Kyphoplasty vs rad/other tx

[Pain_doc]

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Just received a notice that a patient I had treated in the past for lumbar issues has lung cancer. Had some thoracic pains and in the workup, T7 wedge fracture with complete marrow replacement at that vertebral body. I'll see her next week and determine if I feel the pain is related to the fracture.

My question to this august panel: any data on what treatments work best for metastatic compression fracture pain? Once I get the records I can call and talk to the oncologist as perhaps he already has some treatment arranged. Thanks for any information.

 

[lobelsteve]

kypho with biopsy. Single bone met?

 

[Orin]

That is a good Osteocool case rather than a regular kypho, takes a little more time but treats the tumor too. Radiation is also reasonable but RF ablating the body is a faster move for analgesia.

 

[lobelsteve]

That is a good Osteocool case rather than a regular kypho, takes a little more time but treats the tumor too. Radiation is also reasonable but RF ablating the body is a faster move for analgesia.

Wedge Fx does not sound like a met. Lets get pics and the report posted.

 

[BobBarker]

Osteocool is really simple if indicated. Not any harder than a regular kypho.

 

[painfree23]

Do u brace em while they r waiting to see you back?

 

[lobelsteve]

I do

 

[painfree23]

I do

What kind of brace? What about after the Kypho?

 

[lobelsteve]

Tlso. No reason to brace once fixed.

 

[Pain_doc]

STIR image and PET scan image

Saw her yesterday. Concordant tenderness. She sees onc and thoracic surgery this am. "diffuse marrow replacement suggesting neoplastic etiology" per radiology report. No other obvious spinal bone involvement. Tissues anterior to T6 demonstrate patchy enhancement. No retropulsion. No cord issues. Although she was told about the compression fracture, no one told her it was due to her cancer.

 

[lobelsteve]

Osteocool