5–6 pm Friday, March 8

The Use of Anesthetic Blocks to Select Patients for Joint Denervation: An Update on the Best Evidence (214)

A discussion of the evidence-base for anesthetic nerve blocks as a tool to predict clinical outcomes following radiofrequency neurotomy for joint pain. The impact of nerve versus intra-articular block, number of blocks, anesthetic volume used, use of contrast agent, and variations in needle tip position will be reviewed.

Medial Branch Nerve Blocks: Evidence-Based Best Practices

Steven P. Cohen, MD

Lateral Branch Nerve Blocks: The Foundational Science and Elements Yet to be Defined

Byron Schneider, MD

Genicular Nerve Blocks: Developments Toward a More Accurate Protoco

Zachary McCormick, MD

Learning Objectives:

  • Review the current diagnostic and clinical outcome literature that addresses medial branch nerve blocks in order to selection patients for radiofrequency neurotomy in the treatment of refractory spinal pain of facet joint origin.
  • Describe the foundational literature that defined an anesthetic block paradigm of the lateral branch nerves in order to anesthetize the posterior sacroiliac joint/dorsal ligaments, and discuss the need for a prognostic studies of lateral branch nerve blocks to determine if such block predict a positive outcome of radiofrequency denervation.
  • Summarize the current state of the evidence for anesthetic genicular nerve blocks and the evolution in protocol optimization that is needed given a recently published anatomic study.
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3:45–4:45 pm Friday, March 8

Peripheral Nerve Stimulation: A New Paradigm for Treatment of Neuropathic Pain (210)

Historically, the options for treating peripheral neuropathic pain mainly focused on targeting the central nervous system. Peripheral nerve stimulation (PNS) was limited in its availability and usefulness. High-resolution ultrasound and new technology have transformed PNS from an open surgery to a minor percutaneous procedure. This session aims to identify the most common nerve targets, pitfalls, and the ultrasound considerations for PNS implants.

Peripheral Nerve Stimulation: History and Basic Principles

Amitabh Gulati, MD

Peripheral Nerve Stimulation: Patient Selection and Nerve Targets

Scott Pritzlaff, MD

Lessons from the Experienced Implanter: PNS Pitfalls and Pearls

Einar Ottestad, MD FIPP CIPS

Learning Objectives:

  • Identify appropriate conditions and nerve targets that would best respond to peripheral nerve stimulation.
  • Develop a simple PNS algorithm to successfully treat peripheral neuropathic pain and minimize complications.
  • Review the evidence-based literature for the current, commercially-available percutaneous PNS systems.
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1:45–2:45 pm Friday, March 8

Indications and Outcomes of Surgical Treatment of Back Pain: Getting the Right Patient to the Right Provider(s) (206)

A spine surgeon, an interventional pain specialist, and a pain psychologist will discuss factors that contribute to the most efficacious treatment of back pain. Utilizing team based approaches they will present case based scenarios to delineate plans for successful treatment, including cross discipline collaboration to ensure optimal outcomes.

Treating Back Pain Is a Team Sport

Judith Scheman, PhD

To Cut or Not to Cut: That Is the Question

Edward Benzel, MD

Who to Needle, Block, Pump, or Stimulate: The Right Patient for the Right Intervention

Manu Mathews

Learning Objectives:

  • Identify the psychosocial factors most likely to influence the success of surgery or other pain interventions.
  • Formulate a treatment plan most likely to help the patient as well as how to present that plan to the patient.
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11 am–Noon Friday, March 8

Controversial Topics in Neuromodulation (202)

The session is designed for all pain providers and will evaluate the current evidence on spinal cord stimulation in various pain conditions. These procedures are being critically evaluated by payors, government systems, and physicians due to cost. A clear understanding of the evidence will improve outcomes and function in this vulnerable population.

Can We Predict Success With Spinal Cord Stimulation?

Ameet S. Nagpal, MD MS Med

Not All Waveforms Are Equal: Comparing and Contrasting Different Methods of Stimulation

Maxim Eckmann

Performing the Procedure and Ethical Considerations

Sanjog Sharad Pangarkar, MD

Learning Objectives:

  • Describe situations in which it is appropriate to refer a patient for spinal cord stimulator evaluation.
  • Interpret imaging, historical data, psychological screening, and physical examination to establish a pre-test probability of successful pain relief and functional outcomes with spinal cord stimulation.
  • Adjust your practice patterns to improve overall safety of spinal cord stimulation.
  • Optimize clinical practice management related to billing, malpractice, and collections in an ethical manner.
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3:30–4:30 Saturday, March 9

Multidisciplinary Care Leading to Contemporary Strategies for Intrathecal Drug Delivery (314)

This session highlights management strategies for patients receiving multidisciplinary care with a targeted drug delivery system.

Multidisciplinary Care with Oral Analgesics Can Lead to Intrathecal Therapy: Selected Adverse Effects and Efficacy

Michael S. Leong, MD

Intrathecal Drug Delivery: Is Bolus Administration Better Than Continuous?

Jason E. Pope, MD

Cost Effectiveness of Targeted Drug Delivery

Robert Bolash, MD

Learning Objectives:

  • Present the current best practice intrathecal treatments.
  • Demonstrate cost-effectiveness data about intrathecal therapy compared with conservative multidisciplinary care.
  • Select optimal patients for intrathecal therapy and adjust dosages, including tapering off intrathecal medications.
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