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This article discusses recent advances in interventional pain management (IPM) and the controversy surrounding whether non-surgical specialists should perform procedures such as spinal decompression and fusion. The article highlights that these minimally invasive procedures have been met with resistance from surgical professional societies, who argue that they should only be performed by spine surgeons. The review evaluates the validity of this claim through a literature search on credentialing and procedural privileging guidelines, fellowship training and education, and procedural outcomes. The findings reveal that pain fellowship curriculums have not kept pace with the advancements in IPM, and there is a lack of studies comparing outcomes between surgeons and interventionalists for complex spine procedures. The article suggests that interventionalists may not have the necessary training to manage potential complications and concludes that decompression and fusion may be outside the scope of their practice
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top spine hospital in UK
Published article
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…
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Curr Pain Headache Rep. 2023 Sep 15. doi: 10.1007/s11916-023-01165-8. Online ahead of print.ABSTRACTPURPOSE 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,
Curr Pain Headache Rep. 2023 Sep 15. doi: 10.1007/s11916-023-01165-8. Online ahead of print.
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. 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.
PMID:37713091 | DOI:10.1007/s11916-023-01165-8
The London Spine Unit : top spine hospital in UK
Read the original publication:
When Does Intervention End and Surgery Begin? The Role of Interventional Pain Management in the Treatment of Spine Pathology
