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So you’re saying I shouldn’t have chosen the option with the lowest pro fee?
Extrapedicular Vertebral Augmentation
Started by manowar rules
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One system pre-surgery.
Different systems so something new after surgery.
This one already has an SCS with paddle that is not helping. Mechanical axial back pain….
Perhaps its cluneal nerves…..
Through perc leads under the paddle as high as they go. If IPG still good....
Why?
I thought we were talking about how to profit off this guys a pain. Didn't realize someone thought he could be made better.
It's ok to put down the needle sometimes.
Update! No intervention was performed. Patient’s pain progressed significantly until new imaging was obtained:
And those are 2 weeks after original imaging below with original report:
Glad I didn’t do that transdiscal kypho! In retrospect I should have been more suspicious of that disc signal
And those are 2 weeks after original imaging below with original report:
Glad I didn’t do that transdiscal kypho! In retrospect I should have been more suspicious of that disc signal
Radiology could have tipped you off on disc signal. Chronic immunosuppression. Guess ESR/CRP could have been done. Glad somebody repeated the imaging. The initial set of films was an impressive in the second set clearly showed the answer. I’d like to know how the guy looked clinically.
His presentation is part of what threw me off. I thought that clinically, he looked like many other patients do with an acute compression fracture. He was obviously uncomfortable and tender to lumbar palpation. He did not appear ill, have neurologic signs, or any weird radiation of his pain. No fever/chills/etc. He could name the instant that his pain started, when he got up out of a chair and twisted a couple weeks before.
I saw a similar thing a couple years ago. I think I posted it in the images thread too. Complicated by a pacemaker. Referred from a partner for possible kypho after CT and Bone scan read as concerning for acute fracture, but on CT the endplate looked very ratty to me - eroded, not compressed. Denied fevers/chills. CRP came back in the 30s.
