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BackTable / MSK / Podcast / Episode #44
ESNR Spine Full Hands-On Course
with Dr. Joshua Hirsch
In this BackTable MSK episode, Dr. Jacob Fleming speaks with Dr. Joshua Hirsch about the current state of spinal interventional radiology. Dr. Hirsch is an interventional neuroradiologist at Massachusetts General Hospital.
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BackTable, LLC (Producer). (2024, March 5). Ep. 44 – ESNR Spine Full Hands-On Course [Audio podcast]. Retrieved from https://www.backtable.com
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Podcast Contributors
Dr. Joshua Hirsch
Dr. Joshua Hirsch is an interventional neuroradiologist with Massachusetts General Hospital in Boston.
Dr. Jacob Fleming
Dr. Jacob Fleming is a diagnostic radiology resident and future MSK interventional radiologist in Dallas, Texas.
Synopsis
Dr. Hirsch discusses the past and future of spinal interventional radiology. He describes his experience in automated percutaneous lumbar discectomy as well as chemonucleolysis with DiscoGel. He also mentions the previous use of chymopapain and the future use of biologics and weight bearing imaging in the spine. Overall, Dr. Hirsch emphasizes the importance of utilizing precise imaging, understanding different safety profiles of each treatment, and breaking down boundaries between specialties.
Timestamps
00:00 - Introduction
03:05 - Discussion on Intradiscal Therapies
05:11 - The Evolution of Percutaneous Discal Treatments
10:39 - The Role of Chemonucleolysis and Lessons from Chymopapain
14:55 - Deciding on a Percutaneous Approach
18:00 - The Emergence of the Spine Interventionalist
21:29 - Utility of Weight Bearing Imaging
24:15 - ESNR Spine Interventional Neuroradiology Hands-On Course
Resources
Efficacy of an ethyl alcohol gel in symptomatic disc herniation (DiscoGel):
https://pubmed.ncbi.nlm.nih.gov/30527290/
Responsible, Safe, and Effective Use of Biologics in the Management of Low Back Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines:
https://www.painphysicianjournal.com/current/pdf?article=NjEwMQ%3D%3D&journal=118
European Society of Neuroradiology (ESNR) Spine Interventional Neuroradiology Hands On Course (April 18-20, 2024:
https://www.esnr.org/event-details/6903
Bone cement: Serious adverse events, some with fatal outcome, associated with the use of bone cements for vertebroplasty, kyphoplasty and sacroplasty include myocardial infarction, cardiac arrest, cerebrovascular accident, pulmonary embolism and cardiac embolism. Although it is rare, some adverse events have been known to occur beyond one year post-operatively. Additional risks exist with the use of bone cement. Please see the IFU for a complete list of potential risks.
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.
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