3. Hall S, Bartleson JD, Onofrio BM, Baker HL Jr, Okazaki H, O’Duffy JD. Lumbar sp<strong>in</strong>alstenosis. Cl<strong>in</strong>ical features, diagnostic procedures, and results of surgical treatment <strong>in</strong> 68patients. Ann Intern Med. 1985 Aug;103(2):271-5.4. Tomk<strong>in</strong>s CC, Dimoff KH, Forman HS, Gordon ES, McPhail J, Wong JR, Battié MC Physicaltherapy treatment options for lumbar sp<strong>in</strong>al stenosis. J Back Musculoskelet Rehabil.2010;23(1):31-7.5. Brown LL. A double-bl<strong>in</strong>d, randomized, prospective study of epidural steroid <strong>in</strong>jection vs.the mild® procedure <strong>in</strong> patients with symptomatic lumbar sp<strong>in</strong>al stenosis. Pa<strong>in</strong> Pract. 2012Jun;12(5):333-41.6. Helm Ii S, Benyam<strong>in</strong> RM, Chopra P, Deer TR, Justiz R. Percutaneous adhesiolysis <strong>in</strong> themanagement of chronic low back pa<strong>in</strong> <strong>in</strong> post lumbar surgery syndrome and sp<strong>in</strong>alstenosis: a systematic review. Pa<strong>in</strong> Physician. 2012 Jul-Aug;15(4):E435-62.7. Costant<strong>in</strong>i A, Buchser E, Van Buyten JP. Sp<strong>in</strong>al cord stimulation for the treatment of chronicpa<strong>in</strong> <strong>in</strong> patients with lumbar sp<strong>in</strong>al stenosis. Neuromodulation. 2010 Oct;13(4):275-9;discussion 279-80.Sudhir Diwan, MD, FIPPBiographical SketchDr. Sudhir Diwan, is recognized as a key op<strong>in</strong>ion leader <strong>in</strong> the field of pa<strong>in</strong> management, is theExecutive Director of Manhattan Sp<strong>in</strong>e & Pa<strong>in</strong> Medic<strong>in</strong>e, New York city. Board certified <strong>in</strong> Pa<strong>in</strong>Medic<strong>in</strong>e and Anesthesiology, Dr. Diwan was the former Director of the Tri-Institutional Pa<strong>in</strong>Fellowship Program and Division of Pa<strong>in</strong> Medic<strong>in</strong>e at Weill Medical College of Cornell Universityfor 10 years, where he also served as associate professor of cl<strong>in</strong>ical anesthesiology at the NewYork Presbyterian Hospital, New York.Dr. Diwan has published extensively <strong>in</strong> prestigious peer-reviewed medical journals and medicalbooks on a variety of pa<strong>in</strong> management topics. He is on the Editorial Board for the Pa<strong>in</strong> Physician- an official journal of ASIPP, and Pa<strong>in</strong> Practice – official journal of WIP. Dr. Diwan is the Exam<strong>in</strong>erfor the Certification Board for American Board of Interventional Pa<strong>in</strong> Physicians (ABIPP) andFellow of Interventional Pa<strong>in</strong> Practice (FIPP) offered by the World Institute of Pa<strong>in</strong>.LectureNeuropathic Pa<strong>in</strong>Neuropathic Pa<strong>in</strong> (honlapon lévő cím)ObjectivesUpon completion of this presentation attendees will be able to discuss• Mechanism and symptomatic presentation of Neuropathic pa<strong>in</strong>• Pathophysiology of neuropathic pa<strong>in</strong>• The cl<strong>in</strong>ical presentation of mixed pa<strong>in</strong>• Why neuropathic pa<strong>in</strong> is difficult to treatKey Po<strong>in</strong>ts• First contact with a patient often results with an <strong>in</strong>adequate evaluation of the patients back pa<strong>in</strong>.• The evaluation of patients with back pa<strong>in</strong> must <strong>in</strong>clude physical exam<strong>in</strong>ation where differentstructures <strong>in</strong> the sp<strong>in</strong>al canal need to be evaluated such as the disc, sp<strong>in</strong>al canal content, nerveroot, posterior longitud<strong>in</strong>al ligament elements, the facet jo<strong>in</strong>t, muscle groups, ventral lateraliliopsoas muscle spasm, and posterior element muscle groups related causes.– 36–
Andrea M. Trescot, MD, FIPPBiographical SketchAndrea Trescot, MD is past president of ASIPP, a former professor at the University ofWash<strong>in</strong>gton <strong>in</strong> Seattle, Wash<strong>in</strong>gton, and previous director of the pa<strong>in</strong> fellowship programs atthe University of Wash<strong>in</strong>gton and the University of Florida. She graduated from the MedicalUniversity of South Carol<strong>in</strong>a, with <strong>in</strong>ternship and residency <strong>in</strong> anesthesia at Bethesda NavalHospital and a fellowship <strong>in</strong> pediatric anesthesia at National Children’s Hospital <strong>in</strong> DC. She is aDiplomate of the American Board of Interventional Pa<strong>in</strong> Physicians, a Fellow of InterventionalPa<strong>in</strong> Practice. Dr. Trescot is board certified <strong>in</strong> anesthesia, pa<strong>in</strong> management, <strong>in</strong>terventional pa<strong>in</strong>management and critical care. She was a pa<strong>in</strong> cl<strong>in</strong>ic director <strong>in</strong> private practice for 20 yearsbefore she moved to academics. She returned to private practice, first back <strong>in</strong> Florida, and mostrecently <strong>in</strong> Alaska as director of the Trescot Pa<strong>in</strong> Fellowship.LectureImag<strong>in</strong>g for Interventional Pa<strong>in</strong> TherapyFor a therapy to be effective, the cl<strong>in</strong>ician needs to have the right diagnosis. Although thehistory and physical exam are critical components of the diagnostic process, imag<strong>in</strong>g can confirmor refute that diagnosis, and imag<strong>in</strong>g has allows the <strong>in</strong>terventional pa<strong>in</strong> physician to provideaccurate diagnosis and treatment. As <strong>in</strong> other fields of medic<strong>in</strong>e, imag<strong>in</strong>g techniques haveprovided technologic advances <strong>in</strong> pa<strong>in</strong> management. This lecture discusses the pa<strong>in</strong> management<strong>in</strong>dications and limitations of thermography, DEXA, fluoroscopy, CT, ultrasound, MRI, fMRI, bonescan, and PET scan, as well as the future directions of these techniques.ObjectivesUpon completion of this presentation, attendees should be able to discuss:• The role of imag<strong>in</strong>g <strong>in</strong> diagnosis of pa<strong>in</strong>ful condition• The dist<strong>in</strong>ction and <strong>in</strong>dications for CT and MRI• The role of fluoroscopy <strong>in</strong> diagnostic <strong>in</strong>jections• The advantages and disadvantages of fluoroscopy vs CT vs ultrasound for diagnostic andtherapeutic <strong>in</strong>terventionsKey po<strong>in</strong>ts• Not all imag<strong>in</strong>g is the same; just like the difference between a hammer and a screwdriver, it isimportant to recognize the strengths and weaknesses of various imag<strong>in</strong>g techniques.• Many <strong>in</strong>terventional techniques can be done by several techniques, such as fluoroscopy, CT, orultrasound; the decision regard<strong>in</strong>g which technique to choose should be based on the qualityof the imag<strong>in</strong>g, the risk to the patient (such as radiation exposure), and the availability of theequipment.Lorand Eross, MD, PhD, FIPPBiographical SketchDr. Lorand Eross is the director of Functional Neurosurgical Program and head of the FunctionalNeurosurgery Department at the National Institute of Neuroscience <strong>in</strong> Budapest. He is a boardcertifiedneurologist and neurosurgeon. He got his PhD degree at Semmelweis University <strong>in</strong>2010. His ma<strong>in</strong> <strong>in</strong>terest is epilepsy surgery, movement disorder surgery, pa<strong>in</strong> treatment, spasticity,<strong>in</strong>traoperative neuromonitor<strong>in</strong>g and neuromodulation. He teaches at Semmelweis UniversitySchool of Medic<strong>in</strong>e and at Pazmany Peter University Faculty of In<strong>format</strong>ion Technology. Hisresearch activity is <strong>in</strong> vitro and <strong>in</strong> vivo electrophysiological <strong>in</strong>vestigational methods <strong>in</strong> epilepsy.LectureNeurosurgical Approaches to Chronic Pa<strong>in</strong> Management– 37–