lumbar bolsters

[facets]

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Does any one know of a good lumbar bolster for reversing the lumbar/thoracic junction lordosis? In the past the ones that I have tried take up too much room in the C in an obese patient. I just finished a SCS trial in an obese patient with a marked scoliosis/ rotation and lordosis that aged me another 10 years 🙂

 

[facets]

Come on anybody? I use regular pillows under the T/L junction, I usually go in around T12/L1. I reviewed this patients X rays from the procedure when she came in the next day for a recheck. It was the most amazing thing. The AP was over about 5 vertebral segments. On the lower part of the X-ray, the spine was left lateral oblique, the view you usually get at about 20-30 degrees, at the top it was right lateral oblique! That was the most twisted/ rotated spine I have ever seen! The kicker was, the MRI reading was unimpressive! I guess that is why a lot of you read your own films. There is a happy ending-100% relief. Steve don't rain on my parade, it is not placebo. If she had no relief, I would have been very depressed.

 

[lobelsteve]

Come on anybody? I use regular pillows under the T/L junction, I usually go in around T12/L1. I reviewed this patients X rays from the procedure when she came in the next day for a recheck. It was the most amazing thing. The AP was over about 5 vertebral segments. On the lower part of the X-ray, the spine was left lateral oblique, the view you usually get at about 20-30 degrees, at the top it was right lateral oblique! That was the most twisted/ rotated spine I have ever seen! The kicker was, the MRI reading was unimpressive! I guess that is why a lot of you read your own films. There is a happy ending-100% relief. Steve don't rain on my parade, it is not placebo. If she had no relief, I would have been very depressed.

FOS SCS, we don't care about anything below the L2 pedicles. When t8-t12 is a twisted mess I test the first lead to see if I want to go left or right of it. Bony midline vs. cord midline.

 

[facets]

Yes Steve, the x rays are taken from L1 up, for the implanting surgeoon the see exactly where you put the leads, and he won't do it if the Xray does not clearly show T12/L1. The x ray showed T12 to about T7. The most twisted rotated mess. Do you go in at T12/L1? Do you use a pillow or bolster?

 

[facets]

PS- you are spot on about spinal vs bony midline. Her sweet spot was way lateral to the spine, about (not sure exactly, I don't have the films in front of me) midway between the facet and spine p. No way I would I thought it was that far lateral. It got there by divine guidance. OK guys, laugh if you want. That's where the first lead really wanted to go and it obtained complete coverage. I don't claim to be that smart.

 

[lobelsteve]

Yes Steve, the x rays are taken from L1 up, for the implanting surgeoon the see exactly where you put the leads, and he won't do it if the Xray does not clearly show T12/L1. The x ray showed T12 to about T7. The most twisted rotated mess. Do you go in at T12/L1? Do you use a pillow or bolster?

I use a bunch of thin pillows and adjust before prep for in office trials. Used a Jackson table today and a flat L1-2, but worked going uphill. Got an S8 in but only after throwing an octrode in first to use it as a bumper. Took forever.