Five pain management physicians discuss promising new developments in pain therapy, including devices, procedures and medications.
Marc Lynch, DO, medical director, Casa Colina Surgery Center (Chino, Calif.): There are two new procedures that I think will have an impact on pain management. First is the MILD procedure. It allows pain physicians to relieve the claudication symptoms of spinal stenosis with a minimally invasive technique. It is an outpatient procedure, and has minimal discomfort post operatively. The second procedure is the ability for pain physicians to place a spinal cord stimulator lead that previously could only be placed after a laminotomy was performed by a neurosurgeon. The use of the new Epiducer allows pain physicians to place a laminotomy type of lead plus additional leads as necessary with only one needle or epidural access. Both of these procures can be viewed as minimally invasive approaches to previous treatments that were only delivered by neurosurgeons. Both are less invasive with great outcomes in properly selected patients.
Timothy Spencer, DO, Saginaw (Mich.) Valley Neurosurgery: I believe the most promising new procedures to be spinal cord stimulators. They are increasing their surface area of coverage and truly helping individuals with intractable pain beyond all measures.
Sheba Jilani, MD, interventional and chronic pain specialist, Brain And Spine Institute of (Orange) California: Patients suffering from chronic neck, back, or joint pain assume that their options are limited to major surgery. One of the newest available, FDA-approved treatments in pain management is a groundbreaking stem cell procedure called inSRT Spinal Renewal Therapy. This regenerative medical procedure has proven to significantly minimize recovery time from pain. It is indicated for treatment of disorders of the spine and peripheral joints such as degenerative disc disease, arthritis, nerve pain, scoliosis, and spinal stenosis.
Joseph Holtman Jr., MD, anesthesiologist, Loyola University Medical Center (Maywood, Ill.): A little-known morphinelike drug is potentially more potent, longer lasting and less likely to cause constipation than standard morphine. The drug, morphine-6-0-sulfate, has a similar chemical structure to standard morphine. Opioids, such as morphine, oxycodone and hydrocodone, are standard drugs for treating moderate to severe pain, including cancer pain. But these drugs can have significant side effects, including constipation, nausea, vomiting, drowsiness, cognitive dysfunction and slowed breathing and heart rates. And while opioids work well for conditions such as back pain and post-operative pain, the drugs are less effective against neuropathic pain, such as tingling, burning or shooting pain.
Cherise Hamblin, MD, Lancaster (Pa.) General Health: For women suffering from chronic pelvic pain and endometriosis, a great technology is the da Vinci surgical robot. This advancement in laparoscopic surgery allows the surgeon to perform more precise surgery, cutting scar tissue and removing endometriosis implants with less blood loss and quicker recovery than other procedures. Fibroid tumors, ovarian cysts, adhesions, and adenomyosis can also be causes of pelvic pain, along with endometriosis. The da Vinci surgical robot is a great tool to address any of these problems.
This is an ongoing series which will feature five pain management physicians' responses to questions about the specialty.
Next week's question is: What is a best business practice that you follow at your center?
Submit responses to taryn@beckershealthcare.com before April 10.
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Marc Lynch, DO, medical director, Casa Colina Surgery Center (Chino, Calif.): There are two new procedures that I think will have an impact on pain management. First is the MILD procedure. It allows pain physicians to relieve the claudication symptoms of spinal stenosis with a minimally invasive technique. It is an outpatient procedure, and has minimal discomfort post operatively. The second procedure is the ability for pain physicians to place a spinal cord stimulator lead that previously could only be placed after a laminotomy was performed by a neurosurgeon. The use of the new Epiducer allows pain physicians to place a laminotomy type of lead plus additional leads as necessary with only one needle or epidural access. Both of these procures can be viewed as minimally invasive approaches to previous treatments that were only delivered by neurosurgeons. Both are less invasive with great outcomes in properly selected patients.
Timothy Spencer, DO, Saginaw (Mich.) Valley Neurosurgery: I believe the most promising new procedures to be spinal cord stimulators. They are increasing their surface area of coverage and truly helping individuals with intractable pain beyond all measures.
Sheba Jilani, MD, interventional and chronic pain specialist, Brain And Spine Institute of (Orange) California: Patients suffering from chronic neck, back, or joint pain assume that their options are limited to major surgery. One of the newest available, FDA-approved treatments in pain management is a groundbreaking stem cell procedure called inSRT Spinal Renewal Therapy. This regenerative medical procedure has proven to significantly minimize recovery time from pain. It is indicated for treatment of disorders of the spine and peripheral joints such as degenerative disc disease, arthritis, nerve pain, scoliosis, and spinal stenosis.
Joseph Holtman Jr., MD, anesthesiologist, Loyola University Medical Center (Maywood, Ill.): A little-known morphinelike drug is potentially more potent, longer lasting and less likely to cause constipation than standard morphine. The drug, morphine-6-0-sulfate, has a similar chemical structure to standard morphine. Opioids, such as morphine, oxycodone and hydrocodone, are standard drugs for treating moderate to severe pain, including cancer pain. But these drugs can have significant side effects, including constipation, nausea, vomiting, drowsiness, cognitive dysfunction and slowed breathing and heart rates. And while opioids work well for conditions such as back pain and post-operative pain, the drugs are less effective against neuropathic pain, such as tingling, burning or shooting pain.
Cherise Hamblin, MD, Lancaster (Pa.) General Health: For women suffering from chronic pelvic pain and endometriosis, a great technology is the da Vinci surgical robot. This advancement in laparoscopic surgery allows the surgeon to perform more precise surgery, cutting scar tissue and removing endometriosis implants with less blood loss and quicker recovery than other procedures. Fibroid tumors, ovarian cysts, adhesions, and adenomyosis can also be causes of pelvic pain, along with endometriosis. The da Vinci surgical robot is a great tool to address any of these problems.
This is an ongoing series which will feature five pain management physicians' responses to questions about the specialty.
Next week's question is: What is a best business practice that you follow at your center?
Submit responses to taryn@beckershealthcare.com before April 10.
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