compression fx in a VB with a pedicle screw

[myrandom2003]

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Anybody get a referral for a kyphoplasty/vertebroplasty in a compressed VB that has pedicle screws in it from previous fixation?

Had a referal for that today (L5 compression in a previous L4/5 fixation). Would it be better to just do a Gray rami block and get them in a brace?

 

[lobelsteve]

I'm thinking bad idea.
But definitely avoid a transpedicular approach (haha)

If edema in there: Miacalcin bid and a brace. Give it a week. Try some Dilaudid.
If fails go parapedicular (if a fatty you may need a longer needle).

 

[myrandom2003]

LOL so no go on the unipedicular approach then??

I think i will give the brace and miacalcin a try. Much obliged 🙂