimulation habituates. The brain is a prediction machine. When a stimulus becomes predictable, the brain minimizes its response. The device doesn't fail. The nervous system gets too good at predicting it. https://t.co/mbbhL1YRmt

[Alexander Taghva, MD @DrTaghva]

I love The Pitt. It’s the most realistic medical show on TV - except for the fact that I have never seen a neurosurgeon in their ER. God knows I’ve spent a lot of time in the emergency room.

[Alexander Taghva, MD @DrTaghva]

The chin tuck is the most commonly prescribed neck exercise and most people are doing it wrong. "Pull your chin back" jams the upper cervical joints and recruits the exact muscles you're trying to bypass. The better cue: grow tall. Big difference. Full Cervical Six breakdown on my Substack. https://t.co/FIW1BRoWP7

[Alexander Taghva, MD @DrTaghva]

Hot take from a neurosurgeon: fusion isn't the problem. Bad indications and lazy decompressions are the problem. Some of my happiest surgical patients have screws and rods in their spine.