The AAPM 2020 educational program will be available in fall 2019. In the meantime browse 2019 meeting sessions and speakers to get a sense of the premier pain education offered during the AAPM Annual Meeting & Preconferences. Access recordings of past meeting sessions on demand.

Pain Debate! Stem Cell Therapy, Cooled Radiofrequency Ablation for Legs, and Stimulation for Back Pain (310)

Pain Debate! High energy short presentations will inform participants of current controversies and allow them to make decisions with high quality evidence for their patients.

Stem Cell Therapy Should Be Used Prior to Other Injections for Joint and Spinal Pain

Pro: Corey Hunter, MD ; Con: James S. Khan, MD MSC

Cooled Radiofrequency Ablation is the Best Treatment for Hip and Knee Arthritis

Pro: Tim R. Deer, MD; Con: Vafi Salmasi, MD

Low Back Pain: Spinal Cord Stimulation Is Better than Percutaneous or Peripheral Therapies

Pro: Mehul J. Desai , MD MPH / Con: Michael S. Leong, MD

Please note this session does not provide CME.

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Pain Management in Service Members and Veterans (309)

The last 18 years of armed conflict, the longest in the nation's history, have resulted in unique challenges to Service members and Veterans in both acute and chronic pain management. The DoD and VHA response to pain management during the war represents a unique opportunity to evaluate how these large federal systems, representing almost 20 million beneficiaries, are improving pain management systems. This program outlines the federal response to the pain management crisis and concurrent opioid epidemic within a high functioning population tasked with defending this country. Federal medicine's adoption of innovative spine procedures, incorporation of integrative health into a stepped collaborative biopsychosocial care model, and new patient reported outcome standards in the management of pain provide opportunities for early civilian adoption of these advances. Civilian systems will benefit from observing how these changes have impacted federal medicine.

Interventional Treatment of Back Pain in Service Members & Veterans

Steven P. Cohen, MD

VA Collaborative Stepped Care Model for Pain

Friedhelm Sandbrink, MD

DoD Pain Patient Reported Outcomes Measures

Chester “Trip” Buckenmaier III, MD COL (Ret.) MC USA

Learning Objectives:

  • Identify service members and veterans who may benefit from procedural interventions for spine pain
  • Describe how integrative health modalities have complemented and enhanced more standard pain management approaches.
  • Discuss the importance of quality patient reported outcomes data to evaluate the success of both individual patient interventions and overall pain management system changes.
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11:15 am–12:15 pm Saturday, March 9

Pain Debate! CGRP Dugs, Ketamine, and Opioids for Back Pain (306)

Pain Debate! High energy short presentations will inform participants of current controversies and allow them to make decisions with high quality evidence for their patients.

CGRP Blockers Are the Wonder Drugs for Migraine Prevention

Pro: Alan M. Rapoport, MD; Con: Robert P. Cowan, MD

Ketamine Should be Used Beyond CRPS

Pro: May Chin, MD; Con: Stephen D. Coleman, MD

Chronic Back Pain in 2019 Should Include Opioid Therapy

Pro: Charles Argoff, MD; Con: Timothy R. Deer, MD

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9:15–10:15 am Saturday, March 9

Pain Debate! Complex Regional Pain Syndrome, Radiofrequency Ablation for Back Pain, and Sacral Stimulation (302)

Pain Debate! High energy short presentations will inform participants of current controversies and allow them to make decisions with high quality evidence for their patients.

Complex Regional Pain Syndrome: Everything But Stimulation

Pro: Vivianne Tawfik, MD PhD; Con: Jason E. Pope, MD

Lumbar Spondylosis: The MINT Study - Radiofrequency Ablation is NOT Effective

Pro: Ajay B. Antony, MD / Con: Steven P. Cohen, MD

Sacral Nerve Stimulation is Better Than Conservative Care for Pelvic Pain

Pro: Corey W. Hunter, MD / Con: Jennifer Hah, MD MS

Learning Objectives:

  • Assess if spinal cord stimulation or other stimulation is necessary to treat CRPS.
  • Describe the role of CGRP for modern migraine therapy.
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General Session III (104): Radiofrequency

Selecting Patients for Facet Blocks and Optimizing Lumbar Facet Radiofrequency Denervation Outcomes

Stephen P. Cohen, MD

Learning Objectives:

  • Assess that medial branch blocks are more of a prognostic than diagnostic procedure.
  • Refine selection criteria for MBB and RF denervation.
  • Individualize and optimize the selection process for candidates for RF denervation.
  • Optimize RF lesion size.
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11 am–Noon Sunday, March 10

Lumbar Medial Branch Radiofrequency Neurotomy: How Understanding Anatomy, Patient Selection, and Technique Affect Outcomes (410)

A successful outcome of lumbar medial branch radiofrequency neurotomy (LMBRFN) is dependent on careful attention to principles of facet join pain diagnosis and elements LMBRFN procedure technique. This session will present in depth discussion of these multiple, intricate factors. The relevant anatomy, diagnostic standards, and physics of radiofrequency lesions as applied to LMBRFN will be detailed, as supported by the current medical literature.

Lumbar Medial Branch Blocks to Accurately Diagnose Lumbar Zygaphophyseal Joint Pain: False Positives, Disease Prevalence, and Diagnostic Confidence

Byron Schneider, MD

Anatomy of the Lumbar Medial Branch Block and How This Relates To Ideal Procedural Technique

Zachary McCormick, MD

Evidence-Based Review of Lumbar Medial Branch Radiofrequency Neurotomy Outcomes

David J. Kennedy, MD

Learning Objectives:

  • Recognize the exact anatomy of the lumbar medial branch nerves and how they can be best accessed.
  • Define the diagnostic principles of medial branch nerve blocks and how they can be interpreted to define a 'positive' for patient selection, based on the best medical evidence.
  • Summarize the physics the lesioning the medial branch nerves via radiofrequency technology, in a manner that is most likely to achieve effective coagulation of the nerve, based on the medical literature.
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9:45–10:45 am Sunday, March 10

Immediate Adverse Events Associated with Epidural Injections, Particulate Versus Non-Particulate Steroid Use During Epidural Injections (406)

New evidence has come to light regarding best safety practices during interventional pain procedures. This session highlights the most current high quality literature that investigates safety considerations related to anticoagulation management during interventional pain procedures, adverse event risk mitigation during epidural steroid injections, and preventing long-term disc degeneration following lumbar provocation discography.

The Risks and Benefits of Ceasing Versus Maintaining Anticoagulation Medications During Interventional Pain Procedures

Byron Schneider, MD

Immediate and Early Adverse Events of Epidural Steroid Injections: What Does the Most Rigorous Evidence Teach Us?

David J. Kennedy, MD

An Evidence-Based Update on Particulate vs. Non-Particulate Steroid Use During Epidural Injections

David J. Kennedy, MD

Learning Objectives:

  • Analyze the body of literature and best evidence regarding anticoagulation management during interventional pain procedures.
  • Define the adverse event rates in the immediate and early post-procedure time period following epidural steroid injection according to clinical practice guidelines and how to mitigate these risks.
  • Interpret new data that addresses the longterm effects of lumbar provocation discography performed according to modern techniques not used in prior studies.
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8:30–9:30 am Sunday, March 10

New Safety Considerations for Interventional Pain: Risks Associated with Cumulative use of Steroid Injections, Short and Long-Term Complications of Disc Puncture and Provocation Discography (402)

The safety of interventional spine procedures: adverse events of spine injections, long-term complications of discography, and risks and benefits of stopping of continuing anticoagulation medications.

An Update on Cumulative Steroid Risk with Spinal Injections

Byron Schneider, MD

Short-Term Risks of Disc Puncture and Provocation Discography

Zachary McCormick

Long-Term Risks of Provocation Discography

Zachary McCormick, MD

Learning Objectives:

  • Quantify the indications, effectiveness, and common complications of epidural steroid injections.
  • Discuss the most up to date information regarding long term outcomes following discography.
  • Discuss the risk and benefits of maintaining versus ceasing anticoagulation medications for spine interventions.
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