Are you considering expanding your IR practice into pain management services? Get the download from someone who’s done it already. In this episode of BackTable MSK, Dr. Sean Maratto from Philadelphia's Jefferson Health Network is joined by guest Dr. Junjian Huang from Emory University School of Medicine to discuss the intricacies of building a pain management practice within the interventional radiology space.
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This podcast is supported by an educational grant from Medtronic.
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SYNPOSIS
Dr. Huang shares his career journey, highlighting his shift towards pain palliation. The conversation covers a range of topics including procedural insights, patient management strategies, navigating institutional politics, and future trends in orthopedic IR. Dr. Huang emphasizes the importance of balancing patient care with building robust referral networks, and shares valuable advice for budding interventional radiologists.
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TIMESTAMPS
00:00 - Introduction
02:20 - What’s Your Why? Why Pain Intervention?
12:52 - Building a Complex Pain Management Practice
24:47 - Marketing a Service Line
30:57 - Patient Impact from Pain Management Services
39:53 - Recommendations and Indications for Cryoneurolysis and BVNA
45:36 - Post-Procedure Follow-up and Psychosomatic Pain Guidance
52:35 - Insight to the Future of Interventional Pain and Final Thoughts
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RESOURCES
Dr. Junjian Huang, MD
https://med.emory.edu/directory/profile/?u=JHUAN22
Dr. Sean Maratto, MD
https://www.jeffersonhealth.org/find-a-doctor/m/maratto-sean-a

To ablate or not to ablate? That is the question. Learn how to tackle complex and unique cases of kyphoplasty and spinal ablation in part two of our discussion with Dr. Asad Baig and host Dr. Michael Barrazza.
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This podcast is supported by an educational grant from Medtronic.
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SYNPOSIS
This episode looks at the ins and outs of real-world kyphoplasty and spinal ablation cases, including detailed patient histories, diagnostic techniques like the Oswestry Disability Index and Roland-Morris Disability Questionnaire, and the challenges of treating patients with extensive spinal hardware, osteoporosis, and other complicating factors.
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TIMESTAMPS
00:00 - Introduction
01:38 - Hx of Osteoporosis and Previous Kyphoplasty
04:06 - Challenges in Identifying Fractures
05:29 - Tool Selection and Technique
10:35 - Post-Kyphoplasty Follow-Up and Patient Outcomes
13:29 - Importance of Timely Treatment
18:13 - Weight Loss and Cancer Concerns
28:26 - Final Thoughts and Takeaway
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RESOURCES
Dr. Asad Baig, MD
https://doctors.columbia.edu/us/ny/new-york/asad-baig-md-51-west-51st-street
OsteoCool RF Ablation System by Medtronic
https://www.medtronic.com/en-us/healthcare-professionals/products/surgical-energy/ablation/radiofrequency-ablation/systems/osteocool-radiofrequency-ablation-system.html

From patient selection to procedure technique–learn the key insights that shape a successful kyphoplasty and spine ablation practice. In this episode of the BackTable MSK Podcast, host Dr. Michael Barraza welcomes back Dr. Asad Baig, an Interventional Radiologist and director of the Interventional Spine Center at Columbia University. They discuss the latest developments at Columbia, focusing on exciting expansions in the interventional radiology and spine realms. The primary focus of their conversation is on advanced techniques in spine ablation and kyphoplasty, and the ideal patient profile for these treatments.
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This podcast is supported by:
Medtronic OsteoCool
https://www.medtronic.com/en-us/healthcare-professionals/products/surgical-energy/ablation/radiofrequency-ablation/systems/osteocool-2-0-bone-tumor-ablation-system.html
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SYNPOSIS
Dr. Baig begins the episode by explaining the importance of collaborating with radiation oncologists and spine surgeons to optimize patient outcomes and emphasizes considerations, such as bone quality, prior to a spinal ablation. The episode also features Dr. Baig’s approach to treating sclerotic versus lytic lesions with his insights on navigating complex cases involving post-radiation fractures and internal fixation complications. This first episode of a two-part series emphasizes a multi-disciplinary approach and the need for precise imaging and patient communication when treating patients with spinal ablation.
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TIMESTAMPS
00:00 - Introduction
01:31 - Evaluating Patients Prior to Spine Ablation
09:02 - Who is the Ideal Candidate for Ablation Kyphoplasty?
14:24 - Approaching Lesions Within the Vertebral Body
21:26 - When is it Appropriate to Use Balloons After an OsteoCool Ablation?
27:58 - Approach to Patients with Significant Vertebral Height Loss
35:33 - Challenging Cases with Kyphoplasty
39:02 - Sclerotic versus Lytic Lesions
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RESOURCES
Dr. Asad Baig, MD
https://doctors.columbia.edu/us/ny/new-york/asad-baig-md-51-west-51st-street
OsteoCool RF Ablation System by Medtronic

https://www.medtronic.com/en-us/healthcare-professionals/products/surgical-energy/ablation/radiofrequency-ablation/systems/osteocool-radiofrequency-ablation-system.html

Resorbable embolics are gaining traction in musculoskeletal interventions, but what are the key technical considerations? Dr. Keerthi Prasad, interventional radiologist at the Centers for Pain Control and Vein Care joins host Dr. Ally Baheti to share practical insights when using resorbable embolics in MSK interventions.
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This podcast is supported by:
Medtronic OsteoCool
https://www.medtronic.com/en-us/healthcare-professionals/products/surgical-energy/ablation/radiofrequency-ablation/systems/osteocool-2-0-bone-tumor-ablation-system.html
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SYNPOSIS
Dr. Prasad opens the conversation with an overview of embolic agents used in MSK interventions—including Imipenem, Lipiodol, and Nexsphere-F—and shares practical insights into technique selection. He explores the nuances of working with various resorbable embolics, highlighting clinical cases from his personal experience. The discussion also highlights Dr. Prasad’s innovative approach to establishing an outpatient-based lab (OBL) focused on musculoskeletal interventions. Additionally, Dr. Prasad also offers insight into the expanding role of resorbable embolics in treating conditions such as knee arthritis, plantar fasciitis, and adhesive capsulitis. The episode ends with a call to broaden access to this evolving treatment.
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TIMESTAMPS
00:00 - Introduction
01:55 - Outpatient Embolization and MSK Procedures
04:20 - Resorbable Embolics in Joint Embolization
04:52 - Available Resorbable Embolics in the US
07:57 - Technical Insights on Using Resorbable Embolics
15:18 - Patient Outcomes and Long-Term Durability
22:24 - Future of MSK Embolization Techniques
24:05 - Exploring New Applications for Resorbable Embolics
27:30 - Innovative Procedures and Techniques
37:00 - Final Thoughts and Advice for Practitioners

What is the optimal embolization technique in GAE? In this BackTable Brief, Dr. Osman Ahmed and Dr. Sid Padia, MD discuss the embolization of abnormal vessels, debating between targeting any abnormal vessel versus only the painful side. They reference studies and papers, including the Landers 2023 paper, to explore best practices. 

They consider the use of temporary resorbable embolics compared to permanent embolics, examining safety profiles, efficacy, and potential complications. The conversation then shifts towards the size of embolic particles and endpoints for different embolization materials. They discuss specific techniques and their impacts, highlighting the reproducibility of certain methods and preparing for the future of resorbable embolics in various medical applications.

Episode Outline

00:00 - Introduction

00:13 - Embolization of Abnormal Vessels

02:34 - Permanent vs. Resorbable Embolics

06:21 - Debating Particle Size 

11:06 - Technique When Using Permanent Spheres 

12:42 - Technique When Using Resorbable Spheres 

Resources

Dr. Venkatesh, “Kavi”, Krishnasamy, MD

https://www.uab.edu/medicine/radiology/faculty/intervent-radiology/profile/krishnasamy

Dr. Osman Ahmed, MD

https://bucksbauminstitute.uchicago.edu/bio/osman-ahmed-md/

Dr. Siddarth, “Sid”, Padia, MD

https://www.uclahealth.org/providers/siddharth-padia

Genicular artery embolization for early-stage knee osteoarthritis: results from a triple-blind single-centre randomized controlled trial

https://pmc.ncbi.nlm.nih.gov/articles/PMC10032233/

Multicenter Randomized Sham Controlled Study of Genicular Artery Embolization for Knee Pain Secondary to Osteoarthritis

https://pubmed.ncbi.nlm.nih.gov/34610422/

Which imaging and treatment techniques are optimal for GAE in the OBL? In this BackTable Brief, Dr. Osman Ahmed and Dr. Sid Padia explore instrument selection and CT techniques in the OBL for genicular artery embolization (GAE). 

Dr. Ahmed and Dr. Padia discuss the importance of not compromising on patient safety, and the careful selection of their approach to treatment. They further elaborate on the use of cone beam CT for more precise treatment planning, sharing insights on catheter selection, contrast solutions, and best practices for ensuring high-quality patient care, especially in the OBL (office-based lab) setting.

Episode Outline

00:00 - Introduction 

00:53 - Discussion on Catheter Selection and Preference 

03:37 - Use of Cone Beam CT in the OBL

10:42 - Cone Beam CT Protocols and Technique: Selective or Non-Selective?

12:38 - Contrast Solutions and Techniques

Resources

Dr. Venkatesh, “Kavi”, Krishnasamy, MD

https://www.uab.edu/medicine/radiology/faculty/intervent-radiology/profile/krishnasamy 

Dr. Osman Ahmed, MD

https://bucksbauminstitute.uchicago.edu/bio/osman-ahmed-md/ 

Dr. Siddarth, “Sid”, Padia, MD

https://www.uclahealth.org/providers/siddharth-padia

When it comes to spinal oncology, no single specialty holds all the answers. In this episode of the BackTable Podcast, host Dr. Alexa Levey, an interventional radiologist from Yale School of Medicine, is joined by Dr. Mark Amsbaugh, a radiation oncologist, and Dr. Ran Lador, an orthopedic spine surgeon, both from the University of Texas McGovern Medical School. The discussion explores complexities and innovations in the multidisciplinary treatment of spinal tumors.

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SYNPOSIS

Dr. Ambsbaugh and Dr. Lador highlight their cohesive, patient-centered approach at Memorial Hermann, integrating various specialties including surgery, radiation oncology, and interventional radiology. The episode emphasizes the importance of collaborative techniques, advances in minimally invasive surgeries, the role of stereotactic radiosurgery, and the critical nature of personalized patient care in improving outcomes for patients with spinal tumors.

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TIMESTAMPS

00:00 - Introduction
01:20 - Multidisciplinary Approach to Spinal Tumors at Memorial Hermann
10:22 - Surgical Techniques and Timing for Radiation Treatments
12:25 - Approach to Collaborative Treatment Planning
25:45 - Connection Between Surgical and Radiation Oncology in Patient Care
31:08 - The Role of Vertebral Augmentation in Spinal Oncology
40:08 - Multimodal Pain Management Strategies
47:35 - Thoughts on Future Directions in Spinal Oncology and Conclusion

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RESOURCES

Dr. Mark Amsbaugh, MD
https://med.uth.edu/neurosciences/dr-mark-j-amsbaugh-md/

Dr. Ran Lador, MD
https://med.uth.edu/ortho/2022/11/02/ran-lador-md/

Dr. Alexa Levey, MD
https://medicine.yale.edu/profile/alexa-levey/

Shownotes

Who is the ideal candidate for genicular artery embolization (GAE)? In this BackTable Brief, Dr. Osman Ahmed and Dr. Sid Padia share how they work up and select GAE patients.

Dr. Padia and Dr. Ahmed discuss the challenges of patient selection in genicular artery embolization, specifically debating the necessity and utility of MRI with contrast. The discussion also explores the pros and cons of femoral vs. pedal access techniques, considering patient characteristics such as BMI and the practicality of these approaches in various clinical settings.

Episode Outline

00:00 - Introduction

00:20 - Use of MRI with Contrast in Patient Selection

04:22 - Challenges and Future Directions of MRI in GAE

07:46 - Pros and Cons of Femoral vs. Pedal Access

10:00 - Practical Considerations

Resources

Dr. Venkatesh, “Kavi”, Krishnasamy, MD

https://www.uab.edu/medicine/radiology/faculty/intervent-radiology/profile/krishnasamy 

Dr. Osman Ahmed, MD

https://bucksbauminstitute.uchicago.edu/bio/osman-ahmed-md/ 

Dr. Siddarth, “Sid”, Padia, MD

https://www.uclahealth.org/providers/siddharth-padia

Where does cryoneurolysis fit in contemporary pain management? In this episode of Backtable MSK, host Jacob Fleming is joined by Dr. Alexa Levey to discuss the role of cryoneurolysis in various pain presentations, covering indications, anatomical targets, and techniques in different clinical scenarios.

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SYNPOSIS

This episode offers practical guidance on how to take a detailed patient history, how to use cryoneurolysis for pain management, and the significance of multidisciplinary collaboration. The conversation also highlights the importance of setting proper patient expectations, understanding different types of pain, and the need for standardizing cryoneurolysis procedures through structured research and education.
Dr. Levey also shares her recent career move to Yale, her passion for research, and the challenges she faced returning to academia from private practice.

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TIMESTAMPS

00:00 - Introduction
03:49 - Discussion of Dr. Levey’s Recent Research Paper
09:35 - The Fine Details of Pain and Pain Management
18:42 - Patient Quality of Life Assessment in Regards to Pain Management
28:28 - Game Plan for Managing Neuritis
37:19 - Collaboration Between Different Specialists
40:16 - Offering Patient Education and Support
42:31 - Final Reflections and Gratitude

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RESOURCES

Dr. Alexa Levey
https://medicine.yale.edu/profile/alexa-levey/

Common Cryoneurolysis Targets in Pain Management: Indications, Critical Anatomy, and Potential Complications
https://pubmed.ncbi.nlm.nih.gov/40376212/

Paging all neuroradiologists and spine specialists interested in enhancing their vertebral nerve ablation practice. In this special ESNR edition of Backtable MSK, host Jacob Fleming welcomes neuroradiologist Dr. Luigi Manfre to discuss the intricacies of vertebral nerve ablation, focusing on patient selection, technical approaches, and emerging practice trends.

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SYNPOSIS

The physicians discuss the importance of careful diagnosis using MRI, SPECT scanning, and nerve block tests to improve treatment efficacy. Dr. Manfre emphasizes the need for strict patient selection to mitigate failures and highlights the variability in vertebral innervation between patients that can affect outcomes. The conversation also explores the nuances of conducting procedures under CT guidance and addresses challenges in treating different spinal levels, including L5 and S1. BONUS: Details on the ESNR Hands-On Spine Course held in Catania, Italy from October 16th-18th, 2025.

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TIMESTAMPS

00:00 - Introduction
02:43 - Upcoming Hands-On Spine Course
08:40 - The Rundown: Basivertebral Nerve Ablation
15:18 - Understanding Modic Changes and Their Implications
26:03 - Unique Innervation and Corresponding Challenges in Ablation
38:13 - Technical Approaches and Difficulties in BVNA
51:16 - Patient Selection and Procedure Efficacy for Ablative Procedures
01:00:29 - Conclusion and ESNR Course Information

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RESOURCES

Dr. Luigi Manfre
https://www.linkedin.com/in/luigi-manfre-20b61284/?originalSubdomain=it

European Society of Neuroradiology (ESNR)
https://www.esnr.org/