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Current Pain and Headache Reports

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15-09-2023 | Spinal Cord Stimulation | Anesthetic Techniques in Pain Management (D Wang, Section Editor)

When Does Intervention End and Surgery Begin? The Role of Interventional Pain Management in the Treatment of Spine Pathology

Authors: Advith Sarikonda, Adam Leibold, Ahilan Sivaganesan

Published in: Current Pain and Headache Reports | Issue 11/2023

Abstract

Purpose of Review

Recent advances in the field of interventional pain management (IPM) involve minimally invasive procedures such as percutaneous lumbar decompression, interspinous spacer placement, interspinous-interlaminar fusion and sacroiliac joint fusion. These developments have received pushback from surgical professional societies, who state spinal instrumentation and arthrodesis should only be performed by spine surgeons. The purpose of this review is to evaluate the validity of this claim. A literature search was conducted on Google Scholar and PubMed databases. Articles were included which examined IPM in the following contexts: credentialing and procedural privileging guidelines, fellowship training and education, and procedural outcomes compared to those of surgical specialties. Our primary research question is: “Should interventionalists be performing decompression and fusion procedures?”.

Findings

Advanced percutaneous spine procedures are not universally incorporated into pain fellowship curriculums. Trainees attempt to compensate for these deficiencies through industry-led training, which has been criticized for lacking central regulation. There is also a paucity of studies comparing procedural outcomes between surgeons and interventionalists for complex spine procedures, including decompression and fusion.

Summary

Pain fellowship curriculums have not kept pace with some of procedural advancements within the field. Interventionalists are also not trained to manage potential complications of spinal instrumentation and arthrodesis, which has been recognized as an essential requirement for procedural privileging. Decompression and fusion may therefore be outside the scope of an interventionalist’s practice.

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Title: When Does Intervention End and Surgery Begin? The Role of Interventional Pain Management in the Treatment of Spine Pathology
Authors: Advith Sarikonda
Adam Leibold
Ahilan Sivaganesan
Publication date: 15-09-2023
Publisher: Springer US
Keyword: Spinal Cord Stimulation
Published in: Current Pain and Headache Reports / Issue 11/2023
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI: https://doi.org/10.1007/s11916-023-01165-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

When Does Intervention End and Surgery Begin? The Role of Interventional Pain Management in the Treatment of Spine Pathology

Abstract

Purpose of Review

Findings

Summary

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose of Review

Findings

Summary

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