Post Vertebroplasty care

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lobelsteve

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Prolia vs Forteo vs Reclast

Most of my folks are older and with GFR around 40. I am using more Prolia because of this but think Forteo is probably the best at reducing recurrent FX risk.

What are you folks doing?

I figure they've failed management with PCP, typically Fosomax or Boniva.
 

Gauss

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I use forteo if they were already on a bisphosphonate, haven't used prolia yet.
I use calcitonin with alendronate if they weren't on a bisphosphonate previously.
Also using donjoy bone stim/CMF Spinalogic
 

Jcm800

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Prolia vs Forteo vs Reclast

Most of my folks are older and with GFR around 40. I am using more Prolia because of this but think Forteo is probably the best at reducing recurrent FX risk.

What are you folks doing?

I figure they've failed management with PCP, typically Fosomax or Boniva.


what is the advantage aside from renal function for Prolia...use a fair amount of forteo, but never have used Prolia...
 

PinchandBurn

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are you folks giving Forteo/prolia pre and post Vplasty?

Finally, are you folks getting 'dumped' on to medical manage these vertebroplasty patients after the Radiologist has done the procedure and doesnt want to medically manage the pt?

Unfortunately, all too often I've seen this to be the case. In my opinion, if you do a procedure you should be able to provide perioperative care. From wht I've seen radiologists do, they simply do a MBB, ESI, vplasty, mild, or whtever procedure and never see them again...........
 

lobelsteve

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are you folks giving Forteo/prolia pre and post Vplasty?

Finally, are you folks getting 'dumped' on to medical manage these vertebroplasty patients after the Radiologist has done the procedure and doesnt want to medically manage the pt?

Unfortunately, all too often I've seen this to be the case. In my opinion, if you do a procedure you should be able to provide perioperative care. From wht I've seen radiologists do, they simply do a MBB, ESI, vplasty, mild, or whtever procedure and never see them again...........

If they come to me with a fresh fracture and not on Forteo or Prolia, I consider it a failure of treatment by the PCP. I discuss with PCP Reclast vs Forteo vs Prolia and order it up or tell them to order it.

Forteo is 2 years of daily injections, while Prolia is an injection every 6 months. Reclast is a yearly infusion. 100% compliance with Reclast and Prolia, Forteo varies by individual. Adjacent level fractures are the norm and agressive treatment can help prevent this.

Getting dumped on? More like stealing them away to try and ensure better care.
 

Tenesma

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I hate to sound like a wimp - but I make referral to Endocrinology and let them do the PTH/etc work-up and fight it out w/ the insurers who don't want to pay for Forteo or Prolia without long letters from an endocrinologist...
 
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