A review of the evidence   David Rosenblum, MD reviews the description and evidence provided by Loibi et al in the published article referenced below.  Dr. Rosenblum discusses personal experiences with treating back pain with regenerative medicine procedures.  Discussed in this podcast: Patient selection Pathophysiology Environment of the disc and it’s impact on MSCs Risks and safety concerns of Intervertebral mesenchymal stem cell transplantation Pain relief and recommendations for MSC injection into the disc in patients suffering from discogenic pain      Claim CME Credit  The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/WAltmH         Course Calendar      Ultrasound Training Dominican Republic- November 12, 2022    Physician Networking Event- November 17, 2022   Ultrasound Training NYC- December 3, 2022   Regenerative Interventional Pain Course January 28th, 2023   Ultrasound Training Costa Rica- February 29, 2023    Pain Management Board Review and Refresher, June 10-12, 2023- NYC Location TBA  Reserve a spot!      References   Loibl, M,  Wuertz-Kozak, K,  Vadala, G,  Lang, S,  Fairbank, J,  Urban, JP.  Controversies in regenerative medicine: Should intervertebral disc degeneration be treated with mesenchymal stem cells? JOR Spine. 2019; 2:e1043. https://doi.org/10.1002/jsp2.1043

Should intervertebral disc degeneration be treated with mesenchymal stem cells?

David Rosenblum, MD, creator of ABAStageExam.com for the Basic and Applied Exams in Anesthesiology, AnesthesiaExam and the Pediatric Anesthesia Board review (PedsAE.com) discusses Anesthesiology Board Review and Practice Management.
Dr. Rosenblum has also published a children's book:
Welwyn Ardsley and the Cosmic Ninjas: Preparing your child and yourself for anesthesia and surgery
Available at Amazon.com and www.MyKidsSurgery.com

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 Dr. Rosenblum describes a patient with chronic shoulder pain who failed shoulder replacement, steroid injections, nerve blocks, cryotherapy, and peripheral nerve stimulation of the axillary and suprascapular nerve block.  In this podcast, he discusses his perfomance of Shoulder Radiofrequency Ablation targeting the articular branches of the suprascapular nerve, axillary nerve, nerve to subscapularis and lateral pectoral nerve.   Reference:  https://www.asra.com/news-publications/asra-newsletter/newsletter-item/asra-news/2020/11/01/how-i-do-it-shoulder-articular-nerve-blockade-and-radiofrequency-ablation   Other Announcements from NRAP Academy:   PainExam App almost ready   Pain Management Board Prep migrated to NRAPpain.org   AnesthesiaExam Board Prep migrated to NRAPpain.org PMRExam Board Prep migrated to NRAPpain.org      Live Workshop Calendar    Ultrasound Interventional Pain Course Registration      For Anesthesia Board Prep Click Here!

Post Operative Pain after Shoulder Replacement: Peri-operative Ablation?

Advocating for Transparency and Oversight in Pain Management Introduction:  Welcome back to Painexam, where we delve into the latest advancements and challenges in pain management. Today's episode highlights a significant advocacy effort made by leading Interventional Pain Physicians and industry experts.  Summary of Lobbying Effort:  On March 20, 2024, a group of esteemed physicians and industry leaders, including Drs. Sean Li, Peter Staats, Mehul J. Desai, David Reece, Hemant Kalia, and David Rosenblum, alongside industry figures Mark Stultz, Christopher Conrad, and Cecelia Ruble, visited Capitol Hill to advocate for greater oversight and transparency in independent review organizations. Despite their busy schedules, they recognized the critical need to address the 0% turnover rate in appeals for denied treatments, which disproportionately affects patients seeking alternatives to surgery and opioid medication.  Importance of Transparency:      The issue extends beyond pain management, impacting patients across various medical fields. While opioid therapy may seem economically favorable initially, the long-term consequences, including delayed care and medication side effects, often outweigh the costs. The group emphasized the importance of an unbiased review for  accessible, cutting-edge treatments to improve patient outcomes and reduce overall healthcare expenses.  Purpose of the Lobbying Effort: Contrary to pushing any specific company agenda, the initiative aims to highlight the challenges patients and physicians encounter in securing optimal treatment outcomes.     For Board Prep, Ultrasound Training and more, visit:  Dr. David Rosenblum, a pioneer in interventional pain medicine, particularly in ultrasound- guided procedures and regenerative pain medicine, underscores the necessity of addressing these issues for the benefit of countless patients suffering from chronic pain. Conclusion and Actionable Steps:  To schedule a consultation with Dr. Rosenblum, patients can visit www.AABPpain.com or contact the Brooklyn Office at 718-436-7246 or the Garden City Office at 516-482-7246. Stay tuned for more updates on advancements and advocacy efforts in pain management.  Outro:  Thank you for joining us on this episode of Painexam. Be sure to subscribe for future discussions on navigating the complexities of pain management. 

IRO's (Independent Review Organizations)- Physicians Lobby for Oversight and Transparency

Dr. Rosenbum discusses Interventional Psychiatry, the role of Stellate Ganglion Blocks in PTSD, Ketamine Infusions for Depression, and the role of Magnesium as a co-factor in ketamine infusions.  Other Announcements from NRAP Academy:   PainExam App almost ready   Pain Management Board Prep migrated to NRAPpain.org   AnesthesiaExam Board Prep migrated to NRAPpain.org PMRExam Board Prep migrated to NRAPpain.org      Live Workshop Calendar    Ultrasound Interventional Pain Course Registration        For Anesthesia Board Prep Click Here!  References  https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1293358/full   References   Górska N, Cubała WJ, Słupski J, Wiglusz MS, Gałuszko-Węgielnik M, Kawka M, Grzegorzewska A. Magnesium in Ketamine Administration in Treatment-Resistant Depression. Pharmaceuticals (Basel). 2021 May 3;14(5):430. doi: 10.3390/ph14050430. PMID: 34063604; PMCID: PMC8147622.    https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.513068/full    https://www.sutterhealth.org/services/behavioral-health/interventional-psychiatry    Hanling SR, Hickey A, Lesnik I, et al  Stellate Ganglion Block for the Treatment of Posttraumatic Stress Disorder: A Randomized, Double-Blind, Controlled Trial   Regional Anesthesia & Pain Medicine 2016;41:494-500.     https://www.psychiatrist.com/jcp/oral-ketamine-for-depression/    

Stellate Ganglion, Ketamine Infusions and Interventional Psychiatry

Dr. Rosenblum interviews West Viriginia Society of Interventional Pain Physician's President Rudy Malayil, MD and discusses the upcoming WVSIPP meeting in April 2024 as well as Dr. Rosenblum's upcoming ultrasound course.   Rudy Mathew Malayil, M.D., completed his internship in General Surgery at New York Presbyterian/Cornell Hospital in New York City, followed by residency training in Physical Medicine and Rehabilitation at New York University Medical School. Dr. Malayil further completed a Pain Medicine Fellowship at the Albert Einstein School of Medicine at the Beth Israel Medical Center Campus in New York City.  After training he went settled in West Virginia and eventually became the president of West Virginia Society of Interventional Pain Physicians and started private practice Pain Management 360.  https://pain360.org https://www.malayilmd.com    Ultrasound Interventional Pain Course Registration        For Anesthesia Board Prep Click Here!  References  https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1293358/full  

Stellate Ganglion Block and Hot Flashes- Rudy Malayil, MD of WVSIPP

In this episode, Garden City (long island) based Pain Physician, Dr. David Rosenblum explores Peripheral Nerve Stimulation, Biologics and Ablations for hip pain. He reviews a case report of a 67-year-old female with a history of a mechanical fall causing injury to her lumbar spine and pelvis resulting in hip and pelvic pain is presented. The patient had hypertrophic non-union of the right iliac wing fracture and displacement of the pubic symphysis and right sacroiliac joint. Medications were not effectively managing her pain, so she sought treatment at a pain management clinic. The patient underwent diagnostic obturator and femoral articular nerve branch injections, as well as a middle cluneal nerve steroid injection, all guided by fluoroscopy and ultrasound. She experienced improvement in her pain following these procedures. Subsequently, she had a peripheral nerve stimulator (PNS) trial and underwent implantation of leads targeting the right middle cluneal nerve and right obturator and femoral articular nerve branches. The patient reported significant relief in both the posterior and anterior distribution of her pain. Her activities of daily living improved, and she was able to sleep without pain after the PNS implantation. The successful use of combined fluoroscopy and ultrasound in targeting the specific nerves and replicating the patient's pain distribution before permanent PNS implantation is highlighted in this case. Additionally, the show notes mention an events calendar located at this link: https://www.nrappain.org/pages/ultrasound-course-calendar. Upcoming Course schedule for NRAP Academy includes the following events:   Ultrasound Guided Pain & Regional Anesthesia Course in New York City on February 10, 2024. This course will cover nerve blocks, joint injections, and more. Attendees will have the opportunity to scan live models after the didactic session.   MSK Pain & Regional Anesthesia Course in Miami, Florida on February 18, 2024. This course will focus on ultrasound-guided nerve blocks and MSK (musculoskeletal) pain management.   Ultrasound Guided Pain Course in Key West, Florida on February 23, 2024. This 4 CME (Continuing Medical Education) course will cover ultrasound-guided nerve blocks, MSK, PRP (platelet-rich plasma), BMAC (bone marrow aspirate concentrate) targets, and regional anesthesia.   Regional Anesthesia and US Guided Pain Management Course in New York City on March 9, 2024. This course will provide training in ultrasound-guided interventional pain management and regional anesthesia.   Ultrasound Guided IPM (Interventional Pain Management) Course in West Virginia on April 14, 2024. This course is part of the Appalachian Regional Spine and Pain Meeting and will be conducted by NRAP Academy. It will focus on interventional pain management using ultrasound guidance.   Regenerative Pain Medicine Course in New York City on May 4, 2024. This course will cover PRP (platelet-rich plasma) and other regenerative pain medicine techniques.    In addition to the live training, attendees will receive bonus material including access to the On Demand Ultrasound Guided MSK Interventional Pain Management Course, a course workbook and certificate, post-course guidance and discounts, and the opportunity to join the mailing list for calendar updates. Please note that these course details are subject to change, so it's recommended to visit the NRAP Academy website for the most up-to-date information. Reference     Fu E, Elsharkawy H #35977 Peripheral nerve stimulation implant for chronic post-traumatic hip and pelvic pain  Regional Anesthesia & Pain Medicine 2023;48:A193.    

Should intervertebral disc degeneration be treated with mesenchymal stem cells?

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