Interspinous ligament

[paingate21]

have a patient with midline lumbar pain - MRI with interspinous edema at 3 levels. Remaining MRI without significant findings - exam benign other than midline pain. has anyone injected the interspinous ligaments? Success? Local? Local plus steroid? Biologics?

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[SSdoc33]

have a patient with midline lumbar pain - MRI with interspinous edema at 3 levels. Remaining MRI without significant findings - exam benign other than midline pain. has anyone injected the interspinous ligaments? Success? Local? Local plus steroid? Biologics?

Baastrups. BIG problem in our equine population.

You can inject it. Won’t work, but you can try

 

[Taus]

Baastrups. BIG problem in our equine population.

You can inject it. Won’t work, but you can try

I thought the treatment was interspinous fusion??!! I learned that on LinkedIn

 

[MD87]

I've had a handful of successes in these patients. Typically in younger patients who are dancers/gymnasts and don't actually have Baastrups but just hyperextend and irritate things. One patient I will never forget - early on in my career - stylet came out of the needle and fluid started dripping out. I almost S*** myself thinking I wet-tapped her. Turns out it was synovial fluid (she had a slight spondy - posterior ligamentous complex inflammatory syndrome).

I place the needle into the bursa, inject 0.5-1cc of steroid/lido, retract til I'm in the ligament and then inject the rest.

I just bill a TPI + fluoro. Not sure if it gets paid.

 

[bedrock]

I’m

I've had a handful of successes in these patients. Typically in younger patients who are dancers/gymnasts and don't actually have Baastrups but just hyperextend and irritate things. One patient I will never forget - early on in my career - stylet came out of the needle and fluid started dripping out. I almost S*** myself thinking I wet-tapped her. Turns out it was synovial fluid (she had a slight spondy - posterior ligamentous complex inflammatory syndrome).

I place the needle into the bursa, inject 0.5-1cc of steroid/lido, retract til I'm in the ligament and then inject the rest.

I just bill a TPI + fluoro. Not sure if it gets paid.

Agree with this. If they get at least 10 days of relief but not 3 months, I have repeated with LR-PRP, and 75% of the time they get a year or more out of the PRP.

If less than 10 days of relief with steroid, I don’t offer PRP.

 

[paingate21]

Patient is in their 40s - does not have baastrups based off imaging.

 

[MitchLevi]

I’ve done Depo and had good results.

This recurs often bc of biomechanic issues. Make sure PT is involved. TENS as an adjunct and topicals too.

 

[oneforfighting]

Injected baastrups with good results n of 1 though

 

[scv]

Injected baastrups with good results n of 1 though

What’s your code for this?

 

[oneforfighting]

What’s your code for this?

20550, 77002