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.

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.

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SHOW NOTES

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

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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