vertebroplasy and kyphoplasty

[DistantMets]

Are any of the good interventional programs giving residents experience with either of these procedures??? Someone told me today that IR and ortho are the only ones that really do it, and that PM&R docs probably wouldn't be allowed to at most hospitals. Thanks.

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[drusso]

PM&R docs can and do it with appropriate training. Different programs emphasize -plasty procedures to different extends. I don't know why hospitals wouldn't let fellowship trained physiatrists do -plasties when most ACGME programs teach pumps and stim placements.

 

[drvlad2004]

I thought that only ortho does kyphoplasty. It is such a cool procedure to see. The short recovery time and improvement that these patients get are astonishing.

 

[paz5559]

I thought that only ortho does kyphoplasty. It is such a cool procedure to see. The short recovery time and improvement that these patients get are astonishing.

Who does kyphoplasty is a political and reimbursement issue, not a qualifications issue. At present, outpatient facilities are not reimbursed for kyphoplasties (there is no specific CPT code for the procedure), and so as a result, all are done as short stay (<24 hr) procedures. but once you do it at a hospital, you need to have privileges to do it, and that is where the surgical services can block your ability to do the particular intervention.

It should be noted, this is NOT the case re vertebroplasties.

As a side note, while cool, the reason both procedures work is probably NOT because of restoration of height or biomechanical construct, but rather due to the exothermic reaction as the methylmethacrylate hardens which probably fries the nociceptive receptors in the vertebral body at the level of the acute fracture.

 

[DigableCat]

As a side note, while cool, the reason both procedures work is probably NOT because of restoration of height or biomechanical construct, but rather due to the exothermic reaction as the methylmethacrylate hardens which probably fries the nociceptive receptors in the vertebral body at the level of the acute fracture.

Do you have any journal article references?

 

[bmw]

So where do you get training in these procedures?