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

The article discusses recent advances in interventional pain management (IPM) and the debate surrounding whether interventionalists should be performing decompression and fusion procedures. The author conducted a literature search to evaluate the validity of the claim that spinal instrumentation and arthrodesis should only be performed by spine surgeons. The findings indicate that advanced percutaneous spine procedures are not universally taught in pain fellowship curriculums, and trainees often rely on industry-led training. There is also a lack of studies comparing procedural outcomes between surgeons and interventionalists for complex spine procedures. Furthermore, pain fellowship curriculums have not kept up with procedural advancements, and interventionalists may not be adequately trained to manage potential complications of spinal instrumentation and arthrodesis. Thus, the author suggests that decompression and fusion procedures may be outside the scope of an interventionalist’s practice

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : the highest rated day surgery unit on Harley Street 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…

Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
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 : the highest rated day surgery unit on Harley Street UK

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

Sciatica My mother was in absolute agony for more than 3 months due to sciatica. It just came out of nowhere and took her out of action. From working full time she went straight to being bed bound and unable to carry out simplest of actions.The pain was 9/10 and she was bed bound for those three months. Multiple trips to A&E and GP and they wouldn't class it as an emergency therefore they wouldn't do anything about it other than upgrading the painkillers which did next to nothing for my mother. I couldn't bear to watch my mother sleeping on A&E bench in pain for 7 hours, just to be told by doctors that she wouldn't be kept in. I remember her joining her hands and begging the doctors to stop the pain which broke my heart. I then started doing research on google and London spine unit came up with Dr Mo AKMAL's profile and review. First meeting with Dr AKMAL was via ZOOM as my mother was bed bound. Dr AKMAL spoke to me and my mom and told us that this is nothing to worry about and that the pain would be 100% gone.Dr AKMAL assured us to visit the hospital so he could physically inspect my mother and give us the best solution. One trip to the london spine unit and Dr AKMAL advised us that the best solution would be to carry out Minimally invasive disectomy. Dr AKMAL advised that due to my mother being bed bound for a while, steroid injection might not give the result that my mother wishes. Dr AKMAL was very confident and showed us some videos from other patients who had gone through the same ordeal. The biggest thing i noticed between before and after was the smile on the patients face. Dr AKMAL was constantly assuring my mother throughout the meeting that he would take care of her pain and gave her 100% confidence that the result would be delivered.He promised her that she would be walking pain free the same day after the operation. Before the operation Dr GURUNG was consulted multiple times and he also was very helpful. Right after the surgery, as Dr AKMAL promised, my mother was walking and the biggest thing was that the pain was gone. My mother had forgotten to smile for three months and there i saw her smiling again. Dr AKMAL and Dr GURUNG gave us brilliant aftercare and informed us that just give them a ring if there was any issue. Its been several weeks now and my mother is heading towards complete recovery without any issues. The pain is completely gone and anyone who is reading this going through the same horrible sciatica pain you must come and see Dr AKMAL. Thank you Dr AKMAL and your whole team for helping my mom achieve this pain free life.

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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

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