Compression Fracture and Vertebral Augmentation

[PinchandBurn]

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Usually I would only do Kyphos on patients with an acute/subacute MRI with edema on the fracture.

I recently saw a patient with a CHRONIC compression fracture. But it is very tender.

I did a literature search, apparently one can do kyphos on chronic appearing fractures. Do you all do it in practice? I didnt know that you could. Thoughts?

 

[callmeanesthesia]

Pain around the site of a chronic fracture I will try medial branch blocks. I’d say better than 50% response rate and success with RF.

 

[lobelsteve]

If no edema on stir, mbb. Check your guidelines. Not indicated.

 

[SommeRiver]

Majority of the time I do MBB on these pts and I end up ablating them. It isn't a slam dunk, but it works pretty consistently in my experience.

I've in the past had those pts that failed MBB/RFA and even considered SCS but I can't figure out what I'd be stimulating in that situation. No, I never actually tried to get it covered insurance and actually do it.

 

[thecentral09]

We did it once in fellowship. I won’t do it again. Healed bone was so incredibly hard we couldn’t insufflate balloon with over 350psi.

 

[lobelsteve]

We did it once in fellowship. I won’t do it again. Healed bone was so incredibly hard we couldn’t insufflate balloon with over 350psi.

Stryker has new balloon to 800psi. Dont treat healed fxs please.