Arthrodesis of the Spine by the Non-Spine Surgeon

[paindoc007]

Yikes
Doug Beale said “you have more chance of putting this in the brain than in the kidney”. I guess that’s not true. Regardless it would be very educational to know where/how this went wrong.

I love Doug beal. I really do. He’s incredible for our field of interventional pain. Buttt he exaggerates 10 fold. Watch some lectures where he talks to fellows. He basically scoffs at the notion of a complications. Like for Kypho he basically says in good hands/technique a complication should never ever ever happen kind of talk. I’ve heard it. So when it comes to that stuff specifically, take what he says there with a Grain of salt

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[RoloTomassi]

Well this is terrible. One of our spine surgeon's patient just had what sounds like a minuteman done poorly by a local pain physician. Next day to ER, found to have internal bleeding. Expired within 3 days of procedure in kidney failure needing dialysis with GI bleeding. Lawsuit likely pending.

Do you have access to any imaging from the hospital?

 

[NJPAIN]

BMI over 40. My spine surgeon told him he had to lose weight before he would consider operating on him.

Please let us know what else you find out. Obviously want to be certain that it was in fact directly related to trauma from the surgery.

 

[RoloTomassi]

I was wondering how GI tract could be hit but looks like it can sometimes be posterior to kidney. In pic (a), I can definitely see how MM k-wire could hit descending colon if done at that level. Seems like it would have to be mid/upper lumbar unless the wag was off. Definitely would do a prone CT pre-op if I ever did one. BMI 40 belly would push contents posterior.

 

[Agast]

Probably more appropriate for private forum. Wife reportedly has her own minuteman that is not doing so hot so I may end up seeing her.

 

[BobBarker]

I can’t remember for sure but I think the lateral approach is only recommended for L2/3 and below per spinal simplicity. The reps tend to recommend a direct lateral approach. I cut down into the paraspinal muscle and angle it down and across. So a more oblique approach than true lateral. Push my hands down when deploying to level out the implant.

 

[lobelsteve]

Probably more appropriate for private forum. Wife reportedly has her own minuteman that is not doing so hot so I may end up seeing her.

100% of the time it works 100% of the time.

 

[pmrmd]

A scoliosis would be a risk factor for cephalocaudad approach and internal organ injury. Unreal.