Kypho and Disco

[emd123]

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How many of you do kyphoplasty and disc procedures?

 

[spinal]

No need for Kypho. Vertebro is better because whatever you inject follows the trabeculae of the ostoporotic bone w/o destroying them. Kypho- destroyes bone trabecula and creates a ball of cement- predisposes to adjacent level fx.
I am not convinced any of the disc procedures do miracles.

 

[PMR 4 MSK]

No need for Kypho. Vertebro is better because whatever you inject follows the trabeculae of the ostoporotic bone w/o destroying them. Kypho- destroyes bone trabecula and creates a ball of cement- predisposes to adjacent level fx.
I am not convinced any of the disc procedures do miracles.

My recent review of the literature indicates vertebro = kypho for pain relief, with one meta suggesting vetrbro better short-term and kypho better intermediate. Kypho is better at restoring height, but that does not translate to better pain.

 

[Jcm800]

My recent review of the literature indicates vertebro = kypho for pain relief, with one meta suggesting vetrbro better short-term and kypho better intermediate. Kypho is better at restoring height, but that does not translate to better pain.

height restoration is not maintained. Study showed whatever nominal height was restored from kypho was lost 6 weeks later.

my personal results are better with Vertebroplasty. i did my own comparison in like 50 patients (not very scientific, i know) but those that had kypho for similar fractures did not get the same immediated and sustained results as vertebro...

 

[epidural man]

No need for Kypho. Vertebro is better because whatever you inject follows the trabeculae of the ostoporotic bone w/o destroying them. Kypho- destroyes bone trabecula and creates a ball of cement- predisposes to adjacent level fx.
I am not convinced any of the disc procedures do miracles.

Huh?

Data please (on predisposition of adjacent level fx).

 

[Ducttape]

Recently talked to a NS friend.

He did a grand rounds for a university, and told me point blank that that both were worthless based on current evidence based medicine on both procedures.

maybe its just me, but if a neurosurgeon is going to teach his residents that a procedure he did/used to do isnt worth doing...

 

[jsaul]

Recently talked to a NS friend.

He did a grand rounds for a university, and told me point blank that that both were worthless based on current evidence based medicine on both procedures.

maybe its just me, but if a neurosurgeon is going to teach his residents that a procedure he did/used to do isnt worth doing...

I just did an L1 kypho on 65 year old who fell 1 month ago and developed this compression fracute. She was in 9/10 pain despite taking 2 norco tid for a month which caused severe constipation and sedation. 5 days after the procedure she has weaned off the meds and is mobile and returned to previous functional status.

 

[lobelsteve]

Kypho will come to the office next year.

Secret from a rep.

 

[Ducttape]

I just did an L1 kypho on 65 year old who fell 1 month ago and developed this compression fracute. She was in 9/10 pain despite taking 2 norco tid for a month which caused severe constipation and sedation. 5 days after the procedure she has weaned off the meds and is mobile and returned to previous functional status.

on the other hand....

the reason i talked to my friend was to run by a patient who was referred to me. L3 compression fracture, kypho no help at all. Pain may have even gotten worse after the procedure.

(i didnt do the kypho, radiology did, so im sure if a real pain doc had done it, it would have worked😉)

Also, what i did for the past 2 patients that have presented with compression fractures is to perform median branch blocks (taking a little liberty of Bogduk's article). In 1 patient, i actually RFA'd her L1, L2, L3 Median branches with good relief of her chronic pain.