X'mas gift

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drpainfree

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thinking about giving myself a x'mas gift (and a small tax write-off), what do you guys think about this spine positioning systems from oakwork?

http://www.oakworksmed.com/spine-positioning-system-ii.asp

I really want to have something to get optimal the c-spine position for cervical procedures. Has any tried or used this device yet?

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I have the one posted. Use it for CESI and cervical RFA to keep patients still and in position. Seems fairly comfortable as most patients tolerate it.


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I bought 3 of these over the years. They are great.
 
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does it really move the shoulder out of the way to show lower cervical levels as it's advertised?

Is the headrest piece stabled for long term use? I would hate to see the head drop in the middle of the CESI?

Do you use it only for cervical procedures, then remove it for lumbar? I don't need for lumbar procedures at all, but concerned if it will cause more inconvenience for lumbar procedures? How is secured on the c-arm table? How easy is it to be removed?
 
This is THE premium cervical positioning device. Very stable but you can adjust the flexion. It does help with the shoulders to a degree. I don't think it fastens to the table, you just put it on and off. But pt is laying on it so it's completely stable. There are cheaper alternatives that are much less comfortable and radiolucent. Merry Christmas.
 
sounds great! if there's BF deal for this, I might get it now:)
 
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thinking about giving myself a x'mas gift (and a small tax write-off), what do you guys think about this spine positioning systems from oakwork?

http://www.oakworksmed.com/spine-positioning-system-ii.asp

I really want to have something to get optimal the c-spine position for cervical procedures. Has any tried or used this device yet?
worked really well for IL CESI. i tried to get it to work for cervical RF, eventually gave up because i could not move the neck head during my procedures.
i like to be able to rotate the head neck during RF to different positions. i could not figure out how to do that. but for cervical IL ESI this is definitely the best headrest.
 
Pays for itself by decreasing aggravation of some of these procedures
 
worked really well for IL CESI. i tried to get it to work for cervical RF, eventually gave up because i could not move the neck head during my procedures.
i like to be able to rotate the head neck during RF to different positions. i could not figure out how to do that. but for cervical IL ESI this is definitely the best headrest.

Well worth it. Very useful for all cervical procedures. (I don't move the neck RF during RF, once I get it lined up)

Also more comfortable for most patients with other spine procedures, as it accommodates the typical generous American belly. Also maintains a more accessible airway. I use it for all prone procedures, except lumbar RF with 15cm cannulae, as it does limit space for decline views with 15 cm cannulae due to the thickness of the frame.
 
tried the device last week. I used only for cervical epidural. Tried to go CLO or lateral view, shoulder does move out of the way, but very difficult to rotate the c-arm with the needle on the top of spinal cord because the device/padding essentially took away significant amount of space in the c-arm arc.

I see this a major problem with this positioning device. How do you get around this problem?
 
tried the device last week. I used only for cervical epidural. Tried to go CLO or lateral view, shoulder does move out of the way, but very difficult to rotate the c-arm with the needle on the top of spinal cord because the device/padding essentially took away significant amount of space in the c-arm arc.

I see this a major problem with this positioning device. How do you get around this problem?
Do u have a super c c arm?
 
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tried the device last week. I used only for cervical epidural. Tried to go CLO or lateral view, shoulder does move out of the way, but very difficult to rotate the c-arm with the needle on the top of spinal cord because the device/padding essentially took away significant amount of space in the c-arm arc.

I see this a major problem with this positioning device. How do you get around this problem?

No device. Pillow under chest, 4" soft foam bloc under forehead.
 
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tried the device last week. I used only for cervical epidural. Tried to go CLO or lateral view, shoulder does move out of the way, but very difficult to rotate the c-arm with the needle on the top of spinal cord because the device/padding essentially took away significant amount of space in the c-arm arc.

I see this a major problem with this positioning device. How do you get around this problem?
No positioning device. A small pillow under the chest and a 4-inch foam block under the forehead.
 
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the problem with pillow and face rest is the shoulder is always in the way. epidural, no biggie, can use CLO to get better lower c-spine review. but for lower cervical MNBB and RF it's almost impossible.

how do you guys get around this?
 
yes, actually, I learnt both lateral and AP techniques in my fellowship. for MNBB it's much easier to use lateral techniques, as long as you can get the lateral mass superimposed. On the other hand, RFA needs to be done on the AP view to get maximum burn area.
 
will try.

do you use one-arm-up or both-arm-up swimmer view?

http://boneandspine.com/what-is-swimmers-view-xray/
90% of the time I use left arm up swimmer view (free style). It's rare that I notice the ii getting close to the hub. Your table might be thicker than mine or c-arm may have smaller clearance. I assume you're using a 3.5 in needle. If there's any question about the c-arm hitting the hub, I ask the tech to telescope out a little, then oblique a little, then come back. As for the shoulders, it's hit or miss for me, depending on the pt. Sometimes (rarely) I can get a perfect lateral view. But I can always find something.

For me the main benefit of the device is pt comfort and cervical flexion. You can't really get cervical flexion without elevation. The other thing is your new device might be overly adjusted to flexion?
 
thinking about giving myself a x'mas gift (and a small tax write-off), what do you guys think about this spine positioning systems from oakwork?

http://www.oakworksmed.com/spine-positioning-system-ii.asp

I really want to have something to get optimal the c-spine position for cervical procedures. Has any tried or used this device yet?

I use this all the time. Paul Dreyfuss invented and designed it entirely. Highly recommended. Use it for all cervical work with a posterior entry point.
 
does it really move the shoulder out of the way to show lower cervical levels as it's advertised?

Is the headrest piece stabled for long term use? I would hate to see the head drop in the middle of the CESI?

Do you use it only for cervical procedures, then remove it for lumbar? I don't need for lumbar procedures at all, but concerned if it will cause more inconvenience for lumbar procedures? How is secured on the c-arm table? How easy is it to be removed?

headrest piece and locking mechanism is very sturdy. Have used it thousands of times. Not a single issue.
 
do you have trouble rotating c-arm from ap to lateral, ligament?
 
Actually, what he has said is that anyone involved in IPM is an amoral thief

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He is a man of contradictions. A man who owes plenty of his accumulated wealth to discograms, but clearly thinks most injections are worthless. A man who knows opioids are not the answer but prescribes 12 norco/day. He is an enigma wrapped in an enigma.

But at least he is basically honest about it all.
 
He is willing to admit what he does, yet disparages anyone else who does the same. What that makes him is a dishonest disingenuous mendacious duplicitous hypocrite

Btw, the Churchill quote is a riddle wrapped in a mystery inside an enigma
 
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Look who's still using 1980s tech. (thesaurus.com)

Next you'll be telling me about the cool new 8-track you were listening to, or that new movie you liked with Michael J. Fox, Lea Thompson, and Christopher Lloyd
 
some things never get outdated tho...

720x405-1413888578_58.jpg
 
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headrest piece and locking mechanism is very sturdy. Have used it thousands of times. Not a single issue.

I like to position the arms down at the patient's side. I find that in that position larger patients are rolling off the side of the wedge cushion.


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Dear All

Paul Dreyfuss here. I invited this device with Oakworks as a method to allow for optimal visualization of the C spine and T spine for posterior approach procedures. We had to build up the chest to allow for the shoulders to drop down out of the plane of the C spine. Although this effectively adds height to the table if your table is adjustable in height setting it to a lower height easily resolves C arm issues. I have never come close to touching a needle when imaging. I use an Oakworks table which is the lowest height table on the market, which also makes it easier for pts to get onto the table and the SPS.

Another trick to allow for better CLO and lateral imaging is to either tuck the arms into the torso recess like "chicken wings" or move the arms in front. At times esp with larger patients it is easier to move the arms forward then tuck them into the torso recess esp if they have lateral chest wall soft tissue rolls.

Also- the SPS II had the torso pad created thinner with an additional harder wedge underneath. Velcro off the extra rigid pad if needed to acquire more clearance if your c arm table does not descend low enough.

The head mechanism is rated to tolerate several hundred lbs.. much more than the head IF the device is fully locked.

Also for lumbar procedures if the pt has neck or shoulder issues they love to lay on the SPS as their neck/shoulders are move comfortable which means faster set up, less wiggle/frustration time for all.

There are velcro strips that allow the SPS to be secured to the table. It should come with your device.

Hope this help.
 
Dear All

Paul Dreyfuss here. I invited this device with Oakworks as a method to allow for optimal visualization of the C spine and T spine for posterior approach procedures. We had to build up the chest to allow for the shoulders to drop down out of the plane of the C spine. Although this effectively adds height to the table if your table is adjustable in height setting it to a lower height easily resolves C arm issues. I have never come close to touching a needle when imaging. I use an Oakworks table which is the lowest height table on the market, which also makes it easier for pts to get onto the table and the SPS.

Another trick to allow for better CLO and lateral imaging is to either tuck the arms into the torso recess like "chicken wings" or move the arms in front. At times esp with larger patients it is easier to move the arms forward then tuck them into the torso recess esp if they have lateral chest wall soft tissue rolls.

Also- the SPS II had the torso pad created thinner with an additional harder wedge underneath. Velcro off the extra rigid pad if needed to acquire more clearance if your c arm table does not descend low enough.

The head mechanism is rated to tolerate several hundred lbs.. much more than the head IF the device is fully locked.

Also for lumbar procedures if the pt has neck or shoulder issues they love to lay on the SPS as their neck/shoulders are move comfortable which means faster set up, less wiggle/frustration time for all.

There are velcro strips that allow the SPS to be secured to the table. It should come with your device.

Hope this help.
Thanks for adding to the discussion.
When you say like "chicken wings" do you mean with elbows maximally flexed and held tightly at their sides? As I stated above, with arms tucked straight down at sides and secured with a blanket, I get alot of patient sway.
 
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