Episódios

  • If your patients are living with painful diabetic neuropathy that is refractory to medications, spinal cord stimulation (SCS) may be an option. Dr. Dana Dunleavy interviews interventional radiologist Dr. Blake Parsons about managing diabetic neuropathy in a multidisciplinary setting and the role of SCS. They also discuss new research findings that support the use of spinal cord stimulators and their broader impact on quality of life, including reduced fall risks and improved foot sensation for patients with diabetes.

    TIMESTAMPS

    00:00 - Understanding Diabetic Neuropathy
    02:06 - Establishing a Neuropathy Clinic
    06:29 - Challenges and Solutions in Patient Referrals
    08:04 - Success and Future Directions

    CHECK OUT THE FULL EPISODE

    BackTable MSK Ep. 48- SCS for Neuropathy: Clinical Insights & Patient Impact with Dr. Blake Parsons:
    https://www.backtable.com/shows/msk/podcasts/48/scs-for-neuropathy-clinical-insights-patient-impact

  • How are orthobiologics transforming the back pain treatment algorithm? In this episode of BackTable MSK, host Jacob Fleming is joined by Dr. Guilherme Ferreira Dos Santos to discuss the management of lumbar pain and the role of platelet-rich plasma (PRP) injections. Dr. Santos is trained in Physical Medicine & Rehabilitation as well as Interventional Pain Medicine, and currently practices at the Hospital Clinic of Barcelona.

    ---

    SYNPOSIS

    Dr. Santos gives an overview of discogenic pain. Each patient case is unique, as pain can be caused by single level or multilevel disease, pure disc disease, or additional facet joint disease. Additionally, discogenic pain can affect young, active patients and typically worsens with spinal flexion. They discuss the Pfirrmann system for intervertebral disc degeneration, medial branch blocks to identify posterior column pain, the risk of disc degeneration after discography, and the rise of orthobiologic treatments such as intradiscal and facet joint PRP injections. Dr. Santos highlights important steps for PRP preparation and techniques for injection. He also gives advice for counseling patients about the timeline to pain relief, longevity of treatment effects, and options for refractory pain. Finally, Dr. Santos encourages the audience to stay tuned for the upcoming RESPINE multicenter trial results.

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    TIMESTAMPS

    00:00 - Introduction
    02:18 - Dr. Santos’ Multicultural Experiences
    08:58 - Challenges in Diagnosing and Treating Discogenic Pain
    20:26 - Role of Intradiscal and Facet Joint PRP Injections
    30:16 - PRP Preparation and Dosing
    34:52 - Technical Aspects of Disc Treatments
    42:54 - Patient Counseling
    56:58 - Future Directions in Regenerative Medicine


    ---

    RESOURCES

    RESPINE Trial:
    https://ecrin.org/clinical-trials/respine

    Lumbar Intradiskal Platelet-Rich Plasma (PRP) Injections: A Prospective, Double-Blind, Randomized Controlled Study (Tuakli-Wosornu, 2016):
    https://pubmed.ncbi.nlm.nih.gov/26314234/

    Clinical outcomes following intradiscal injections of higher-concentration platelet-rich plasma in patients with chronic lumbar discogenic pain (Lutz, 2022):
    https://pubmed.ncbi.nlm.nih.gov/35344055/

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  • Spinal cord stimulation can be a useful tool for treating chronic low back and leg pain. In this BackTable Brief, Drs. Dana Dunleavy and Blake Parsons discuss the specifics of implanting lumbar spinal cord stimulation. They explore patient positioning, anesthesia, needle angulation, and the importance of targeting spinal levels correlated to pain.

    TIMESTAMPS

    00:00 - Pre-Operative Setup
    02:10 - Obtaining Access and Placing Leads
    05:05 - Postoperative Considerations
    08:43 - Evaluation of Patient Candidacy

    CHECK OUT THE FULL EPISODE

    BackTable MSK Ep. 48– SCS for Neuropathy: Clinical Insights & Patient Impact:
    https://www.backtable.com/shows/msk/podcasts/48/scs-for-neuropathy-clinical-insights-patient-impact

  • Acetabular lesions present unique challenges for interventionalists due to their location within the pelvis. In this episode of the BackTable Podcast, host Dr. Jacob Fleming interviews Dr. Jason Levy, an experienced practitioner in musculoskeletal interventional oncology based in Atlanta, Georgia, about techniques for ablating acetabular lesions.

    ---

    This podcast is supported by an educational grant from:

    Medtronic
    https://www.medtronic.com/en-us/index.html

    ---

    SYNPOSIS

    The doctors discuss the unique considerations involved in treating the acetabulum, including its susceptibility to various axial loading, shear, and torsion forces. Dr. Levy prefers to use radiofrequency ablation combined with cement augmentation to enhance joint stability. He outlines the procedural steps and shares his preferred imaging methods. Additionally, he addresses potential complications, such as instability from inadequate cement delivery, cement leakage into the hip joint space, and avascular necrosis. Throughout the episode, the doctors emphasize the importance of collaboration with orthopedic oncologists and staying updated on current research in musculoskeletal interventional oncology.

    ---

    TIMESTAMPS

    00:00 - Introduction
    05:11 - Unique Considerations for Acetabular Lesions
    09:06 - Collaboration with Orthopedic Oncologists
    13:10 - Anatomy and Procedural Steps
    24:40 - Preventing Complications
    35:25 - Concluding Thoughts

    ---

    RESOURCES

    BackTable MSK Ep. 17- Multidisciplinary Approach to Treating Spinal Metastases with Dr. Jason Levy and Dr. Amir Lavaf:
    https://www.backtable.com/shows/msk/podcasts/17/multidisciplinary-approach-to-treating-spinal-metastases

    BackTable VI Ep. 68- RF Ablation Therapy for Bone Metastases with Dr. Jason Levy and Dr. Sandeep Bagla:
    https://www.backtable.com/shows/vi/podcasts/68/rf-ablation-therapy-for-bone-metastases


    BackTable MSK Ep. 12- Ortho/IR Collaboration in Private Practice:
    https://www.backtable.com/shows/msk/podcasts/12/ortho-ir-collaboration-in-private-practice


    Radiofrequency Ablation for the Palliative Treatment of Bone Metastases: Outcomes from the Multicenter OsteoCool Tumor Ablation Post-Market Study (OPuS One Study):
    https://pubmed.ncbi.nlm.nih.gov/33129427/


    Hip Joint Distraction Technique during Cryoablation of Acetabular Bone Tumor to Prevent Femoral Head Osteonecrosis:
    https://www.jvir.org/article/S1051-0443(22)01119-8/fulltext

  • Tumor embolization is a versatile procedure that can provide symptomatic and long-term benefits for patients. In this episode of BackTable MSK, host Dr. Michael Barraza discusses musculoskeletal tumor embolizations with Dr. Gina Landinez from the Miami Cardiac and Vascular Institute, where she is helping to grow the MSK interventions program.

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    SYNPOSIS

    Dr. Landinez explains that the main indications for embolization are preoperative tumor shrinkage and pain palliation. Embolization decreases hemorrhagic risk and procedure time during surgical resection and leads to better surgical margins. Pain palliation can also be achieved due to tumor size reduction and decreased pressure on surrounding nerves and tissue. Dr. Landinez explains that lesions well-suited embolization are hypervascular, large, not sensitive to radiation, and painful. She also describes the risks of off-target skin and muscle embolization and the importance of exercising caution with vertebral tumors.
    Finally, Dr. Landinez shares valuable practice-building tips about developing relationships with orthopedic surgeons and providing adequate follow up care.

    ---

    TIMESTAMPS

    00:00 - Introduction
    03:51 - Indications for Embolization
    08:08 - Building Referral Networks
    13:45 - Preoperative Planning
    18:34 - Technical Aspects of Embolization
    27:25 - Challenges and Considerations
    31:23 - Importance of Outpatient Follow Up

  • Interventional radiologists can play a vital role in pain management and palliative care through spinal cord stimulation (SCS). In this BackTable Brief, Dr. Dana Dunleavy speaks with Dr. Blake Parsons about this technology and the learning opportunities it presents.

    Dr. Parsons reflects on his introduction to outpatient spinal cord stimulation during his training at the Medical College of Wisconsin, where he gained exposure to both palliative care and interventional oncology. He discusses the technical aspects and challenges associated with permanent SCS procedures, including accessing the epidural space and the risks of nerve injury. Additionally, Dr. Parsons explores the economic considerations of SCS, comparing reimbursement rates for trials and permanent implants across various settings.

    TIMESTAMPS

    00:00 - Introduction
    02:38 - Understanding Permanent Implants
    04:38 - Procedure Details and Challenges
    06:52 - Reimbursement and Financial Considerations
    09:28 - Time Utilization and Efficiency
    11:44 - Final Thoughts

    CHECK OUT THE FULL EPISODE

    BackTable MSK Ep. 48– SCS for Neuropathy: Clinical Insights & Patient Impact:
    https://www.backtable.com/shows/msk/podcasts/48/scs-for-neuropathy-clinical-insights-patient-impact

  • More often than not, a surgical innovation is not the result of an overnight success, but rather the result of iterative improvements on a tool or technique that leads to better outcomes. In this episode of the BackTable MSK Podcast, we interview Dr. Jim Marino, a retired orthopedic surgeon and prolific medtech innovator. Dr. Marino gives us an inside look at his extensive career, detailing his role in orthopedic device innovation and the trials and tribulations that he faced along the way.

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    SYNPOSIS

    Having trained in an era where joint arthroscopy was emerging, Dr. Marino had a vision to build devices for minimally invasive spine surgery that paralleled developments in peripheral joint surgery. Alongside venture capitalists, he founded the company NuVasive, and eventually Trinity Orthopedics. He discusses the COREX device, a percutaneous autologous bone harvester that rivals the use of biologics. COREX maintains the gold standard of using cancellous bone grafts and significantly decreases donor site pain. Applications for this device started with bone grafting for spinal fusion surgery, but are now expanding to foot and ankle procedures.
    Throughout this episode, Dr. Marino also shares valuable advice for aspiring physician innovators on maintaining a clinical practice during the entrepreneurship journey and balancing patient safety with innovative practices.

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    TIMESTAMPS

    00:00 - Introduction
    14:34 - Reflections on Spine Innovation
    25:03 - Clinical and Radiographic Evaluation
    31:50 - Founding NuVasive: From Ideas to Reality
    43:28 - Minimally Invasive Bone Grafting with COREX
    1:00:06 - Future Applications of COREX
    01:10:21 - Advice for Aspiring Physician Innovators

    ---

    RESOURCES

    NuVasive:
    https://www.nuvasive.com/

    COREX Minimally Invasive Bone Harvester:
    https://trinityorthodevice.com/

    YODA Project for rhBMP-2 safety and efficacy :
    https://yoda.yale.edu/about/data-holders/medtronicrhbmp-2/

    Seattle Science Foundation YouTube:
    https://www.youtube.com/channel/UChIIig54yF9aQYvpWGe1DPg

  • Genicular artery embolization (GAE) is quickly emerging as a treatment option for knee osteoarthritis when other therapies have failed. In this episode of the BackTable Podcast, Dr. Osman Ahmed discusses the origins of GAE and how he employs it in his practice.

    ---

    This podcast is supported by an educational grant from:

    Guerbet
    https://www.guerbet-us.com

    ---

    SYNPOSIS

    Dr. Ahmed, an interventional radiologist at the University of Chicago, shares details about the procedure, his journey in adopting it, and his thoughts on the current landscape of GAE. Topics include procedural techniques, patient selection, anatomical considerations, potential complications, and the importance of ongoing research in this field.

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    TIMESTAMPS

    00:00 - Introduction
    04:43 - Knee Osteoarthritis and Current Treatments
    07:54 - Building a GAE Practice
    13:23 - Tools and Procedure: Step-by-Step
    25:05 - Post-Procedure Care and Complications
    30:26 - Future of GAE and Other Applications
    34:03 - Conclusion and Contact Information


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    RESOURCES

    BackTable INN Ep. 46- New Innovations in Treatment of PE: The Flow Medical Story
    with Founders Dr. Osman Ahmed and Dr. Jonathan Paul:
    https://www.backtable.com/shows/innovation/podcasts/46/new-innovations-in-treatment-of-pe-the-flow-medical-story

    BackTable VI Ep. 429- Tackling Upper GI Bleeds: Techniques and Tools with Dr. Osman Ahmed:
    https://www.backtable.com/shows/vi/podcasts/429/tackling-upper-gi-bleeds-techniques-tools

    BackTable VI Ep. 447- Exploring GAE: Clinical Insights & Outcomes with Dr. Mark Little:
    https://www.backtable.com/shows/vi/podcasts/447/exploring-gae-clinical-insights-outcomes

    GEST MSK Conference 2025 (Paris):
    https://www.gestmsk.com/

    Okuno Y et al. Transcatheter arterial embolization as a treatment for medial knee pain in patients with mild to moderate osteoarthritis (2014):
    https://pubmed.ncbi.nlm.nih.gov/24993956/

    Little MW et al. Genicular artEry embolizatioN in patiEnts with oSteoarthrItiS of the Knee (GENESIS 1) Using Permanent Microspheres: Interim Analysis (2021):
    https://pubmed.ncbi.nlm.nih.gov/33474601/

    Little MW et al. Genicular Artery Embolisation in Patients with Osteoarthritis of the Knee (GENESIS 2): Protocol for a Double-Blind Randomised Sham-Controlled Trial (2023):
    https://pubmed.ncbi.nlm.nih.gov/37337060/

    Correa MP et al.GAUCHO - Trial Genicular Artery Embolization Using Imipenem/Cilastatin vs. Microsphere for Knee Osteoarthritis: A Randomized Controlled Trial (2022):
    https://pubmed.ncbi.nlm.nih.gov/35304614/

    Sapoval M et al. Genicular artery embolization for knee osteoarthritis: Results of the LipioJoint-1 trial (2024):
    https://pubmed.ncbi.nlm.nih.gov/38102013/

  • Decisions that prioritize patient welfare can often be challenging with our physician bias toward action. Interventional radiologists Dr. Eric Keller and Dr. Sean Tutton highlight the importance of education in discussions about end-of-life care and futility. Dr. Tutton shares a poignant story illustrating the necessity of team-based approaches to futile procedures. They also discuss ethical considerations of IR procedures, the significance of proper consent, and the true costs of ‘expensive hope.’ 

    TIMESTAMPS

    00:00 - Importance of Training in End-of-Life Conversations
    02:15 - Case Study: Ruptured AAA in a High Risk Patient
    05:26 - Ethical Dilemmas in Interventional Radiology

    CHECK OUT THE FULL EPISODE

    BackTable MSK Ep. 27: Palliative Care in IR with Dr. Sean Tutton:
    https://www.backtable.com/shows/msk/podcasts/27/palliative-care-in-ir

  • Building a top-tier musculoskeletal (MSK) interventional service line involves taking risks, continuously learning, and always being available for your patients, according to Dr. Igor Latich, an interventional radiologist at the Yale School of Medicine.

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    CHECK OUT OUR SPONSOR

    Stryker Interventional Spine
    https://www.strykerivs.com

    ---

    SYNPOSIS

    He discusses his passion for MSK interventions and his collaborative efforts with orthopedic surgeons, radiation oncologists, and industry partners to develop his comprehensive service line. Dr. Latich provides examples of exploring new procedures, such as cervical ablations. His key advice for navigating new territories includes closely studying the patient’s anatomy, reviewing the literature on prior procedures, and communicating with industry partners about the necessary tools. Finally, Dr. Latich underscores the importance of establishing a strong clinical practice and being consistently available to patients to build trust and goodwill.

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    TIMESTAMPS

    00:00 Introduction
    05:33 Carving a Niche in MSK Interventions
    16:30 Learning from Global Perspectives
    19:48 Collaborations and Overcoming Challenges
    24:20 Importance of Building a Clinical Presence
    34:30 Learning New Procedures
    39:17 Industry Collaboration and Device Innovation
    44:22 Maximizing Availability and Support
    53:16 Prioritizing Clinical Acumen and Learning

  • What is the difference between palliative care and hospice? Dr. Sean Tutton clarifies the distinctions and interactions between the two. He explains that palliative care focuses on symptom management and improving quality of life, while addressing common misconceptions about it. Dr. Tutton also provides insights on the role of palliative care physicians and emphasizes the importance of integrating palliative care into treatment plans for patients with terminal or chronic diseases. Additionally, the conversation offers practical advice for interventional radiologists on how to communicate effectively with patients about their conditions and treatment goals.

    TIMESTAMPS

    00:00 - Defining Palliative Care 
    03:20 - Challenges in Palliative Care Referrals
    06:44 - Practical Approaches for Interventional Radiologists
    07:51 - Effective Communication with Patients
    09:24 - Conclusion and Final Thoughts

    CHECK OUT THE FULL EPISODE

    BackTable MSK Ep. 27: Palliative Care in IR with Dr. Sean Tutton:
    https://www.backtable.com/shows/msk/podcasts/27/palliative-care-in-ir

  • Intentional probe selection is an important part of any ablative procedure. This MSK Brief focuses on tools for genicular nerve ablation. Dr. John Smirniotopoulos shares his perspectives on radiofrequency ablation (RFA) and cryoablation probes, including the Cool Leaf probe and its benefits. He goes on to explain the procedure, including ablation techniques, motor stimulation tests, and handling potential complications such as synovitis and hemarthrosis.

    TIMESTAMPS

    00:12 - Choosing the Right Probe
    01:29 - Cryoablation vs. RFA: Pros and Cons
    02:32 - Ablation Techniques and Strategies
    04:42 - Motor Stimulation and Safety Measures
    05:51 - Potential Complications and Mitigation
    07:50 - Patient Counseling and Follow-Up

    CHECK OUT THE FULL EPISODE

    BackTable MSK Ep. 22- Genicular Nerve Ablation
    https://www.backtable.com/shows/msk/podcasts/22/genicular-nerve-ablation

  • Cervical and thoracic epidural steroid injections (ESIs) can offer relief for patients with chronic pain; however, these procedures can carry serious risks. Providers should be well-trained to anticipate and mitigate these risks before treating patients with ESIs. In this episode of the Backtable MSK Podcast, co-hosts Dr. Chris Beck and Dr. Jacob Fleming dive deep into various techniques and considerations for performing ESIs.

    ---

    CHECK OUT OUR SPONSOR

    Stryker Interventional Spine
    https://www.strykerivs.com

    ---

    SYNPOSIS

    Dr. Beck and Dr. Fleming discuss the importance of trajectory and level aiming, the differences between interlaminar and transforaminal approaches, and the nuances of cervical and thoracic ESI procedures. The episode also covers patient positioning and potential complications.

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    TIMESTAMPS

    00:00 - Introduction
    02:10 - Techniques for Transforaminal Approach
    08:51 - Cervical ESI
    15:15 - Risks of Cervical ESI
    24:07 - Thoracic ESI
    29:03 - Post-Procedure Considerations
    32:34 - Caudal ESI

    ---

    RESOURCES

    BackTable MSK Ep. 55 - BackTable Basics: Lumbar Epidural Injections
    with. Dr. Chris Beck:
    https://www.backtable.com/shows/msk/podcasts/55/backtable-basics-lumbar-epidural-injections

  • An epidural steroid injection (ESI) is a minimally invasive technique used to treat back pain. Providers from various specialties and settings can learn and offer this procedure. In this episode of the Back Table MSK Podcast, hosts Jacob Fleming and Chris Beck share their experiences and techniques for performing ESIs.

    ---

    CHECK OUT OUR SPONSOR

    Stryker Interventional Spine
    https://www.strykerivs.com

    ---

    SYNPOSIS

    The doctors detail the technical aspects of their ESI procedures, including guidance on patient and C-arm positioning, considerations for an interlaminar approach, and potential complications to watch for.

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    TIMESTAMPS

    00:00 - Introduction
    03:41 - Learning How to Perform ESIs
    06:58 - Common Indications for ESIs
    10:49 - Dr. Beck’s Technical Approach
    32:22 - Dr. Fleming’s Technical Approach
    40:49 - Treating Intrathecal Complications

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    RESOURCES

    Atlas of Image-Guided Spinal Procedures (Furman et al, 2018):
    https://shop.elsevier.com/books/atlas-of-image-guided-spinal-procedures/furman/978-0-323-40153-1

  • Genicular nerve ablation is becoming more common for patients with osteoarthritis, underscoring the preference for nonsurgical,minimally invasive treatment. Our host Dr. Michael Barraza welcomes Dr. John Smirniotopoulos to discuss his experience performing genicular nerve ablation, including a detailed ‘how-to’ on his procedure technique. The conversation delves into the anatomy and key nerves targeted during the procedure, based on recent cadaveric dissections. Dr. Smirniotopoulos also highlights the use of fluoroscopy and ultrasound for precise needle placement.

    TIMESTAMPS

    00:12 - Genicular Nerve Anatomy
    01:06 - Procedure Techniques and Tools
    03:20 - Patient Interaction and Expectations
    04:58 - Sedation and Pain Management

    CHECK OUT THE FULL EPISODE

    BackTable MSK Ep. 22- Genicular Nerve Ablation
    https://www.backtable.com/shows/msk/podcasts/22/genicular-nerve-ablation

  • Intentional probe selection is an important part of any ablative procedure. This MSK Brief focuses on tools for genicular nerve ablation. Dr. John Smirniotopoulos shares his perspectives on radiofrequency ablation (RFA) and cryoablation probes, including the Cool Leaf probe and its benefits. He goes on to explain the procedure, including ablation techniques, motor stimulation tests, and handling potential complications such as synovitis and hemarthrosis.

    TIMESTAMPS

    00:12 - Choosing the Right Probe
    01:29 - Cryoablation vs. RFA: Pros and Cons
    02:32 - Ablation Techniques and Strategies
    04:42 - Motor Stimulation and Safety Measures
    05:51 - Potential Complications and Mitigation
    07:50 - Patient Counseling and Follow-Up

    CHECK OUT THE FULL EPISODE

    BackTable MSK Ep. 22- Genicular Nerve Ablation
    https://www.backtable.com/shows/msk/podcasts/22/genicular-nerve-ablation

  • In this episode of The Back Table MSK Podcast, Dr. Alexa Levey discusses the importance of multidisciplinary treatment planning for sarcomas with Dr. Yvette Ho and Dr. Jessica Jones.

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    CHECK OUT OUR SPONSOR

    Stryker Interventional Spine
    https://www.strykerivs.com

    ---

    SYNPOSIS

    The conversation explores the necessity of a multidisciplinary approach and the challenges associated with managing both osseous and soft tissue sarcomas. Dr. Jones highlights recent advancements in precision medicine, including a novel drug, nirogacesta, for desmoid tumors. Dr. Ho addresses common misconceptions surrounding desmoid tumors, emphasizing their potential for significant tissue destruction, and shares insights from her experience in limb salvage surgery. Dr. Levey discusses the considerations involved in needle biopsy and presents case studies where cryoablation effectively reduced desmoid tumor sizes.
    The doctors also discuss strategies for managing nociceptive and mechanical pain, such as intrathecal pain pumps, radiation therapy, and kyphoplasty.

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    TIMESTAMPS

    00:00 - Introduction
    03:51 - Challenges in Sarcoma Management
    13:06 - Precision Medicine in Treatment Planning
    16:44 - The Role of Biopsy
    20:51 - The Importance of Specialized Oncology Care
    25:13 - Collaboration Throughout Treatment Course
    31:03 - Cryoablation and Case Studies
    35:13 - New Drug Development for Desmoid Tumors
    39:06 - Limb Salvage Considerations
    41:13 - Metastasis, Recurrence, and Pain Management
    49:57 - Final Thoughts

    ---

    RESOURCES

    OGSIVEO (Nirogacestat):
    https://www.ogsiveo.com/

  • Basivertebral nerve ablation is a potential solution for anterior column spine pain. Dr. Olivier Clerk-Lamalice outlines a typical ablation procedure and discusses alternative approaches for challenging target locations.

    The procedure generally uses a transpedicular approach with an 8-gauge introducer needle, visualized under fluoroscopy. The needle angle should ensure that the probe can later be placed in the center of the vertebral body. The basic technique is similar to that of vertebral augmentation, employing an aneural and avascular approach. A bipolar ablation probe is aimed 1-cm ventral to the posterior wall of the vertebral body to establish a safe ablation zone and avoid neural structures. The ablation is performed at 85°C for 15 minutes. It is important to ablate the nerve at the vertebral bodies both above and below the target level.

    For challenging targets, such as at L5, S1, high-riding pelvis, or in cases with prior transpedicular screw placement, the goal is to take the straightest path possible, which can require the transiliac approach. 

    TIMESTAMPS

    00:00 - Standard Procedure Walkthrough 
    05:54 - Alternate Approaches for Challenging Targets

    CHECK OUT THE FULL EPISODE

    BackTable MSK Ep. 13- Basivertebral Nerve Ablation 
    https://www.backtable.com/shows/msk/podcasts/22/genicular-nerve-ablation 

  • The basivertebral nerve has gained recognition over the past decade as a source of vertebrogenic pain. Dr. Olivier Clerk-Lamalice explains both the anatomy of the nerve and his treatment algorithm for basivertebral nerve ablation.

    The basivertebral nerve is intraosseous, non-myelinated, and located in the central portion of the vertebral body within the basivertebral canal. It does not regenerate after ablation. This nerve transmits afferent pain signals to the central spinal cord, and MRI is the primary diagnostic tool used for evaluation.

    During the physical exam, back pain originating from the anterior column is assessed through maneuvers such as sitting at a 15-degree angle, bending forward, and experiencing vibrations from car or plane travel. MRI findings are reviewed for Modic changes: Type 1, characterized by edematous endplates, is highly correlated with pain, while Type 2 shows early and later changes, with early changes generally being less painful.

    To confirm that a patient will benefit from basivertebral nerve ablation, an anesthetic discogram is performed to identify the specific disc level causing pain. Dr. Clerk-Lamalice performs the discogram for every patient, and improvements are tracked based on patient-reported pain scores.

    TIMESTAMPS

    00:00 - Basivertebral Nerve Anatomy and Vertebrogenic Pain
    04:15 - Modic Type 1 and 2 Definitions
    05:51 - Utility of Anesthetic Discograms 

    CHECK OUT THE FULL EPISODE

    BackTable MSK Ep. 13- Basivertebral Nerve Ablation 
    https://www.backtable.com/shows/msk/podcasts/22/genicular-nerve-ablation 

  • Dr. Aditya Bagrodia sits down with Elie Toubiana, founder and CEO of ScribeMD.ai, to discuss the transformative potential of artificial intelligence (AI) in medical documentation.

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    SYNPOSIS

    Their conversation covers the capabilities and benefits of using an AI-driven medical scribe that ensures HIPAA compliance, reduces physician burnout, and enhances patient interactions. Elie also shares his insights about the technology’s adaptability across various medical fields. Finally, Dr. Bagrodia and Elie discuss ethical considerations surrounding applications of AI in other aspects of healthcare, such as medical workup and diagnosis.

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    TIMESTAMPS

    00:00 - Introduction
    06:00 - How ScribeMD AI Works
    14:14 - Integration with EMR
    20:31 - Legal Considerations with AI Technology
    26:34 - Cost Implications of AI Scribes
    38:46 - Future of AI in Medical Diagnosis
    41:45 - Conclusion and Final Thoughts

    ---

    RESOURCES

    ScribeMD.ai
    https://www.scribemd.ai/