Aiken SC doc for FBSS
Patient over 10 yrs. On 90meq and adjuncts. UDS/PDMP always appropriate. MRI 3/22 with no surgical pathology. Epidural fibrosis. Plan was SCS but moving to care for wife in Aiken. Will see back if care unacceptable. A chance to review my charts..... (Source: Student Doctor Network)
Source: Student Doctor Network - October 19, 2022 Category: Universities & Medical Training Authors: lobelsteve Tags: Pain Medicine Source Type: forums
JAMA's Fake Science/Hit Piece on SCS for Chronic Radic after Spine Surgery
If I were an SCS KOL, I'd be pissed...
Effect of Spinal Cord Burst Stimulation vs Placebo Stimulation on Disability in Patients After Lumbar Spine Surgery
This placebo-controlled, crossover randomized clinical trial compares the effects of spinal cord burst stimulation vs placebo stimulation in patients with chronic radiculopathy after surgery for degenerative lumbar spine disorders.
jamanetwork.com (Source: Student Doctor Network)
Source: Student Doctor Network - October 19, 2022 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums
Weird application of stimulators
The "Holy Grail" of stimulation has been axial or back pain. Traditionally, dorsal column stims have had fairly good coverage of radicular pain, but poor coverage of axial pain. Placement of stims (with the exception of recent root stimulation called DRG stim) has traditionally been in the dorsal epidural space.
However, if we look at the innervation of the lumbar discs, a presumed common source of pain, the innervation through the sinovertebral nerve and grey rami communicans is lateral...
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Source: Student Doctor Network - October 18, 2022 Category: Universities & Medical Training Authors: deleted993114 Tags: Pain Medicine Source Type: forums
Getting Kypho Referrals
Hey all,
Long-time lurker and infrequent poster. Really appreciate everything I have learned from this forum and would appreciate any advice I can get on this.
I am a new grad working in a hospital-employed group. My group does some kypho, but I am starting out of 2 new locations without any established pain physicians or set referral sources. One location is attached to a small, rural non-trauma hospital and the other is associated with a busy level 3 trauma center. There are no spine...
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Source: Student Doctor Network - October 12, 2022 Category: Universities & Medical Training Authors: deadhead2 Tags: Pain Medicine Source Type: forums
SCS for low back pain
What diagnosis codes (for insurance/ Medicare approval) do you use for the 80+ year old, non surgical patient with severe arthritis, severe multilevel stenosis, cauda equines impingement, never had surgery/not offered surgery because of age but wants to try SCS? I think it’s perfectly reasonable to offer this to patients but running into insurance companies who don’t think so because “patient never had back surgery” or doesn’t have “crps”? (Source: Student Doctor Network)
Source: Student Doctor Network - October 11, 2022 Category: Universities & Medical Training Authors: painfree23 Tags: Pain Medicine Source Type: forums
Medical Assistant/Lab Technician Opportunity in Brooklyn, NY
Busy Interventional Orthopedics and Regenerative Practice in Brooklyn, NY is looking for a new medical assistant ASAP.
The practice is non-surgical interventional pain management, and the candidate would work for the Interventional Pain Physician who coordinates patient care with our in-house team of physical therapists and chiropractors. There is a procedure suite with a fluoroscope where spine injections, joint injections...
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Source: Student Doctor Network - October 10, 2022 Category: Universities & Medical Training Authors: LightFaber Tags: Jobs and Help Wanted Board Source Type: forums
Low back and testicular pain
I have seen two patients this week referred to me with unilateral low back and testicular pain. To me these are separate and unrelated, but I wanted to hear from you all. Have you seen any correlate between the two? (Source: Student Doctor Network)
Source: Student Doctor Network - October 6, 2022 Category: Universities & Medical Training Authors: ED50 Tags: Pain Medicine Source Type: forums
PP Questions
Hi all,
I had a few other questions about negotiating for a small PP group. Currently there are only two docs in the group who are ortho, but they are potentially planning on merging with another ortho group that would include ortho spine.
1) They have multiple times said they want me to become a partner after two years. Should this be put into writing in the contract and if so, are there usually metrics that are outlined? How should it be worded such that it is fair for me and them?
2)...
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Source: Student Doctor Network - October 2, 2022 Category: Universities & Medical Training Authors: PainApp2021 Tags: Pain Medicine Source Type: forums
Saints Quarter Back will be playing today with 4 fractures in his back
WTF. The way we treat athletes is horrendous. (Source: Student Doctor Network)
Source: Student Doctor Network - September 18, 2022 Category: Universities & Medical Training Authors: Agast Tags: Pain Medicine Source Type: forums
Peloton or Tonal
I think there was a Peloton thread awhile back but can’t quite remember. Anyone have a peloton or Tonal and want to link up on there? I am gettting my peloton tomorrow. I have had a Tonal
since July and I love it. (Source: Student Doctor Network)
Source: Student Doctor Network - August 30, 2022 Category: Universities & Medical Training Authors: BobBarker Tags: Pain Medicine Source Type: forums
Opinions on spine surgery
I had an interesting conversation with an academic guy the other day who essentially doesn’t believe in spine surgery whatsoever. He went on to say neurosurgery is kind of a sham specialty where they essentially only decompress things (and not fix/treat anything).
Clearly an extreme individual, I’ve seen some success stories and horror stories from spine surgery. I wanted to get your opinions (Source: Student Doctor Network)
Source: Student Doctor Network - August 29, 2022 Category: Universities & Medical Training Authors: nopain1234 Tags: Pain Medicine Source Type: forums
Newbie...can someone please verify my MDM to appropriately bill 99204 for all new patients?
PROBLEM COMPLEXITY (LOW)
-typically low since I keep visits to 1 stable chronic illness
DATA (3 points from category 1) (MODERATE)
-review of CBC and BMP (1pt)
-review of X-ray spine report everytime (1pt)
-review of MRI spine report everytime (1pt)
(I’m in a busy private group so MRI is usually always done)
-review of the same Xray/MRI counts everytime right? I do this out of good practice.
MANAGEMENT (MODERATE)
-RX management OR injection discussion at every visit...
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Source: Student Doctor Network - August 21, 2022 Category: Universities & Medical Training Authors: cameroncarter Tags: Pain Medicine Source Type: forums
cervical disc arthroplasty
I'd like to hear everyones thoughts about contemporary cervical disc arthroplasty.
I'm not a fan of lumbar disc replacement as the physics are different and it seems like lumbar disc arthroplasties always fail, either initially or within a few years.
Initially cervical disc arthroplasties were a mixed bag, but supposedly in well chosen patients with newer disc hardware/surgical techniques have better outcomes?
I met with several spine surgeons in LA who offered cervical arthroplasties and...
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Source: Student Doctor Network - August 20, 2022 Category: Universities & Medical Training Authors: bedrock Tags: Pain Medicine Source Type: forums
Case Discussion
Had this case recently, I'll fill in details as we go along.
72 yr old scheduled for a single level laminectomy. Hx of OSA, HTN and known AS. TTE from two years ago shows moderate AS, AVA of 1.2 and preserved EF. METs are limited by chronic back pain. Able to golf but needs a cart to get around since he can't walk.
Do you proceed with surgery or repeat TTE? (Source: Student Doctor Network)
Source: Student Doctor Network - August 20, 2022 Category: Universities & Medical Training Authors: Ronin786 Tags: Anesthesiology Source Type: forums
HOPD Employee- How busy?
Hi everyone,
I am looking into an employed position at a community hospital. They do not currently have a pain department and I would be helping to establish it. I was told by the CEO that there would be no difficulty filling my clinic with spine pain and filling two days for procedures. I want to provide the best patient care, but at the same time I am willing to hustle and work hard. They told me they would do all the marketing for me (put me on billboards, TV, etc) in the community and...
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Source: Student Doctor Network - August 17, 2022 Category: Universities & Medical Training Authors: PainApp2021 Tags: Pain Medicine Source Type: forums
