Discseel Procedure

[TeslaCoil]

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Was recently contacted by the VA who is looking for a physician to refer patients to for discseel. Thinking of adding this to our repertoire. Anybody have the skinny on this procedure? How are outcomes? Potential complications? Thanks!

 

[SgtThunderfistMD]

waste of time

 

[bubaghanush]

Don't want to hijack the thread but is Viadisc a waste as well? A couple of colleagues seems quite excited about it, but every intradiscal procedure seems to be overhyped and eventually fizzle out.

 

[TeslaCoil]

waste of time

care to expand on that?

 

[RoloTomassi]

I've had 2-3 patients who it didn't work for. Could be selection bias but probably not.

 

[Baron S]

Don't want to hijack the thread but is Viadisc a waste as well? A couple of colleagues seems quite excited about it, but every intradiscal procedure seems to be overhyped and eventually fizzle out.

I did somewhere around 10 while in DoD and had a >50% success rate, better than anything else I had tried intradiscal.

 

[bedrock]

I think intracept is far more effective (if covered by their insurance company)

 

[hyperalgesia]

Was recently contacted by the VA who is looking for a physician to refer patients to for discseel. Thinking of adding this to our repertoire. Anybody have the skinny on this procedure? How are outcomes? Potential complications? Thanks!

Probably a veteran heard about the procedure and asked his PCP, who then requested it on behalf of the patient. Neither patient, nor referring doc has any idea of the indications or implications of the procedure.

So, I would expect it to be a one-off from the VA, most likely an inappropriate referral, if that is part of your calculus...

 

[bubaghanush]

I think intracept is far more effective (if covered by their insurance company)

I am doing Intracept now and agree it is effective. I'll see how my colleagues do with Viadisc for now.

 

[Taus]

My understanding is, it sounded very promising, and then the trial results were very underwhelming not much different from placebo. Apparently it only works when you get super special training from pauza and charge like 20 K cash.

 

[clubdeac]

I am doing Intracept now and agree it is effective. I'll see how my colleagues do with Viadisc for now.

Did it 10 yrs ago while at the VA. You at the VA?

 

[bubaghanush]

Did it 10 yrs ago while at the VA. You at the VA?

No in academics. Wow I didn't realize it's been out that long.

 

[clubdeac]

No in academics. Wow I didn't realize it's been out that long.

just had a complete brain fart. I was reading the thread on intradiscal procedures and for some reason I read intracept as biacuplasty. I was doing biacuplasty, thermal coagulation of the disc, over 10 yrs ago when it was a thing

 

[TeslaCoil]

Probably a veteran heard about the procedure and asked his PCP, who then requested it on behalf of the patient. Neither patient, nor referring doc has any idea of the indications or implications of the procedure.

So, I would expect it to be a one-off from the VA, most likely an inappropriate referral, if that is part of your calculus...

This is so typical and cynical and true. I just had to laugh.

 

[BobBarker]

How do you even bill for it? No set fee schedule…

Ok, VAMC, that will be $16,000 paid in advance. 😂 Surely, that isn’t the way it is done?

 

[hyperalgesia]

How do you even bill for it? No set fee schedule…

Ok, VAMC, that will be $16,000 paid in advance. 😂 Surely, that isn’t the way it is done?

I think every VA is different but most use Medicare rates. I wouldn't touch it without written auth for anything you're gonna do.

 

[joshmir]

 

[joshmir]

Appears there is a company that is Russian that manufactures another type of intradiscal injectate, that is also purported to “seal” (in addition to other mechanisms)

I love the caption in the YouTube video on their website that says “Video realized in real time without any trickery”

Anyways, some have put forth that a reduction in disc pressure is helpful, but I would think that anything that seals the annulus fibrosus would not intuitively reduce pressure, but I’m sure it’s more complicated than that.

 

[clubdeac]

Appears there is a company that is Russian that manufactures another type of intradiscal injectate, that is also purported to “seal” (in addition to other mechanisms)

I love the caption in the YouTube video on their website that says “Video realized in real time without any trickery”

Anyways, some have put forth that a reduction in disc pressure is helpful, but I would think that anything that seals the annulus fibrosus would not intuitively reduce pressure, but I’m sure it’s more complicated than that.

I wouldn’t inject anything in my body from Russia or China for that matter. Funny thing is we use and ingest crap imported from China every day. That’s the likely cause of our markedly increase in cancer under 40 and sky rocketing autism.

 

[callmeanesthesia]

I wouldn’t inject anything in my body from Russia or China for that matter. Funny thing is we use and ingest crap imported from China every day. That’s the likely cause of our markedly increase in cancer under 40 and sky rocketing autism.

See, now I think you’re onto something. Wasn’t it in the news recently that a study found the average brain contains like a tsp of microplastics? (Don’t quote me on that - I might just be making it up. Maybe it’s the microplastics talking).

 

[bedrock]

I wouldn’t inject anything in my body from Russia or China for that matter. Funny thing is we use and ingest crap imported from China every day. That’s the likely cause of our markedly increase in cancer under 40 and sky rocketing autism.

See, now I think you’re onto something. Wasn’t it in the news recently that a study found the average brain contains like a tsp of microplastics? (Don’t quote me on that - I might just be making it up. Maybe it’s the microplastics talking).

That number sounds close.

Personally I feel a major reason for the increased cancer rate is all the artificial junk we now take into our bodies.

For a decade my lady and I have eaten only organic produce and pastured raised/fresh caught meats 98% of the time. We also cook for ourselves the vast majority of the time because it is healthier. We don’t eat any highly processed and packaged foods. We don’t smoke and drink extremely rarely, as in a few times per year.

Microplastics are a real concern and we never use plastic water bottles, or consume anything that was heated in plastic. Same applies to Starbucks or other coffee chains. All of those cups have a liner that leaches into your coffee with heat.

I feel more healthy, with more energy, more normal GI tract, than I did a decade ago, when I was 10 yrs younger, but eating standard processed western foods.

 

[clubdeac]

That number sounds close.

Personally I feel a major reason for the increased cancer rate is all the artificial junk we take into out body.

For a decade my lady and I have eaten only organic and pastured raised/fresh caught 98% of the time. We cook for ourselves the vast majority of the time because it is healthier. We don’t eat any highly processed and packaged foods. We don’t smoke and drink extremely rarely, as in a few times per year.

Microplastics are a real concern and we never use plastic water bottles, or consume anything that was heated in plastic. Same applies to Starbucks or other coffee chains. All of those cups have a liner that leaches into your coffee with heat.

I feel more healthy, with more energy, more normal GI tract, than I did a decade ago, when I was 10 yrs younger, but eating standard processed western foods.

We have a fancy cuisinart coffee/latte/espresso maker. All the coffee gets filtered through a metal filter but passes over and around black plastic. All that hot water pouring through black plastic. I flipped over the machine and sure enough it’s made in China. You think they give a *** if black plastic is leaching into the coffee during the process? Definitely not. I’ve been reluctant to throw it out bc it was like $500 but I think I’m going to have to

 

[bedrock]

We have a fancy cuisinart coffee maker. All the cider gets filtered through a metal filter but passes over black plastic. All that hot water pouring through black plastic. I flipped over the machine and sure enough it’s made in China. You think they give a if the black plastic is leaching into the coffee during the process? Definitely not. I’ve been reluctant to through it out bc it was like $500 but I think I’m going to have to

I’d toss it.

 

[callmeanesthesia]

We have a fancy cuisinart coffee/latte/espresso maker. All the coffee gets filtered through a metal filter but passes over and around black plastic. All that hot water pouring through black plastic. I flipped over the machine and sure enough it’s made in China. You think they give a *** if black plastic is leaching into the coffee during the process? Definitely not. I’ve been reluctant to throw it out bc it was like $500 but I think I’m going to have to

Been using one of these for years. Makes great coffee. Stainless steel. Also note the cast iron and carbon steel pans in the background - no non-stick.

We aren’t great about stuff with plastic packaging though, I have to admit. Practicalities of having 4 kids though.