When Does Intervention End and Surgery Begin? The Role of Interventional Pain Management in the Treatment of Spine Pathology.
Publication/Presentation Date
11-1-2023
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. 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.
Volume
27
Issue
11
First Page
707
Last Page
717
ISSN
1534-3081
Published In/Presented At
Sarikonda, A., Leibold, A., & Sivaganesan, A. (2023). When Does Intervention End and Surgery Begin? The Role of Interventional Pain Management in the Treatment of Spine Pathology. Current pain and headache reports, 27(11), 707–717. https://doi.org/10.1007/s11916-023-01165-8
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
37713091
Department(s)
Administration and Leadership
Document Type
Article