Recent content by knoxdoc

Just like doing injections around lumbar hardware - there are no issues. Like SS said, the hardware is not intra-articular, so zero concerns.

100% true and 100% sad. It's pathetic that it has come to this.

... and don't forget to scrub away all the sub-pannicular candida. Then spend the next two weeks wondering if you seeded the joint. Its all well worth the $46.

No I do not, only pain log scores.

Office visit to discuss both MBB and potential subsequent RFA. Give paperwork describing the procedures. Schedule MBB#1. Do MBB #1, staff calls next day to get pain log, shows me results. If no go, schedule f/u. If good, schedule MBB#2 in 2 weeks. Do MBB#2, briefly describe RF again right...

I had a lady who had knee pain s/p TKA. We talked about GNB/RF but she was hesitant. I started her on gabapentin for her "nerve pain" and she came back a month later with 75% improvement. Complete placebo effect. Try it.

What kind of special glasses does it take to read a plain CT and see a disc bulge? The radiologist calls a disc bulge with moderate stenosis and all I see is a bunch of gray throughout the spinal canal. Its like those old stereogram pictures you have to stare at for 20 minutes before you start...

"An analysis of pregabalin deaths in England between 2004-2020 has shown that in over 90 percent of deaths, the presence of other opioids (including methadone or morphine) was detected. However, in only a quarter of cases were these opioids actually prescribed to the person. This suggests that...

RF for Baastrups works reasonably well.

Medicare does not allow RF at the level of an ALIF per their LCD. Not sure about PLIF.

Thanks everyone for the input - that is exactly how I recall it now. I can do the other side but then no repeat RF in C spine for 12 months.

Just did RF of R TON, C3, C4 MBs on a Medicare patient and that side is doing well. He is now having more pain on the left (same levels). I'm having a brain fart here - can I proceed with the left sided MBBs/RF at the same level now, or do I need to wait 6 months?

I recently moved out East and have been ordering post-op spine MRIs without and with contrast (as I always have). I am getting pushback from insurance companies and radiologists about this - they want a plain MRI or a different Dx code. First of all, am I missing something regarding ordering...

TC pays poorly and you need auth if you want to sneeze. Anyway, set up a lunch with the PCPs on base and let them know what you do. They will refer to you.

If the patient thrashes when you are trying to thread a quincke into a 3mm wide epidural space, that's bad.