Manipulation under Anesthesia

[analgesic]

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I had a patient who received no relief from epidurals and recently underwent manipulation under anesthesia. He had an L5/S1 herniation with subsequent radiculopathy. I must say I am quite impressed with his return of strength and lack of pain following the procedure. Is anyone else familiar with this procedure?

 

[drusso]

Cigna reviewed MUA for reimbursement purposes and deemed it to be an unproven and experimental procedural.

Cigna Link

Chiropractors have been trying to increase their scope of practice and use MUA as an entry into hospital-based services.

Chiro position paper

It's waxed and waned in use among DO's over the years. I think that the added risks incurred from anesthesia probably don't outweigh the benefits, but again, no one has performed formal outcomes studies or calculated NNT.

 

[analgesic]

Thanks for the links Drusso. This particular MUA was performed by an M.D. orthopaedic surgeon at Texas Back Institute. I was not aware that this procedure has been around for quite some time. I was wondering why I couldn't find any Meta analysis outcome studies. I myself am an advocate of manual medicine if appropriate biomechanical forces are applied. Perhaps this procedure requires further investigation in terms of efficacy.

Cigna reviewed MUA for reimbursement purposes and deemed it to be an unproven and experimental procedural.

Cigna Link

Chiropractors have been trying to increase their scope of practice and use MUA as an entry into hospital-based services.

Chiro position paper

It's waxed and waned in use among DO's over the years. I think that the added risks incurred from anesthesia probably don't outweigh the benefits, but again, no one has performed formal outcomes studies or calculated NNT.

 

[Aether2000]

Chiropractors can be certified in MUGA. Our center used to provide anesthesia for the lumbar MUGA procedures, but we declined to permit cervical procedures. The outcomes were in general, only marginally better than standard chiropractic...