Interventional Spine, An Algorithmic Approach

Interventional Spine

An Algorithmic Approach

By Curtis W. Slipman, MD, Director, Penn Spine Center, University of Pennsylvania Health System, Philadelphia, PA, USA; Richard Derby, MD, Clinical Associate Professor, Division of Physical Medicine and Rehabilitation, Stanford University Medical Center; Medical Director, Spinal Diagnostics and Treatment Center, Daly City, CA, USA; Frederick A. Simeone, MD, Professor of Neurosurgery, The University of Pennsylvania School of Medicine; Chief of Neurosurgery, Pennsylvania Hospital; Director of Neurosurgery, Elliott Neurological Center of Pennsylvania Hospital, Philadelphia, PA, USA; and Tom G. Mayer, MD, Medical Director, Orthopedic Surgery and Rehabilitation, Productive Rehabilitation Institute of Dallas for Ergonomics, Dallas, TX, USA


Part 1 General principles

Section 1: Introduction

1. Past, present and future of interventional physiatry
2. Epidemiology

Section 2: Spinal pain

3. Inflammatory basis of spinal pain
4. Transduction, transmission and perception of pain
5. Central influences on pain

Section 3: General diagnostic technique

6. Radiology
7. Nuclear medicine imaging with an emphasis on spinal infections
8. Electrodiagnostic approach to patients with suspected radiculopathy
9. The psychiatric and psychological evaluation of the chronic pain patient

Section 4: Practical pharmacology

10. Nonsteroidal antiinflammatory drugs
11. Adjuvant analgesics for radicular pain
12. Pharmacology of local anesthetic agents
13. Steroids in spine interventions
14. Opioid analgesics
15. The diagnosis and treatment of anxiety disorders in chronic spinal pain

Part 2: Interventional spine techniques

Section 1: Principles and concepts underpinning spinal injection procedures

16. Principles of diagnostic blocks
17. Neurophysiology of diagnostic injections
18. Placebo
19. Patient education and support
20. Side effects and complications of injection procedures: anticipation and management
21. Radiation Safety ? Theory and Practical Concerns
22. Sedation for percutaneous procedures

Section 2: Interventional spine techniques

23. Spinal injections
24. Technique of radiofrequency denervation
25. Discography
26. IDET technique
27. Technique for chemonucleolysis of lumbar disc herniation
28. Automated percutaneous lumbar discectomy: technique
29. Laser
30. Spinal cord stimulation for chronic pain management implantation techniques
31. Intrathecal therapies and totally implantable drug delivery systems
32. Vertebroplasty
33. Kyphoplasty technique

Part 3: Specific disorders

Section 1: Medical spinal disoders

34. Medical Radiculopathies
35. Spondyloarthropathies
36. Spine Infections: an algorithmic approach
37. Nonosseous spinal tumors

Section 2: Osseus spinal tumors

Subsection i: Physiology and assessment

38. Bone biology
39. Osteoporosis
40. Paget?s disease
41. Secondary Bone Tumors
42. Primary Tumors

Subsection ii: Treatment

43. Spinal Orthoses
44. Vertebroplasty
45. Kyphoplasty

Section 3: Cervical Spine

Subsection i: Anatomy and assessment

46. Developmental and functional anatomy of the cervical spine
47. Medical causes of neck pain
48. Examination of the cervical spine
49. Biomechanics and assessment of the painful shoulder
50. Cervical myelopathy
51. Cervical instability

Subsection ii: Whiplash

52. Biomechanics of the cervical spine during whiplash injury
53. Pathophysiolgic evidence of injury
54. Sociocultural evidence and whiplash
55. Soft tissue injuries following whiplash
56. Epidemiology of disc, joint and root pain in whiplash

Subsection iii: Treatment

Subsubsection i: Cervical radicular pain

57. Cervical radicular pain: an algorithmic methodology
58. Rehabilitation methods in cervical radicular pain
59. Cervical radicular pain: injection procedures
60. Surgery for cervical radicular pain
61. Surgical decompression for foraminal stenosis

Subsubsection ii: Cervical axial pain

62. An algorithmic methodology for cervical axial neck pain
63. Rehabilitation methods
64. Therapeutic injections for the treatment of axial neck pain and cervicogenic headaches
65. Sympathetic System
66. Cervical spine
67. Cervical discography: diagnostic value and complications
68. Fusion Surgery for axial pain

Subsubsection iii: Other disorders of the cervical spine

69. Cervicogenic Headache
70. Surgical treatment of cervical myelopathy

Section 4: Biomechanical disorders of the thoracic spine

71. Developmental and functional anatomy and examination of the thoracic spine
72. Thoracic spinal pain
73. Injection procedures
74. Thoracic pain syndromes
75. Surgery: thoracic disc disease

Section 5: Biomechanical disorders of the lumbar spine

Subsection i: Intervertebral disk disorders

Subsubsection i: Physiology and assessment

76. Medical causes of low back pain
77. The Lumbar Degenerative Disc
78. Biomechanics of the intervertebral disc
79. Physical examination of the lumbar spine
80. Developmental and functional anatomy of the lumbar spine

Subsubsection ii: Lumbar radicular pain

81. Medical rehabilitation
82. An algorithmic methodology
83. Injection procedures
84. Percutaneous discectomy
85. Percutaneous disc decompression
86. Surgical decompression for herniated nucleus pulposus
87. Surgical decompression for spinal stenosis
88. Postoperative rehabilitation

Subsubsection iii: Lumbar axial pain

89. Lumbar axial pain ? an algorithmic methodology
90. Medical Rehabilitation ? Lumbar Axial Pain
91. Manipulation and Manual Methods
92. Injection procedures
93. Radiofrequency Denervation
94. Lumbar provocation discography: clinical relevance, sensitivity, specificity, and controversies
95. Intradiscal steroids and prolotherapy: clinical relevance, outcomes and efficacy
96. Intradiscal electrothermal annuloplasty
97. Surgical treatment of axial back pain
98. Spondylolisthesis: epidemiology and assessment
99. Spondylolisthesis: medical rehabilitation and interventional spine techniques
100. Surgical management of isthmic, dysplastic and degenerative spondylolisthesis
101. Instability: clinical manifestations and assessment
102. Fusion surgery

Subsection 4: FBSS - Cervical, Thoracic and Lumbar

103. Failed back surgery
104. Neural scarring
105. Postoperative pseudomeningocele, hematoma and seroma
106. Lysis of Adhesions
107. Spinal cord stimulation in chronic pain
108. Neuraxial drug administration to treat pain of spinal origin
109. Spinal ablative techniques for the treatment of chronic pain conditions

Subsubsection 1: Functional restoration

110. History and principles of pain rehabilitation
111. Deconditioning
112. Functional restoration program characteristics in chronic pain tertiary rehabilitation
113. Tertiary rehabilitation program outcomes

Part 4: Extra-spinal disorders

Section 1: Sacroiliac Joint Syndrome

114. Epidemiology and examination
115. Sacroiliac joint rehabilitation and manipulation
116. Therapeutic injections and radiofrequency denervation
117. Surgery for sacroiliac joint syndrome

Section 2: Sacral Disorders

118. Hip spine syndrome
119. Sacral insufficiency fractures
120. Coccydynia
121. Piriformis syndrome

Part 5: Pregnancy

122. Epidemiology
123. Low back pain and pregnancy?examination and diagnostic work-up in the pregnant patient
124. Treatment of low back pain in pregnancy ? special considerations

Part 6: Interventional spine in sports

125. Biomechanics of the spine in sports
126. On-the-field assessment of the cervical spine-injured athlete
127. Epidemiology of injuries
128. Acute Intervention and Return to Play
129. Spondylolysis
130. Return to competition following prolonged injury

Part 7: New Frontiers

131. Disc replacement
132. Fusion ? minimally invasive techniques
133. Endoscopic discectomy and foraminal decompression