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Anyone have any good articles/advice for beginners doing kyphoplasties in the pain world? I am just now starting to incorporate this procedure into my practice.
Enjoy it when your kypho rep says, "Wow look at that reduction Doc!", when in fact there is NO reduction whatsoever. I also like my rep but I feel the benefit of kypho vs vertebroplasty is minimal, if it exists at all. I read a study that says the "average" fracture reduction with kyphoplasty is 40%. Maybe, since I don't do kyphos immediately and try conservative tx first, I certainly don't ever see that kind of reduction.
2) Are you guys adding antibiotics to the PMMA mix to ward off infections?
Any of you guys use the Carefusion/Card Health Vplasty? We switched over to them from Stryker at myplace. Their system is pretty neat, sort of rules out the need for kyphos...what do you all think?
Since being in practice I've only used Carefusion with the curved needle. It obviates the bipedicular approach but sometimes you can't get the curved needle to punch though the bone if it's not osteoporotic. I only did 5 in fellowship so I don't have much to compare to.
On a side note, I got two referrals for "fresh" compression fractures on xray. Well, I got MRIs prior to each and both patients had >60% cord compression from either retropulsion or disc/osteophyte complex. I sent both to neurosurgery for decompression. I assume everyone on here only does vplasty after getting an MR, right?[/QUOTE]
or CT, depending if the cant get an MRI...
or CT, depending if the cant get an MRI...
Same here and haven't had a problem yet. But what do you think of this article for kyphoplasty? The authors feel you should get both CT and MRI every time.
http://www.orthosupersite.com/view.aspx?rid=35997
Same here and haven't had a problem yet. But what do you think of this article for kyphoplasty? The authors feel you should get both CT and MRI every time.
http://www.orthosupersite.com/view.aspx?rid=35997
what a waste. Bet they own an imaging center that has BOTH CT and MRI....
I did tons in my fellowship (>100 vert and kyphos) and the IR doc I did them with is a leading expert, and no, no ABx in the mix.
WOW, thats great! Which fellowship is this? Sounds like MDAnderson????
We didn't rotate through IR for kypho experience - our attendings (Anes, PM&R, Neuro do them. My guess is that this is MGH, the fellows there rotate through IR with Dr. Hirsch. That guy is a cement machine.
BTW Midline, how's Suheil?