In episode 10, our experts covered your questions on:

• What does the latest research tell us about knee, shoulder, and hip joint denervation?
• What protocol is recommended for identifying and treating pain with knee and other joint denervations
• Should we consider denervation before or after joint replacement, peripheral stimulation, or orthobiologic therapy in our protocol?
• Which modality provides the most effective image guidance – fluoroscopy or ultrasound – and can or should they be combined?
• Do enhanced lesioning treatments utilizing cooled radiofrequency, bipolar, and or multi-tined radiofrequency probes improve outcomes?
• Is phenol neurolysis comparable to radiofrequency denervation, and if so, what phenol volume and concentration should be used?
• Are hip and shoulder denervation comparable to knee denervation on a risk vs benefit basis?

Your expert panel for this October 10, 2024 webinar included:

• Christine Hunt, DO, MS, of the Mayo Clinic in Jacksonville, Florida, who also serves IPSIS as Vice-Chair of the Evidence Analysis Committee; and
• Ameet Nagpal, MD, MS, MEd, MBA, of the Medical University of South Carolina College of Medicine, who also serves IPSIS as Chair of the Guidelines Committee.

The panel was moderated by Michael Furman, MD, MS, Fellowship Director at OSS Health, who also serves on the IPSIS Board as a Member-at-Large.

Episode 10 Show Notes: These are the abstracts referenced by our experts.

• Anatomical Study of the Innervation of Anterior Knee Joint Capsule: Implication for Image-Guided Intervention
• Cooled Radiofrequency Ablation of the Articular Sensory Branches of the Obturator and Femoral Nerves using Fluoroscopy and Ultrasound Guidance: A Large Retrospective Study
• Genicular nerve radiofrequency ablation for the treatment of chronic knee joint pain: a real-world cohort study with evaluation of prognostic factors
• Radiofrequency ablation of the hip: review
• Shoulder Ablation Approaches
• Terminal Sensory Articular Nerve Radiofrequency Ablation for the Treatment of Chronic Intractable Shoulder Pain: A Novel Technique and Case Series

You can also watch the video of this webinar here.

© 2024 International Pain and Spine Intervention Society – All Rights Reserved
Materials presented in this activity have been made available by the International Pain and Spine Intervention Society for educational purposes only.

In episode 10, our experts covered your questions on:

• What does the latest research tell us about knee, shoulder, and hip joint denervation?
• What protocol is recommended for identifying and treating pain with knee and other joint denervations
• Should we consider denervation before or after joint replacement, peripheral stimulation, or orthobiologic therapy in our protocol?
• Which modality provides the most effective image guidance – fluoroscopy or ultrasound – and can or should they be combined?
• Do enhanced lesioning treatments utilizing cooled radiofrequency, bipolar, and or multi-tined radiofrequency probes improve outcomes?
• Is phenol neurolysis comparable to radiofrequency denervation, and if so, what phenol volume and concentration should be used?
• Are hip and shoulder denervation comparable to knee denervation on a risk vs benefit basis?

Your expert panel for this October 10, 2024 webinar included:

• Christine Hunt, DO, MS, of the Mayo Clinic in Jacksonville, Florida, who also serves IPSIS as Vice-Chair of the Evidence Analysis Committee; and
• Ameet Nagpal, MD, MS, MEd, MBA, of the Medical University of South Carolina College of Medicine, who also serves IPSIS as Chair of the Guidelines Committee.

The panel is moderated by Michael Furman, MD, MS, Fellowship Director at OSS Health, who also serves on the IPSIS Board as a Member-at-Large.

Episode 10 Show Notes: These are the abstracts referenced by our experts.

• Anatomical Study of the Innervation of Anterior Knee Joint Capsule: Implication for Image-Guided Intervention
• Cooled Radiofrequency Ablation of the Articular Sensory Branches of the Obturator and Femoral Nerves using Fluoroscopy and Ultrasound Guidance: A Large Retrospective Study
• Genicular nerve radiofrequency ablation for the treatment of chronic knee joint pain: a real-world cohort study with evaluation of prognostic factors
• Radiofrequency ablation of the hip: review
• Shoulder Ablation Approaches
• Terminal Sensory Articular Nerve Radiofrequency Ablation for the Treatment of Chronic Intractable Shoulder Pain: A Novel Technique and Case Series

Listen on the go — make "Ask the Experts" your new go-to podcast! Besides the video, an audio download is also available here.

© 2024 International Pain and Spine Intervention Society – All Rights Reserved Materials presented in this activity have been made available by the International Pain and Spine Intervention Society for educational purposes only.

In episode 9, our experts covered your questions on:

• How do you recognize, diagnose, and treat symptomatic hypersensitivity reactions to contrast media?
• How do you prevent repeat hypersensitivity reactions with a proper history?
• How do you discuss pretreatment for patients with known hypersensitivity reactions?
• Which iodinated contrast media should we consider?
• When should gadolinium-based contrast media be considered?
• What are appropriate contrast media concentrations and volumes?
• How should you manage procedures when there are iodinated contrast media shortages?

Your expert panel for this August 6, 2024 webinar included:

• Past President Timothy Maus, MD, a Mayo Clinic Professor Emeritus of Radiology, and moderator of the Case Review Community; and
• Christin A. Tiegs-Heiden, MD, of the Mayo Clinic in Rochester, Minnesota.

The panel was moderated by Michael Furman, MD, MS, Fellowship Director at OSS Health, who also serves on the IPSIS Board as a Member-at-Large.

You can also watch the video of this webinar here.

Episode 9 Show Notes: These are the abstracts referenced by our experts.

• The American College of Radiology Manual on Contrast Media
• The Use of Contrast Agents in Interventional Pain Procedures: A Multispecialty and Multisociety Practice Advisory on Nephrogenic Systemic Fibrosis, Gadolinium Deposition in the Brain, Encephalopathy After Unintentional Intrathecal Gadolinium Injection, and Hypersensitivity Reactions

© 2024 International Pain and Spine Intervention Society – All Rights Reserved
Materials presented in this activity have been made available by the International Pain and Spine Intervention Society for educational purposes only.

In episode 9, our experts covered your questions on:

• How do you recognize, diagnose, and treat symptomatic hypersensitivity reactions to contrast media?
• How do you prevent repeat hypersensitivity reactions with a proper history?
• How do you discuss pretreatment for patients with known hypersensitivity reactions?
• Which iodinated contrast media should we consider?
• When should gadolinium-based contrast media be considered?
• What are appropriate contrast media concentrations and volumes?
• How should you manage procedures when there are iodinated contrast media shortages?

Your expert panel for this August 6, 2024 webinar included:

• Past President Timothy Maus, MD, a Mayo Clinic Professor Emeritus of Radiology, and moderator of the Case Review Community; and
• Christin A. Tiegs-Heiden, MD, of the Mayo Clinic in Rochester, Minnesota.

The panel was moderated by Michael Furman, MD, MS, Fellowship Director at OSS Health, who also serves on the IPSIS Board as a Member-at-Large.

Listen on the go — make "Ask the Experts" your new go-to podcast! Besides the video, an audio download is also available here.

Episode 9 Show Notes: These are the abstracts referenced by our experts.

• The American College of Radiology Manual on Contrast Media
• The Use of Contrast Agents in Interventional Pain Procedures: A Multispecialty and Multisociety Practice Advisory on Nephrogenic Systemic Fibrosis, Gadolinium Deposition in the Brain, Encephalopathy After Unintentional Intrathecal Gadolinium Injection, and Hypersensitivity Reactions

© 2024 International Pain and Spine Intervention Society – All Rights Reserved Materials presented in this activity have been made available by the International Pain and Spine Intervention Society for educational purposes only.

IPSIS members are invited to unlock this free introductory set, which includes the modules:

Ultrasound-Guided Spine Care and Relationship to IPSIS Guidelines
Ultrasound Principles and Technical Aspects 
Ultrasound-Guided Shoulder Injections

Then, when you're ready, use your special member pricing to unlock:
Core Curriculum: Ultrasound-Guided Interventions of the Spine and Masqueraders (Basic),
Core Curriculum: Ultrasound-Guided Interventions of the Spine and Masqueraders (Advanced), 
or the all-inclusive full Core Curriculum: Ultrasound-Guided Interventions of the Spine and Masqueraders set.

© 2019, 2023, 2024 International Pain and Spine Intervention Society – All Rights Reserved Materials presented in this activity have been made available by the International Pain and Spine Intervention Society for educational purposes only. We reserve all rights to such material.

*Continual membership is expected to access the modules in your member profile.

Watch the free Post Fellowship Guide webinar on securing the “right” contract and nailing that first critical year as an attending interventional pain medicine physician.

• What are the real factors you should be weighing to identify your ideal path to attending physician?
• When should new attending physicians tell their department/chair “no” — and what questions should always be answered with “yes”?
• How do successful new attending physicians avoid burnout?
• What regrets do attending physicians have that make them wish for a “do-over” first year?

Your panel includes:

• Heidi Chen, MD, an Attending Spine Physiatrist at VUMC/Assistant Professor of PM&R at Vanderbilt University Medical School in Nashville, who completed a fellowship at OSS Health in York, Pennsylvania;
• Max Epstein, MD, an Interventional Spine Physiatrist and Instructor in Physical Medicine & Rehabilitation at Spaulding Rehabilitation/Massachusetts General Hospital, who completed a fellowship at the University of Utah Hospital; 
• Guilherme Ferreira Dos Santos, MD, a Senior Specialist and Pain Medicine Clinical Lead at the Hospital Clínic de Barcelona, who completed a fellowship at the Department of Anesthesiology and Pain Medicine, University of Toronto; and
• Amrita Prasad, MBBS, a Physiatrist and Pain Physician working in private practice in Queensland, Australia, who completed a pain fellowship with the Faculty of Pain Medicine, at the Australia New Zealand College of Anaesthetists.

The panel is moderated by IPSIS Early Career Council Chair, Alexandra Fogarty, MD, a fellow at Massachusetts General Hospital/Harvard Medical School in Boston, who also serves on the IPSIS Board as an Early Career Physician; and Christopher Robinson, MD, PhD, an anesthesiology resident at Beth Israel Deaconess Medical Center.

© 2024 International Pain and Spine Intervention Society – All Rights Reserved Materials presented in this activity have been made available by the International Pain and Spine Intervention Society for educational purposes only.

Jump right to the section of Episode 8 that you want to explore:

• 03:40    What history suggests a vertebrogenic pain source?
• 06:10    Which exam findings suggest a vertebrogenic pain source?
• 11:10    What imaging and diagnostic tests can identify or rule out a vertebrogenic pain source?
• 17:38    What procedures are indicated for patients with modic changes?
• 22:00    Should other pain sources be considered/ruled out before treating vertebrogenic pain?
• 24:00    Is there a role for discography?
• 25:30    What roles do Schmorl's nodes play?
• 26:10    What other types of treatments are available for vertebrogenic pain?
• 32:20    How do you select patients when MRIs demonstrate multiple spinal pathologies and Modic changes?
• 39:30    What would you see on follow up MRI?
• 41:00    Should bone density screening be done for all patients?
• 43:30    What is the maximum recommended patient age for these procedures? What is the average age?
• 46:00    What procedures are indicated with Modic changes at L2/3?
• 44:07    What is the neuroanatomy of the discovertebral junction?
• 48:10    How do you use MRIs for pre-op planning?
• 51:55    What procedures are indicated in the setting of lumbar scoliosis and Modic changes?
• 55:05    What type of anesthesia should be used for these procedures?
• 56:00.   What is the incidence of post procedural neuritis or other nerve related pathology?
• 58:40    Final Words     

Your expert panel for this June 4, 2024 webinar included:

• Ryan Reeves, MD, of Spine Team Texas in Southlake, Texas; and
• Past President Matthew Smuck, MD, of Stanford University in Redwood City, California.

The panel was moderated by Michael Furman, MD, MS, Fellowship Director at OSS Health, who also serves on the IPSIS Board as a Member-at-Large.

Listen on the go — make "Ask the Experts" your new go-to podcast! Besides the video, an audio download is also available here.

© 2024 International Pain and Spine Intervention Society – All Rights Reserved Materials presented in this activity have been made available by the International Pain and Spine Intervention Society for educational purposes only.

Jump right to the section of Episode 8 that you want to explore:

• 03:40    What history suggests a vertebrogenic pain source?
• 06:10    Which exam findings suggest a vertebrogenic pain source?
• 11:10    What imaging and diagnostic tests can identify or rule out a vertebrogenic pain source?
• 17:38    What procedures are indicated for patients with modic changes?
• 22:00    Should other pain sources be considered/ruled out before treating vertebrogenic pain?
• 24:00    Is there a role for discography?
• 25:30    What roles do Schmorl's nodes play?
• 26:10    What other types of treatments are available for vertebrogenic pain?
• 32:20    How do you select patients when MRIs demonstrate multiple spinal pathologies and Modic changes?
• 39:30    What would you see on follow up MRI?
• 41:00    Should bone density screening be done for all patients?
• 43:30    What is the maximum recommended patient age for these procedures? What is the average age?
• 46:00    What procedures are indicated with Modic changes at L2/3?
• 44:07    What is the neuroanatomy of the discovertebral junction?
• 48:10    How do you use MRIs for pre-op planning?
• 51:55    What procedures are indicated in the setting of lumbar scoliosis and Modic changes?
• 55:05    What type of anesthesia should be used for these procedures?
• 56:00.   What is the incidence of post procedural neuritis or other nerve related pathology?
• 58:40    Final Words     

Your expert panel for this June 4, 2024 webinar included:

• Ryan Reeves, MD, of Spine Team Texas in Southlake, Texas; and
• Past President Matthew Smuck, MD, of Stanford University in Redwood City, California.

The panel was moderated by Michael Furman, MD, MS, Fellowship Director at OSS Health, who also serves on the IPSIS Board as a Member-at-Large.

You can also watch the video of this webinar here.

© 2024 International Pain and Spine Intervention Society – All Rights Reserved
Materials presented in this activity have been made available by the International Pain and Spine Intervention Society for educational purposes only.

IPSIS members, unlock this set of basic ultrasound lectures, which includes the modules:

Ultrasound-Guided Spine Care and Relationship to IPSIS Guidelines
Ultrasound Principles and Technical Aspects
Ultrasound-Guided Greater Occipital Nerve Blocks
Ultrasound-Guided Suprascapular Nerve Blocks
Ultrasound-Guided Lateral Femoral Cutaneous Nerve Thigh Injections
Ultrasound-Guided Intra-articular Knee Injections
Ultrasound-Guided Shoulder Injections 
Ultrasound-Guided Intra-articular Hip Joint and Greater Trochanter Bursa Injections

Looking for a sample? Unlock the free introductory set, which includes the first two modules and the Ultrasound-Guided Shoulder Injections module. Then, when you're ready, use your special member pricing to unlock this basic set, or
Core Curriculum: Ultrasound-Guided Interventions of the Spine and Masqueraders (Advanced), or go all in with the all-inclusive full Core Curriculum: Ultrasound-Guided Interventions of the Spine and Masqueraders set.

© 2019, 2023, 2024 International Pain and Spine Intervention Society – All Rights Reserved Materials presented in this activity have been made available by the International Pain and Spine Intervention Society for educational purposes only. We reserve all rights to such material.

*Continual membership is expected to access the modules in your member profile.

Educational Objectives 
Upon completion of this activity, participants should be able to:

• Discuss the US principals, techniques, and terminology;
• Perform USG spinal interventions;
• Perform USG interventions on spine masqueraders.

Speaker Disclosure Information   
RELEVANT FINANCIAL RELATIONSHIPS WITH ACCME-DEFINED INELIGIBLE COMPANIES 

Drew Trainor, DO
Consultant: Boston Scientific; NALU; Vertiflex
Speaker: Boston Scientific; NALU  

None of the other planners or speakers had relevant financial relationships with ACCME-defined ineligible companies. All relevant financial relationships have been mitigated.

References 
References are provided within the speakers' presentations.

Commercial Support
No commercial support was received for this activity.

Accreditation Statement     
The International Pain & Spine Intervention Society (IPSIS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement     
IPSIS designates this enduring material for a maximum of 2.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Date of Activity Release: 4/27/2023      
Date of Activity Expiration: 4/26/2026

Jump right to the section you want to explore:

• 00:11    Introductions -Dr(s). Furman, Naftulin and Derby
• 03:21    Defining Discogenic Pain. What History and Exam Findings Suggest a Discogenic Pain Etiology?
• 07:00    Introduction Dr. Calodney
• 08:03    What History and Exam Findings Suggest a Discal Pain Source? (continued)
• 11:51    What is the Correlation Between the Finding of a High-intensity Cone on MRI and the Presence of Discogenic Pain?
• 13:06    What is the Role of Discography in the Diagnosis of Discogenic Pain?
• 14:24    What is the Role of Discography in Selecting Between Intradiscal Therapies and Basivertebral Nerve Ablation ?
• 18:45    What is the Role of Analgesic Discography in the Treatment of Discogenic Pain?
• 23:55    When Should Prophylactic Antibiotics Be Used Prior to Intradiscal Procedures?
• 27:44    What is the Optimal Route of Antibiotic Administration?
• 29:40    Are Biomarkers Useful in the Diagnosis of Discogenic Pain?
• 31:57    What is the Role of Discography in Differentiating Between Discogenic and Vertebrogenic Pain Etiologies?
• 35:37    What is the Role of Intradiscal Electrothermal Therapy (IDET) in the Treatment of Discogenic Pain?
• 37:44    What is the role of intradiscal biologic therapies in the treatment of discogenic pain?
• 43:56    What is the Optimal Colume of Injectate When Using Intradiscal Biologic Therapies?
• 45:24    Is There a Role for Targeting Additional Anatomic Structures (Z-joint, Epidural Space, etc.) When Using Biologic Therapies? 
• 48:08    Is There a Role for Other Therapies Such as Intradiscal Ozone and Intradiscal Allogenic Disc Tissue (VIADISC) in the Treatement of Discogenic Pain?
• 53:31    Final Treatment Recommendations from the Experts

Your expert panel for this April 25, 2024 webinar included:

• IPSIS Master Instructor Aaron Calodney, MD; and,
• IPSIS Past President and Founding Member, Richard Derby, MD, and
• IPSIS Membership Committee Chair, Scott Naftulin, DO

The panel was moderated by Michael Furman, MD, MS, Fellowship Director at OSS Health, who also serves on the IPSIS Board as a Member-at-Large.

You can also watch the video of this webinar here.

Episode 7 Show Notes: These are the abstracts referenced by our experts.

• Autologous Bone Marrow Concentrate Intradiscal Injection for the Treatment of Degenerative Disc Disease with Three-Year Follow-up
• Bone Marrow Concentrate and Platelet‐Rich Plasma Differ in Cell Distribution and Interleukin 1 Receptor Antagonist Protein Concentration
• Case Series of Ultrasound-Guided Platelet-Rich Plasma Injections for Sacroiliac Joint Dysfunction
• Clinical Outcomes Following Intradiscal Injections of Higher‐Concentration Platelet‐Rich Plasma in Patients with Chronic Lumbar Discogenic Pain
• Effectiveness of Intradiscal Platelet Rich Plasma for Discogenic Low Back Pain Without Modic Changes: A Randomized Controlled Trial
• Effect of Age on Outcomes After Allogeneic Disc Tissue Supplementation in Patients with Chronic Discogenic Low Back Pain in the VAST Trial
• Evaluation of the Effectiveness of Autologous Bone Marrow Mesenchymal Stem Cells in the Treatment of Chronic Low Back Pain Due to Severe Lumbar Spinal Degeneration: A 12-Month, Open-Label, Prospective Controlled Trial
• Increased Expression of Inflammatory Cytokines and Discogenic Neck Pain
• Injections of Concentrated Bone Marrow Aspirate as Treatment for Discogenic Pain: a Retrospective Analysis
• Insights into Exosome in the Intervertebral Disc: Emerging Role for Disc Homeostasis and Normal Function
• Intradiscal Platelet-Rich Plasma Injection for Discogenic Low Back Pain and Correlation with Platelet Concentration: A Prospective Clinical Trial
• Mesenchymal Stem Cells: Environmentally Responsive Therapeutics for Regenerative Medicine
• Platelet-Rich Plasma-Releasate (PRPr) for the Treatment of Discogenic Low Back Pain Patients: Long-Term Follow-Up Survey
• Potential Role for Stem Cell Regenerative Therapy as a Treatment for Degenerative Disc Disease and Low Back Pain: A Systematic Review
• Preclinical Animal Study and Pilot Clinical Trial of Using Enriched Peripheral Blood-Derived Mononuclear Cells for Intervertebral Disc Degeneration
• Regulatory Roles of Noncoding RNAs in Intervertebral Disc Degeneration as Potential Therapeutic Targets (Review)
• Risks of Intradiscal Orthobiologic Injections: A Review of the Literature and Case Series Presentation
• Safety and Efficacy of Platelet Rich Plasma for Treatment of Lumbar Discogenic Pain: A Prospective, Multicenter, Randomized, Double-blind Study
• Single-Cell Transcriptome Profiling Reveals Multicellular Ecosystem of Nucleus Pulposus during Degeneration Progression
• Stem Cells and Discogenic Back Pain
• Stem Cells and Exosomes: New Therapies for Intervertebral Disc Degeneration
• Structural Organization of the Bone Marrow and its Role in Hematopoiesis
• Systematic Review of Platelet-Rich Plasma for Low Back Pain
• Technical Considerations in Obtaining Platelet Rich Fibrin for Clinical and Periodontal Research
• The Analgesic Efficacy of Intradiscal Injection of Bone Marrow Aspirate Concentrate and Culture-Expanded Bone Marrow Mesenchymal Stromal Cells in Discogenic Pain: A Systematic Review
• The Effect of Intradiscal Platelet-Rich Plasma Injection for Management of Discogenic Lower Back Pain: A Meta-Analysis
• The Safety and Effectiveness of Orthobiologic Injections for Discogenic Chronic Low Back Pain: A Multicenter Prospective, Crossover, Randomized Controlled Trial with 12 Months Follow-up
• VAST Clinical Trial: Safely Supplementing Tissue Lost to Degenerative Disc Disease
  

© 2024 International Pain and Spine Intervention Society – All Rights Reserved
Materials presented in this activity have been made available by the International Pain and Spine Intervention Society for educational purposes only.