Interventional radiologist Michael Barraza talks with orthopedic spine surgeon Thomas Andreshak about his approach to vertebral augmentation for compression fractures, including unipedicular vs. bipedicular approach, technique pearls, and post-procedure care.

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SHOW NOTES

In this episode, orthopedic surgeon Dr.Thomas Andreshak and our host Dr. Michael Barraza discuss kyphoplasty technique, including different methods of imaging, approaches, sedation, and follow-up.

Dr. Andreshak starts with obtaining a standing X-ray because it allows him to better observe cases of spondylolisthesis. He describes both unipedicular and bipedicular approaches, noting that the unipedicular approach can allow for greater cost savings, less cement used, and lower radiation exposure.

The doctors also review the stages of bone healing: hematoma formation, fibrocartilage formation, bony callus formation, and bone remodeling. Dr. Andreshak warns against overfilling the vertebra, which creates stiffness and puts stress on the adjacent endplate. Finally, they discuss follow-up and considerations for future treatment if pain persists.

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RESOURCES

Consulting Orthopedic Associates:
https://consulting-ortho.com/

Kyphon Assist:
https://www.medtronic.com/us-en/healthcare-professionals/products/spinal-orthopaedic/vertebral-augmentation/kyphon-assist.html