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Discussion in 'Pain Medicine' started by Spine Specialist, Nov 23, 2005.
Any physiatrists doing vertebroplasty?
Please share your experiences.
i've had some experience. technically not very demanding. considered high risk procedure or PM&R or Anes as if you retropulse a fragment or leak PMMA into the canal- we'll you'll need a spine surgeon/ neurosurgeon to help out.
I no longer do these as my largest referral base is NS and they do kypho- I don't think offending the referral base is ggod business practice.
I had limited experience but did do an L3 (no cord nearby) for a 4 y/o Fx with discordant pain (pain centered over L5-S1) and the patient got up and said her pain was gone. Of course an N of 1 is an N of none.
I have done a few with one of my attendings who has done many for 5 years. But my first patient had cement migration. Even though another fellow did that T12 level but I was stuck pushing the patient to the CT and calling the neurosurgeon. Thank god all was well. No sensory, motor deficits and the patient was happy and pain free 2 weeks followup. I am not sure I want to be stuck in the hospital and fearing for my life/license again.
vertebroplasty is great in a community where you are pretty much the only one doing it... however, if the neurosurgeons are doing it they might show their discontent with their referral patterns. Most pain guys won't touch vertebroplasty (which isn't that hard to master) primarily because of the stress of the morbidity and the time consumption (since in most states you have to do it in a hospital) and would prefer to stick to the ESIs and facets.
The downside is that this affects your call life...