Epidural Space intact?

[Timeoutofmind]

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Seems like her epidural space should be intact after this Harrington Rod type procedure she had as a teenager, correct? There really is no decompression/lami type element to the procedure it appears...

Would you put a needle in there for SCS or ESI?

 

[drrosenrosen]

DRG, bilateral T8-T12. You may need a few IPGs...

 

[bedrock]

Epidural space likely intact, but you never know for sure. if ESI do TFESI. If SCS enter below hardware and gently try to advance leads.

 

[lobelsteve]

There's no clinical history and no pain diagram. I'd rather stick a needle in her brain.

 

[Timeoutofmind]

There's no clinical history and no pain diagram. I'd rather stick a needle in her brain.

Lol!
Was more just of a theoretical question after this kind of surgery...
No intervention planned

 

[Yo GabbaPentin]

There's no clinical history and no pain diagram. I'd rather stick a needle in her brain.

What do you bill for this procedure? I am billing 64999 but it keeps getting denied.

 

[drrosenrosen]

What do you bill for this procedure? I am billing 64999 but it keeps getting denied.

What's the CPT for pithing?

 

[lobelsteve]

What do you bill for this procedure? I am billing 64999 but it keeps getting denied.

64610 if RF

 

[Biohazard685]

What's the CPT for pithing?

What's the CPT for a cisterna magna tap?

 

[Biohazard685]

Seems like her epidural space should be intact after this Harrington Rod type procedure she had as a teenager, correct? There really is no decompression/lami type element to the procedure it appears...

Would you put a needle in there for SCS or ESI?

View attachment 236168

View attachment 236169

Thread catheter at lower interspace or caudal catheter and run some contrast to confirm?

 

[Orin]

Epidurogram with catheter to assess feasibility, but I'm still not sure what the pain pattern here is.

With the harrington rods, I think the issue is more the lamina hooks or wires causing scarring, making it hard to drive, and taking up space, but her setup doesn't look like it has any significant hooks above T11.

 

[Timeoutofmind]

Epidurogram with catheter to assess feasibility, but I'm still not sure what the pain pattern here is.

With the harrington rods, I think the issue is more the lamina hooks or wires causing scarring, making it hard to drive, and taking up space, but her setup doesn't look like it has any significant hooks above T11.

What I was looking for, thanks!

 

[Ducttape]

I did one case with Harrington rods. Indication was arachnoiditis.
Not an easy injection and not a successful trial.