Episode # 44 • 05 Mar 2024
ESNR Spine Full Hands-On Course
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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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)
- Responsible, Safe, and Effective Use of Biologics in the Management of Low Back Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines
- European Society of Neuroradiology (ESNR) Spine Interventional Neuroradiology Hands On Course (April 18-20, 2024
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More about this episode
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.
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.
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