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7 years of back pain. Worse in last 3 months. Xray negative. Started getting weaker in thighs. No B/B.
What did they read that as? Did it get better with steroids? It looks maybe like a vascular malformation or cancer with associated edema7 years of back pain. Worse in last 3 months. Xray negative. Started getting weaker in thighs. No B/B.
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So..they will get 2 weeks of relief with dex?T1-2 tfesi. foraminal hnp. Min relief with interlam. Mapped path/angle carefully on mri to avoid ptx…. Love my new c arm…. Oec 9900
Intradural/extramedullary. Schwannoma. Surgical pathology confirmed.What did they read that as? Did it get better with steroids? It looks maybe like a vascular malformation or cancer with associated edema
Potentially, but worth trying before sending to surgeon imho. Already did interlam w depo.So..they will get 2 weeks of relief with dex?
WC-bound paraplegic.Damn. What’s their Neuro exam like ?
L4/5 looks nice and well hydrated though. At least that’s something
Probably the T12-L1 Modic changes. It’s vertebrogenic pain.WC-bound paraplegic.
i also wouldnt touch this.Never seen a sacral fx quite like this one. Two weeks out.
43 F. CT negative for cancer, mets, etc. Starting osteoporosis work up. Multiple surgeons don't have any answers or don't want to touch her.
Does anyone have any suggestions for interventions that might help? Trying to get her to get that giant poop out is project #1 since she hasn't gone in 6-7 days.
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That is a huge poop. Looks like she needs a manual.
Sacroplasty but reduction/fixation would be better with the displacement. Trauma surgeons are the ones that see this more than your usual ortho folks, so sending it to a level 1 trauma center may make sense.Never seen a sacral fx quite like this one. Two weeks out.
43 F. CT negative for cancer, mets, etc. Starting osteoporosis work up. Multiple surgeons don't have any answers or don't want to touch her.
Does anyone have any suggestions for interventions that might help? Trying to get her to get that giant poop out is project #1 since she hasn't gone in 6-7 days.
what is he talking about "no prior auths with medicare"?
ah.... ok.Medicare and a lot of Medicare advantage plans do not require auth for office and ASC.
they say a PDPH is possible with a TFESI. ive never seen it.....Patient stating severe positional headache 30 minutes after this beautiful TFESI with a 23g?
What am I missing here?
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More views. More likely they’re having a headache and looked up positional headache after epidural.Patient stating severe positional headache 30 minutes after this beautiful TFESI with a 23g?
What am I missing here?
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Everything is a post dural. If they call their PCP, they will say is is pdph. Even if they had an si jointMore views. More likely they’re having a headache and looked up positional headache after epidural.
Doubt your local needle could reach on a TF no matter how hard you hubbed it. 25/27 g not likely to cause anywayMiddle aged lady. Maybe I got her with the local needle?
dont use a local needleMiddle aged lady. Maybe I got her with the local needle?
I agree I really can’t comment too much on that picture. It’s in an oblique view, not AP to see needle tip position to pedicle and the remainder of the medial contrast. Mixed flow happens… lateral dural sleeves happen.More views. More likely they’re having a headache and looked up positional headache after epidural.
Revise it. Move it 3" laterally. Too close to spine for my liking.Pocket pain. We've all had a few pts with IPG pain, and it usually gets better over time as the battery settles and the pocket forms. I don't rush the pocket creation, and I take an extra few minutes because it seems to yield better results when the pocket is nice and relaxed during recovery.
This lady was implanted a few months ago. Pocket pain is severe, and she has cramping at the IPG. Stimulator is functioning well and she's actually doing pretty good other than the IPG site. The battery looks to have rotated medially, but they move all the time and I can't see why that would matter.
How long do yall usually let an IPG sit until you move it? We're at 2 months now.
No signs of infection. No warmth, redness, fullness, etc.
She has insulin-dependent diabetes, and I gave her clinda 300mg TID (I realize that's probably an overkill) and baclofen 10mg TID. Zanaflex failed. She does not take opiates.
The lateral images didn't come down inferiorly enough, but I didn't feel like getting more images. If not better in 4W I will reimage her and make sure we got lower on the pelvis.
Nevro. This is another reason I prefer Abbott Eterna.
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How long would you wait?Revise it. Move it 3" laterally. Too close to spine for my liking.
It tames me a month from OV to OR most ofvthe time. So do it now move.How long would you wait?