Kyphoplasty

[bedrock]

What percentage of Kyphoplasty cases are done in office vs HOPD?

My ortho partners are overreacting to me wanting to do kypho in office.

(I’m currently doing intracept in our ASC)

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[SpineandWine]

I do 100% in facility
Office kyphos and them letting you keep your collections (minus cost of equipment)- would be unreal.
It may draw the attention of spine surgeons in the group who would then start doing it as well

Kyphos don’t make money for ASC (mine is HOPD), you lose money

 

[RoloTomassi]

I don't do a ton but always office w/ IV conscious

 

[BobBarker]

They don’t make any money in the ASC. End of discussion.

 

[Taus]

100% in office. When they run the numbers, they’ll likely change their mind.

 

[PinchandBurn]

100% in office. When they run the numbers, they’ll likely change their mind.

This is what I do..Office.

I've sedation or oral.

 

[BoardingDoc]

I don't do a ton but always office w/ IV conscious

What are you using for in office sedation? A little fent and 2mg versed or something like that?

 

[Taus]

What are you using for in office sedation? A little fent and 2mg versed or something like that?

I’ve done 30 in past 4 months. All po only. Most just triazolam 0.5mg. A few (younger or on chronic bzd) needed 3rd 0.25mg tab and/or oxy 5. Overall has worked out just fine, only a couple cases that were challenging with this. The ability to use nitrous or titrate with IV would be better… But it’s not in the cards with my set up. 2% lido skin to bone first… then go open Kypho kit, set up equipment.

 

[RoloTomassi]

What are you using for in office sedation? A little fent and 2mg versed or something like that?

Yes, usually start with 2 mg Versed, 100 mcg fentanyl in younger patients, half dose in smaller/older. Sometimes need to titrate up to max 4 mg / 150 mcg.

 

[BobBarker]

Nitrous and diazepam works great.