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Introduction
Advances in Neuromodulation and Regenerative Medicine

Advances in Neuromodulation and Regenerative Medicine

with Elmer G. Pinzon, MD, MPH, DABIPP

There are numerous medical conferences that Practical Pain Management (PPM) tries to attend and cover. We are fortunate that when the PPM staff can’t attend a conference, we usually can call upon one of our expert editorial board members to act as our “roving reporter.”

We were fortunate to have Elmer G. Pinzon, MD, MPH, physiatrist at the University Spine and Sports Specialists in Knoxville, Tennessee, attend this year’s annual meeting of the American Society of Interventional Pain Physicians (ASIPP), held at Caesars Palace in Las Vegas this past April. 

Dr. Pinzon offers his highlights of the meeting, which included a variety of informative presentations on topics ranging from neuromodulation to humanistic care, vertebral augmentation, regenerative medicine, controlled substance prescribing, and much more.

The early Thursday morning session began with the Raj-Racz Distinguished Lectures provided by the esteemed ASIPP board chairman/CEO Laxmaiah Manchikanti, MD; Abraham Verghese, MD, of Stanford University School of Medicine; and Richard North, MD, president, Neuromodulation Foundation, Inc. Dr. Verghese discussed “Delivering Humanistic Care in the Era of High Tech and Learning Resources,” providing humanistic and historical perspectives on the specialty of interventional pain medicine (IPM). Dr. North discussed “Evolving Concepts of Neuromodulation:  Past, Present, and Future,” providing a historical perspective on the origins on neuromodulation as well as a look at the exciting expanding prospects for interventional pain physicians who use this technology for advanced, chronic pain patients.  

In the late Thursday morning session, Phillippe Hernigou, MD, chief of orthopedic surgery department, University Paris East, France, discussed “Innovations in Stem Cell Therapy for Musculoskeletal Injuries” and the developing, progressive, novel approaches available to treat our musculoskeletal pain patient population, as well as and the universality of interventional pain technology on a global state. Also in the late morning session, Joshua Hirsch, MD, academic director, ASIPP, presented on “Evidence-Based Vertebral Augmentation: Current Perspectives and Future Strategies,” covering the future multivariate utility of vertebral augmentation in these unfortunate, suffering pain patients.  

The day progressed to a luncheon symposium sponsored by Boston Scientific Corporation on the topic of “Patient Variability and the Dynamic Nature of Pain: Customizing Therapy With Multiple Waveform Options,” by Richard Bowman, MD; Nameer Haider, MD; and Louis Raso, MD; moderated by Richard Rauck, MD.

The Thursday afternoon session began with the classic breakout session series, during which registered participants could choose from 3 tracks depending on their particular interests: Regenerative Medicine, Emerging Concepts in IPM, and Resident/Fellow.  Alternating between the Regenerative Medicine and Emerging Concepts in IPM tracks, I attended interesting lectures in the Regenerative Medicine track by Aaron Calodney, MD (session chair); Phillippe Hernigou, MD; Annu Navani, MD; David Karli, MD; Steve Aydin, MD; and George Chang Chien, MD, covering considerations in regenerative medicine including stem cell/mesenchymal concentration for bone marrow cell therapy in the elderly, regenerative medical treatments for degenerative disc disease, platelet-rich plasma (PRP) and regenerative medicine for osteoarthritis (OA) and soft tissue/tendon injuries, and the practical considerations of the business aspects of establishing an office setting for regenerative medicine.  

The lectures in the Emerging Concepts in IPM track by Peter Staats, MD, (session chair), Amol Soin, MD, Sean Li, MD, Ramsin Benyamin, MD, Sal Abdi, MD, Gabor Racz, MD, Sudhir Diwan, MD, Ricardo Vallejo, MD, Jay Grider, MD, and Steve Aydin, MD, covered new and older techniques for peripheral neuropathy, phantom pain neuromodulation, lysis of epidural adhesions, complex regional pain syndrome, spinal cord/dorsal column stimulation, and OA of the knee. I found that alternating between the breakout session tracks was great for quenching my desire to review the current and past treatments, but I always was feeling that I missed out on another good lecture at the same time as the one I was attending.

The early Friday morning session began with the Manchikanti Distinguished Lectures by Robert Laszewski, president, Health Policy and Strategy Associates, LLC, and Robert Wachter, MD, of the University of California, San Francisco, School of Medicine. The first lecture covered “US Health Care:  Present Status and Future Directions for Independent Physicians,” and Dr. Wachter covered “The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age.”  These topics were both very appropriate, bringing our attention to current and future trends important to our specialty.

In the late morning session, the lecturers covered the historical and future trends and strategies in place for ASIPP and IPM specifically. Dr. Manchikanti discussed “Evolution or Innovation: Current Perspectives and Future Strategies of IPM,” and Andrea Trescot, MD, discussed a “Historic Overview of ASIPP.”

After an interactive luncheon symposium on “Wireless Frontier for Customized Pain Therapy” sponsored by Stimwave, the Friday afternoon session began with the interactive breakout session series, during which IPM participants could choose from 4 tracks: Compliance, Billing, and Coding, Responsible Controlled Substance Prescribing, Current and Future Concepts in IPM, and Endoscopic Decompression. Alternating again between the options, I first attended the Compliance, Billing, and Coding track. Session chair Vicki Mychowiak, Esq, discussed some practical business issues, and Judith Blaszczyk, RN, CPC, discussed urine drug testing, documentation and coding for non-physician practitioner services in pain practice, HIPPA updates, and more.

In the Responsible Controlled Substance Prescribing track, Sanford Silverman, MD (session chair); Christopher Gharibo, MD; Andrea Trescot, MD; and Hans Hansen, MD; covered the following topics: Opioids in Chronic Pain, the Science and Application of Cannabinoids, Risk Strategies for Chronic Opioid Prescribing, Exit Strategies from Controlled Substance Therapy, The Management of Polypharmacy in Chronic Pain, and Legal Perspective of Chronic Opioid Therapy.

In the Current and Future Concepts in IPM track, speakers Mark Boswell, MD; Annu Navani, MD; Peter Staats, MD; Scott Glaser, MD; Harold Cordner, MD; Aaron Calodney, MD; Nebojsa Knezevic, MD; and Kenneth Candido, MD, covered the following topics: Personalizing Pain, Placebo-Nocebo: Your Key to Success or Failure, Avoidable Disasters of Lumbar Transforaminal Epidurals, Indirect Spinal Decompression Procedure, and others.  Lastly, in the Endoscopic Decompression track, speakers Frank Falco, MD  (session chair); Jason Capra, MD; Kaixuan Liu, MD; and Sukdeb Datta, MD, covered the following topics: Evolving Concepts of Endoscopic Spine Surgery, Applications for Transforaminal Endoscopic Surgery, Interlaminar Endoscopic Surgery: Comparison to Open Surgery, and others.

The last day of the meeting was a condensed educational day to cover some important and interesting topics by some esteemed lecturers. The main general session, “Survival Strategies for IPM: Business, Advocacy, and EBM,” was well covered by various interesting lecturers, including Dr. Staats (session chair); Dr. Manchikanti; the Honorable Rudolph Giuliani; Congressman Ed Whitfield; Nathan Miller, MD; Lukasz Paszek (ArborMetrix); Francis Riegler, MD (session chair); Vikram Patel,  MD; Tim Coan; Devi Nampiaparampil, MD (distinguished speaker); Nilesh Patel, MD; Sudhir Diwan, MD; Ms. Myckowiak; and Michael Sebahar, MD.  The final day topics included the following: Organizational Leadership: In the Face of Change and Crisis, Incorporating Clinical Trials Into Your Practice, ASIPP QCDR Registry for MIPS and Outcomes, The Disabled Physician—How to Survive When the Cookie Crumbles, Survival Strategies for Independent Practices, and others.

The conference concluded on a strong note with captivating topics by esteemed lecturers. I welcome those in the IPM medical and non-medical community to take part in more year-round ASIPP activities. I am already looking forward to participating and learning from another great reunion of IPM ideas and lecturers at next year’s ASIPP annual meeting.

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