Journal of Pain & Relief
Open Access

Abstract

Introduction: The treatment of chronic pain has changed from opioids alone, to a multidisciplinary comprehensive treatment program. Isolated physicians and surgeons treating spinal pain without communicating with each other led to suboptimal outcomes for patients. Eisenhower Medical Center in Rancho Mirage California, has created a Spine Center with surgeons, pain physicians, physical therapists and pain psychologists working together to create a customized plan for individuals suffering in pain. The communication between the spine surgeon and the interventional pain physician, has provided the missing link in improving both surgical as well as interventional procedure outcomes. Fluoroscopic guided interventions performed at the direction of a spine surgeon, provides diagnostic value leading to better outcomes from surgery. Methods: Retrospective analysis was conducted on 30 patient charts. Fifteen patients had surgery without interventional therapy. Interventional therapy defined as epidural steroid injection or facet based injections performed under fluoroscopic guidance. The other 15 patients had surgical treatment with interventional therapy directed by the surgeon for diagnostic purposes. Discussion: Treating spinal pain continues to be a challenge due to the multiple potential pain generators that can create similar symptoms in an individual. If surgical treatment is considered, advanced imaging, MRI or CT and clinical exam are no longer sufficient to isolate the primary pain generator. Fluoroscopically guided interventional procedures can differentiate between individual neuroforamen that can be responsible for the patient's symptoms. Conclusion: Spine Center is an optimal model to treat patients with spinally mediated pain. By creating an environment of discussion between many different specialties - a Spine Center facilitates a better understanding of patients symptoms, disease etiology and outcome.

Biography

Hazmer Cassim is currently a Chair at the Eisenhower Medical Center, USA. He is also the Director of Desert Orthopedic Center of California in USA.