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Dr. Rajesh

Radiologist, Chennai

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Dr. Rajesh Radiologist, Chennai
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I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage....more
I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage.
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Dr. Rajesh is an experienced Radiologist in Ambikapuram, Chennai. You can consult Dr. Rajesh at Janani Hospital in Ambikapuram, Chennai. You can book an instant appointment online with Dr. Rajesh on Lybrate.com.

Lybrate.com has an excellent community of Radiologists in India. You will find Radiologists with more than 36 years of experience on Lybrate.com. You can find Radiologists online in Chennai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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No 7, Amman Street, Bharathi Nagar, Nesapakkam. Landmark: Near To Police booth, ChennaiChennai Get Directions
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Signs and Symptoms You Might Be Suffering From Breast Cancer

MBBS Bachelor of Medicine and Bachelor of Surgery, MS - General Surgery
General Surgeon, Hyderabad
Signs and Symptoms You Might Be Suffering From Breast Cancer

Breast cancer is characterized by an abnormal multiplication of cells in the tissues of the breast. The disease is the second most common cancer in women, and mostly affects women in the age group 55-65. However, the disease may occur in men as well.

Causes-

The exact cause of breast cancer is not known as of now. Some of the factors that influence multiplication of cells are your genes and the environment. Other factors such as late menopause, being subjected to hormone therapy post-menopause and dense breast tissues can be other triggers for this disease.

Symptoms-

The symptoms of breast cancer are:

  1. Discharge from your nipples
  2. A swelling in the breast
  3. You may have a lump in your armpits
  4. The skin around the breast may become flaky
  5. The skin around the breast may be irritated

Treatments-

The treatment depends on the size, grade and stage of the breast cancer. The sensitivity of the cancerous cells to the hormones in the body is also considered in this regard. The various treatment methods are:

  1. Surgery: There are multiple types of surgeries which may be used to treat breast cancer. In some cases, only a small area of the breast may be removed if the size of the tumor is small. Sometimes, mastectomy is performed where the entire breast tissue has to be removed.
  2. Chemotherapy: Chemotherapy is a type of treatment in which the cancerous cells are targeted by using certain drugs which are injected in to the body. However, chemotherapy has its own share of side effects such as hair loss, sudden and drastic weight loss and persistent fatigue.
  3. Radiation Therapy: This procedure involves using radiations such as x-rays to destroy cancer cells in the body. This procedure is carried out with the help of a machine that focuses radiation on the affected areas of the body. In case you have a concern or query you can always consult an expert & get answers to your questions!
2698 people found this helpful

Breast Cancer - 8 Things You Must Do To Avoid it!

DNB (Obstetrics and Gynecology), MBBS
Gynaecologist, Mumbai
Breast Cancer - 8 Things You Must Do To Avoid it!

Breast cancer is one of the most common cancers in women about 1 in 8 women in the USA develop invasive breast cancer. The incidence of breast cancer has increased with changes in lifestyle including smoking, drinking and loss of physical activity. The risk factors are age, ethnicity and family history cannot be changed. However, there are some risk factors that can definitely be acted upon to reduce the chances of developing breast cancer.

  1. Weight management: Obesity is one of the major risk factors for breast cancer and managing weight and a good body mass index will help reduce the risk of developing breast cancer. This is especially important in women undergoing menopause.
  2. Reducing smoking: The benefits of quitting it are manifold and reducing the risk for breast cancer is one of them. This will, as a byproduct, also result in a host of other benefits including improved quality of life, reduced chances of heart disease, stroke, and other cancers.
  3. Physical activity: In addition to helping in weight management, this also helps reduce the risk of breast cancer. Ideal recommendation is 30 minutes of physical activity per day, plus strength training.
  4. Breastfeeding: This helps in reducing the risk of breast cancer. Prolonged feeding is shown to have a greater protective benefit.
  5. Hormone replacement therapy: When possible, limit the use of hormone replacement therapy for prolonged periods of time. Explore options of non-hormonal substitutes or use the least permissible or required dose. Be sure to get periodic check-ups when on hormone therapy.
  6. Reduce exposure to environmental pollution: Higher levels of pollutants are linked to a higher incidence of breast cancer. When possible, avoid getting exposure to environmental pollutants.
  7. Screening: If there is a strong family history or other risk factors, then screening can help detect breast cancer very early in the process. Recommended ages for mammography are as follows:
    • If you are age 40 – 44: Go for annual mammograms after discussing risks and benefits with the doctor.
    • If you are age 45 – 54: Go for annual mammogram.
    • If you are age 55 or over: Mammograms are recommended every other year. You can choose to continue to have them every year. Self-breast exams are not sufficient. However, if being done, they can also be an input to an abnormality.
  8. Cautious use of birth control pills: Birth control pill usage to be discussed with your gynaecologist if you are above 35 years of age and smoke. The good news is that the risk associated with it disappears slowly after the pill is stopped.

These will help reduce the risk of developing breast cancer, early detection, and improved prognosis.

12 people found this helpful

Natural Ways to Treat Swollen Legs, Ankles and Feet

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Natural Ways to Treat Swollen Legs, Ankles and Feet

You know that feeling after a long day when your feet are so sore or swollen that you can’t bear the thought of standing on them for any longer? once you take off your shoes and sit down, or even soak them in a warm bath, it’s still an unpleasant experience. Luckily, I’ve collected 10 natural remedies for such an occasion and I want to share them with you.
 
Important: regular swelling vs potential health risks
When experiencing swelling in the feet and legs, apply pressure to the area with a finger. If the dimple created by the finger remains for more than a couple of seconds, it may indicate oedema, which can be the result of heart, liver, or kidney problems. When this occurs, see a doctor at the first possible opportunity.
If you experience swelling in one leg but not the other, you should also see a doctor as this may be an indication of deep venous thrombosis (a blood clot blocking the blood vessels).
If the swelling is accompanied by shortness of breath, fever, bluish skin, and chest pains, get immediate medical attention.
 
10 natural remedies:

1. Soak your feet in epsom salts
Pour 250g of epsom salt into a hot bath, and take a nice long soak. You can also add essential oils to the mix for enhanced relaxation. Your feet will thank you, your body will thank you, and you’ll emerge from that bath a happier person.
2. Massage the area
Massaging the painful area increases blood flow and moves the fluids that accumulate and cause the swelling. If you want to indulge, get someone to massage your feet for you, preferably with hot essential oils.
3. Stop smoking
If you smoke tobacco (cigarettes, cigars, etc.), you should know that one of the many negative effects of nicotine is constriction of blood vessels, which can lead to sore feet.
4. Stay hydrated
When the caffeine and sodium we consume accumulate in the body, they can cause swelling and pain in the limbs. The best way to dilute them and flush them out is by drinking water. If you want to maximize the efficiency of hydration, squeeze a lemon or lime into the glass of water for a boost of vitamins and antioxidants.
5. Eat healthy, avoid excess salt
While we need salt for our body to function well, when we overdo it, it can have adverse effects. Reduce the amount of salt you consume every day, and consider cutting down on caffeine as well.
6. Elevate the legs
If you’re suffering from chronically sore legs/feet, try keep your legs elevated for 30 minutes, three times a day. You will notice a difference within a couple of days. Also, when you’re in bed, use a couple of pillows to prop up your feet. Elevating the legs helps to drain the excess fluids that causes the swelling and pain.
7. Avoid sitting for prolonged periods
Whether you’re flying, taking the bus, or just sitting in an office all day, keeping your legs stationary can lead to pain and swelling. If you know you’re going to sit for a long period of time, make sure to stand up, stretch, and walk around every 20 minutes or so.
8. Use compression socks when traveling
If you’re going to fly overseas, another excellent solution is to use compression socks. These socks apply pressure to your feet, preventing fluid from building up – the main cause of swelling and pain in the feet.
 9. Exercise
Exercise will help boost your cardiovascular system, which in turn will reduce the possibility of swelling in the limbs. Exercise increases blood-flow in the body and reduces weight. 
10. Take magnesium supplements
Magnesium is essential for our body’s function. That said, many people suffer from a magnesium deficiency. By adding magnesium to your system, you will improve your overall health, reduce hangover symptoms and suffer less pain in your extremities

3 people found this helpful

How Long Do You Need Physiotherapy Post-Fractures?

MPT, BPT
Physiotherapist, Noida
How Long Do You Need Physiotherapy Post-Fractures?

A broken bone or a fracture can be painful and it requires medical attention for the fracture to heal properly. Proper healing is necessary for the right alignment of the bone. A doctor chooses to either reduce or set the bone in terms of new alignment. The bone reduction can happen manually or surgically depending on the severity of the injury. A Surgical procedure known as the open reduction internal fixation is performed for serious fractures. It ensures that the all the broken pieces are fixed together and the injury can heal properly.

Post the fracture, the bone need to be immobilised for proper healing. This is generally achieved by imposing a cast. For fractures that are not severe in nature, a doctor might choose to impose a temporary cast so that simple motion can happen around the site of the injury. For serious fractures, a permanent cast is placed around the injury site. In the case of a shoulder injury, a patient is required to wear a sling so that the bones are immobilised.

Time Duration of a Therapy Session:

While the exact duration of physiotherapy can vary from individual to individual, it takes a minimum of 2-8 weeks for the fracture to completely heal. Certain fractures take more time to heal. The rate of healing also depends on the severity of the injury, pain threshold level of the patient, extent of work with the physiotherapist, the robustness of the physiotherapy program, extent of the injury of the soft tissue and certain other factors. Typically shoulder and neck injuries heal quicker than a fracture of the legs. The time duration of fracture healing also depends on the type of bone that has been affected.

Physiotherapy in a Hospital:

If the fracture happens in the ankle or leg, a physiotherapist might have to intervene in the hospital in order to teach patient about using assistive devices such as crutches and cane. Things that are taught during this time include using the device in order to climb stairs, right walking posture, getting into a car, taking the device off while sitting and such other techniques.

Physiotherapy at Home:

Physiotherapy can also happen from home if the doctor specifically instructs to do the same. This is typically done for people where the condition is too serious to go outside and get the physiotherapy done. Certain weight bearing restrictions are imposed around this time. The training remains the same as in the case with a hospital.

In the Clinic:

Once the patient becomes mobile enough, a doctor might suggest a patient go to a clinic to get the physiotherapy done. A physiotherapist evaluates certain things such as pain, range of motion, gait, flexibility etc. of the patient before suggesting a certain exercise plan. If you wish to discuss any specific problem, you can consult a physiotherapist.

6001 people found this helpful

Breast Cancer - The Truth !

MBBS, DNB ( Radiation Oncology)
Oncologist, Mumbai

Breast Cancer is the most common cancer of females in urban cities. It is a curable disease if detected early. The usual age of presentation is usually after 40 to 50 years of age, though it is becoming common in earlier age as well. This could be due to many factors like late marriages, older age of pregnancy, diet and lifestyle, etc. The usual presentation is a swelling or lump in the breast, not associated with pain. That is the reason why females are advised regular self-breast examination, clinical breast examination and annual mammograms for screening purpose in order to detect early breast cancers. Many times, the breast lump is associated with blood stained discharge from the nipple. There can be skin changes on the breast like thickening, crusting or sometimes itching. If the skin lymphatics get blocked, there may be pitting and or dimpling of the skin too. There may be lumps felt in the armpit felt too. Many times the lump is not noticeable or felt and felt by chance during a bath. These are some of the commonest presentations. The lady should immediately consult a doctor and get evaluated in such scenario. Many women are at increased risk of developing breast cancer like those who have a positive family history especially first degree relatives like mother& sister. Breast cancer is usually a disease of women but 1% of cases are also seen in men.

If a lady feels any such lump she should immediately bring it to the attention of a doctor or oncologist who can do the necessary evaluation and investigations. Breast cancer is curable if detected early, hence the importance!

The primary modality of treatment is surgery followed by chemotherapy and or radiotherapy and or hormonal treatment depending on the report of the specimen after the surgery. Many times if the lump cannot be operated upfront, initially chemotherapy and or targeted therapy can be given to shrink the tumor for better resectability.

People should be aware that having cancer is not the end of life. It can be treated like many other diseases and the most important thing is awareness and early detection for a durable cure.

Breast Cancer - Ways It Can Be Prevented!

FACS, MBBS, MS - General Surgery
Oncologist, Gurgaon
Breast Cancer - Ways It Can Be Prevented!

The very term 'breast cancer' can send shivers down a woman's spine. The associated pain, agony, sufferings are enough to deter a person. The effectiveness of the treatment depends on the stage in which the condition is detected. Unfortunately, many women neglect and overlook the early signs, thereby delaying the treatment.

Self-awareness is vital for prevention, early detection and treatment of breast cancer. Treatment and prevention can only work when a person is alert and agile. If you notice any unusual symptoms, waste no time and consult an experienced physician at the earliest. However, prevention is always better than a cure. A few healthy habits, if practiced diligently, can go a long way to prevent and reduce the incidences of breast cancer.

  1. A healthy body weight: Overweight and obese women are at a greater risk of suffering from breast cancer. The key to this problem is as simple as shedding off the extra kilos. Research suggests that incidences of breast cancer are slightly lower in women who maintain body weight within healthy limits. Enrich your diet with fruits and vegetables. Drink water and other healthy fluids (coconut water, fresh fruit juice,) at regular intervals.
  2. Breastfeed for a healthy breast: Breastfeeding is important for the health of both the baby and the mother. While babies get the necessary nourishment, women who are into breastfeeding are less likely to suffer from breast cancer. Thus, all healthy lactating mothers should breastfeed their babies.
  3. Keep the vices at bay: Severe smoking and alcohol consumption can harm your body beyond imagination, with breast cancer being one the many harmful side effects. Drinking within limits (1 drink or even less per day) is still acceptable, but anything in excess is sure to spell doom.
  4. Some of the imaging and diagnostic tests can be harmful to your body: Repeated exposure to the radiations from CT-scan can put a woman at an increased risk of developing breast cancer. Limiting the exposure to such radiations may help to check the incidences of breast cancer.
  5. Physically active and agile: Lack of physical exercise and an unhealthy lifestyle can wreak havoc with health complications as serious as breast cancer. It is important to keep your body physically active. Light to moderate exercise (for 30 minutes), jogging, cycling, swimming and other physical activities can work wonders for your body. Avoid stress and anxiety. Proper rest and a sound sleep are equally important.

Various research and studies suggest that women who are into hormone therapy are more susceptible to breast cancer. Such patients are often advised to avoid and replace hormone therapy with alternative treatments. However under extreme conditions (where the alternative treatments fail to produce the desired result), limiting the duration as well as the dosage of the hormone therapy may be helpful. If you wish to discuss about any specific problem, you can consult an Oncologist.

1820 people found this helpful

5 Ways to Train Your Brain to Learn Faster and Remember More

MCh Neurosurgery, MS - General Surgery, MBBS
Neurosurgeon, Guwahati
5 Ways to Train Your Brain to Learn Faster and Remember More

The brain is not a stagnant realm fed with a granted quota of intelligence and memory at birth. It is always in a state of flux. Exercising your brain in various ways accelerates its ability to perform better. It is in your hands to have a sharper take on situations and occurrences. Playing games that require brainstorming, solving quizzes, crosswords or playing chess makes you feel rejuvenated and tired at the same time; the reason being activated brain cells. A healthy brain will affect your life decisions positively and you probably will think rightly before you leap.

Tips to exercise those brain cells:

  1. Meditate and calm your mind: Ten minutes of meditation each day can help you get over anxiety. When your mind is at peace you think out pros and cons with enhanced insight. This composure reflects in each of your actions. Meditation demands your brain to be quiet when it is accustomed to work; you therefore have greater control over it.
  2. Music can improve your brain abilities: Music is the best antidote for a sloppy brain. Music excites the neurons healing a bruised memory. It gifts you with clarity of thought. Apart from listening to music one must try to play a musical instrument. Teaching yourself things puts your mind through a strict regimen of constructive activities.
  3. Take out time to learn a new language: We are paralyzed the minute our brain gives up. Due to several external and internal reasons each one of us is likely to suffer from cognitive disorders on being subjected to extreme pressure or shock. Trying to learn a new language motivate your brain cells to have a wider vocabulary, which further restricts your chances of brain damage.   
  4. Mental mathematics could better your intelligence: Calculators, computers and phones are ridding us of our ability to compute individual data. Computation and consolidation of data helps your mind to work faster with precision. So, you now know those lessons on mental mathematics in childhood were actually the key to a well rounded brain. 
  5. Think of something novel: The more the number of neurons the merrier is your brain. Take pains to direct your mind on a novel track. Thinking beyond what is given and expected helps your brain grow new neurons. It builds up your creativity letting you discover more of your capabilities. Consult an expert & get answers to your questions!
3686 people found this helpful

Hello, I am 41 yr. Old, female. I have got breast cancer & undergoing chemotherapy. I have completed 5 chemo out of 8. Since 2 days I am experiencing severe and unbearable pain in right leg. Is this a symptom of chemotherapy? We have tried all kinds of balm and oils, but nothing is working. Pls prescribe me some medicine or home remedy for it.

MD - Radio Diagnosis/Radiology
Radiologist, Kolkata
Kindly get venous Doppler b/l lower limb done .it can be due to DVT. Its a serious condition. It can occur in a cancer patient as well as pt on chemotherapy.
1 person found this helpful
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Breast Cancer Dimpling - What Are The Reasons Behind It?

Training in IVF / ICSI, Fellowship in Minimal Access Surgery, MD - Obstetrtics & Gynaecology, MBBS
Gynaecologist, Pune
Breast Cancer Dimpling - What Are The Reasons Behind It?

When the skin of a breast looks uneven, it is known as a dimpled skin. Sometimes the skin might appear to be red or inflamed. In this condition, the breast tissue gets affected and this can be a serious sign of concern for cancer. Moreover, this sign is hard to detect on your own. Usually when the sign occurs, it only occurs in one of the breasts. If a woman has it in both the breasts, then likely that it has not been caused by cancer.

Causes of breast cancer dimpling are as follows
1. Advanced breast cancer
2. Breast abscess: A hollow space in the breast that is filled with pus and is at times surrounded by an inflamed tissue.
3. Duct obstruction: The ducts that carry the milk from the nipple are obstructed causing rapid abnormal growth and functioning of the cells present in the breasts causing cancer.
4. Fat necrosis: In this condition, the neutral fats are split into glycerol and fatty acids because the adipose tissue tends to degenerate.
5. Inflammation: Inflammation in the fatty tissue of the breast
6. Mastitis: The breast tissue tends to swell up and get infected. This happens because of the bacteria that enter the breasts through the nipple and this may cause infection in the milk glands.
7. Genetic: Carrying the faulty gene is one of the main reasons why many women end up literally inheriting breast cancer. This can usually be tested with a mammography, especially if one has a history of breast cancer in the family. Yet, one must remember that it is not advisable to take this test too many times as it puts you at risk of contracting breast cancer even if you do not have it, when there is repeated exposure.

First, the doctor might perform certain tests to diagnose and determine the problem. Tests like an ultrasound, MRI or even a mammogram might be used. Depending on what the diagnoses is, the doctor might even want to perform a biopsy. In case breast cancer is diagnosed, there are certain treatments that are available. These include:

  1. Surgery: The cancerous tissue is removed from the breast or at times when the tissue is too big, the entire breast might have to be removed.
  2. Chemotherapy: Chemotherapy is a medication that uses a method to send fluids that tend to kill the cancerous cells or prevent them from growing. It is a three to four hour long session at times.
  3. Radiation: High beam x-rays are used in order to target and destroy the cancer cells present in the breasts.
  4. Hormonal therapy: In this treatment, the hormones that fuel the growth of cancerous cells are blocked either through medications or surgically. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
3861 people found this helpful

Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

MBBS, MD, FIMSA, FIPP
Pain Management Specialist, Delhi
Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

As life expectancy is increasing so is the incidence of vertebral body (VB) fractures now being the commonest fracture of the body. PVP is an established interventional technique in which bone cement is injected under local anaesthesia via a needle into a fractured VB with imaging guidance providing instant pain relief, increased bone strength, stability, decreasing analgesic medicines, increased mobility with improved quality of life and early return to work in days.

In this era of minimally access surgery replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression fracture spine.

Morbidity & consequences of spinal fracture:

  • Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly
  • Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory & GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
  • High risk of primary or consequential damage to neural, bony or disc element
  • Increased wedging, deformity & increase incidence of adjacent VB
  • Chronic pain of altered spine mechanics
  • Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
  • Cost of surgery and hospital treatment
  • Cost of implants
  • Phobia of surgery
  • Prolonged recovery period & Extensive rehabilitation
  • Changed spinal mechanics & transition syndrome
  • Major surgery & anesthesia with its own complications

Results / Outcome

  • PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral.
  • Different studies show an immediate pain relief in (85 – 90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
  • PVP does augment height of VB but ideal would be kyphoplasty
  • Patient is either off medicine or on reduced doses.
  • Patient feels so well that he almost forgets if he had VB
     

Percutaneous Vertebroplasty (PVP) is an emerging interventional technique in which surgical polymethyl methacrylate bone cement is injected under local anaesthesia via a large bore needle into a vertebral body (VB) under imaging guidance providing increased bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL and early return to work. Started in 1984 by Galibert PVP is done in host of indications.

Senile osteoporotic compression remains the commonest Indication. Other indications are  Metastatic VB,  Multiple myeloma VB, VB haemangioma,  Vertebral osteonecrosis & for strengthening VB before major spinal surgery. The benefit has been extended to the traumatic stable uncomplicated VB compression (VCF)   which is commoner in younger age group with active life profile and prime of their career where strict bed rest and acute or chronic pain are unacceptable and they are more demanding for proactive treatment approach so as to be back to work ASAP.

Discovering the fact that VB is the commonest of body, its incidence >the hip, it becomes imperative to take it more seriously. With increasing life-span there is more of aged osteoporotic population, more so due to sedentary indoor lifestyle and post menopausal osteoporosis.  Diabetics, smokers & alcoholics are at higher risk of developing osteoporosis. I have seen such alcoholic patient developing six spine fractures in just three months time from a single fracture being on complete bed rest.

Quick fix of fracture spine makes patient walk back same day instead of bed rest of months together avoiding morbidity & mortality of prolonged bed rest, making bedridden patient walk, in a way bringing patient  back to normal life.

In this era of MAS replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression.

Morbidity & consequenses of spinal 

  • Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly.
  • Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory &
  • GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
  • High risk of primary or consequential damage to neural, bony or disc elements.
  • Increased wedging, deformity & increase incidence of adjacent VB
  • Chronic pain of altered spine mechanics.
  • Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.

Morbidity and complication of spinal surgery 

  • Cost of surgery and hospital treatment
  • Cost of implants
  • Phobia of surgery
  • Prolonged recovery period & Extensive rehabilitation
  • Changed spinal mechanics & transition syndrome
  • Major surgery & anesthesia with its own complications

Preparation & Procedure:
X-ray spine in a/p & lat view. CT is more informative of bone & morphology. MRI is good for soft tissue injuries. Ask for pedicle size in all dimensions and construct a 3D image aiming needle placement and cement filling in scan room itself as rehearsal of PVP. This reduces operative time & gives better results. Conventionally PVP is done by hammering the vertebroplasty needle through the bone. Here we use light weight drill to bore through the vertebra. It is important to set the needle at exact entry site & side with right trajectory aiming the defects.

In lateral view needle should go through middle of the pedicle going up to anterior 1/3 of VB. In P/A view the needle can be in midline or paramedian depending upon & if uni/bipedicular approach is planned. Approach varies as per location of vertebra, anterolateral in cervical, costotransverse/parapedicular in thoracic & transpedicular in lumbar vertebra.

Do bone biopsy if there is any doubt about lession. Do dye test (vertebral venography). Make cement more radiopaque by adding barium /or tungsten. Inject cement with 1or2 ml luerlock syringes strictly under fluoroscope in lateral view & cross checking in P/A view. Stop injecting either there is adequate filling or at the first sight of ectopic cement leak. Keep sample cement to see for hardening. Remove needle with rotational movement before cement hardens.

Pain relief is by virtue of different mechanisms postulated :

  • Cementing of fragments.
  • Thermal neurolysis of VB nerve ending due to heat of polymerization.
  • Washing away of nociceptor chemicals.
  • Neurolytic action of liquid monomer.
  • By allowing early ambulation decreasing pains of immobility & bed rest.

Complications 

  1. PVP is generally safe with low risk.
  2. Ectopic cement leak is frequent but generally inconsequential.

Outcome 

  1. PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral
  2. Different studies show an immediate pain relief in (85 – 90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
  3. PVP does augment height of VB but ideal would be kyphoplasty.
  4. Patient is either off medicine or on reduced doses.
  5. Patient feels so well that he almost forgets if he had VB

In case you have a concern or query you can always consult an expert & get answers to your questions!

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