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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…

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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

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

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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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