Overall Course Objectives

Upon completion of this course, participants should be able to:

Discuss fluoroscopic anatomy.
Demonstrate needle placement utilizing fluoroscopic guidance and ultrasound for interventional pain techniques.
Discuss the fundamental concepts of radiation safety as it applies to modern clinical interventional pain medicine.
Assess candidates to identify those where neural stimulation is appropriate.
Differentiate the indications and contraindications for spinal cord stimulation.
Describe the anatomical relationships between the facet joints and medial branches.
Discuss the anatomical foundation for selecting a transforaminal versus an interlaminar approach to steroid administration for lumbar (and cervical) radicular pain syndromes.
Explain the acceptable approaches to the vertebral body for performing vertebral augmentation procedures and demonstrate proper execution of the procedure.
Describe the anatomical relationships between the facet joints and medial branches.

Content Objectives

Basic Fluoroscopic Concepts and Anatomy
- Discuss fluoroscopic anatomy.
- Discuss the fundamental concepts of radiation safety as it applies to modern clinical interventional pain medicine.
- Demonstrate needle placement utilizing fluoroscopic guidance and ultrasound for interventional pain techniques.
Head and Neck Blocks
- Devise and implement a standard treatment algorithm for managing chronic cervicogenic headache and neck pain.
- Recommend specific interventions for headache and neck pain, facial pain, and cervical radicular and sympathetic pain.
- Demonstrate how to perform a cervical medial branch block, occipital nerve block, trigeminal nerve block, and maxillary and mandibular nerve blocks.
Sympathetic Nervous System Related Pain (Truncal) Sympathetic Blocks
- Discuss indications and techniques for thoracic splanchnic nerve block, celiac plexus block, lumbar sympathetic block, superior hypogastric plexus block and ganglion impar block.
- Discuss positioning for and side effects and potential complications of sympathetic and neurolytic blocks.
- Recognize how to avoid complications associated with performing sympathetic blocks.
Radiofrequency Ablation for Spine Pain
- Weigh anatomical considerations and disc anatomy when using radiofrequency interventions.
- Describe the anatomical relationships between the facet joints and medial branches.
Overview of Disc Stimulation and Percutaneous Intradiscal Therapies
- Discuss the anatomical foundation for selecting a transforaminal versus an interlaminar approach to steroid administration for lumbar (and cervical) radicular pain syndromes.
- Identify discogenic pain and methods to properly diagnose.
- Discuss the premise, rationale, validity, indications, and contraindications of discography.
- Explain the procedure for performing discography.
- Identify four disc simulation categories.
Spinal Cord Stimulation for Pain Management
- Assess candidates to identify those where neural stimulation is appropriate.
- Differentiate the indications and contraindications for spinal cord stimulation.
- Differentiate between cases where spinal cord stimulation and intrathecal drug delivery is most appropriate.
- Identify intrathecal drug delivery systems and situations for their use.
Ultrasound-Guided Interventional Procedures in Pain Management

Discuss ultrasound basic techniques and anatomy.
Discuss techniques to avoid preventable complications.
Review novel application of ultrasound in interventional management of extremity and spine pain.