New SIR–Thieme book on vertebral augmentation coming soon Several procedures can stabilize broken vertebra in an effort to alleviate patients’ pain. A new book on these vertebral augmentation (VA) treatments is being developed by Thieme, SIR’s book publishing partner, and interventional musculoskeletal radiologist Douglas P. Beall, MD, chief of services at Clinical Radiology of Oklahoma.
Patient Gene Johnson (far right) describes how IR changed his life. Also pictured (left to right): Theresa Caridi, MD; Susan E. Sedory, MA, CAE; Alexander Y. Kim, MD; and J. David Prologo, MD. View the video clip at
bit.ly/irqpainkillers.
month after undergoing GAE, eight patients were followed up with. They had decreased pain, reduced stiffness and increased mobility.
Interventional musculoskeletal radiologist Douglas P. Beall, MD, chief of services at Clinical Radiology of Oklahoma, is taking part in the VAST Study, which is using allogeneic stem cells from a tissue bank to treat patients with low back pain. Preliminary results have shown that back pain was cut in half in 82 percent of patients, according to Dr. Beall. Three years later, 92 percent of these patients still had the same positive result.
Results from the SMART Trial offer another potential solution for chronic back pain. In a study of 225 participants, basivertebral nerve ablation via radiofrequency was performed on patients with chronic low back pain for at least six months in whom conservative treatment had failed. Three months post-procedure, 75 percent of patients in the treatment arm showed improvement compared to 55 percent in the sham control arm.
Increasing awareness While new treatments are being studied, many minimally invasive pain therapies are available now. The problem is that few outside IR know about them. Patients often only discover these therapies when they are referred to an IR for another procedure.
Dr. Kim encourages IRs to take the time to ask patients about their pain. “I’ll talk to my patients about their pain level and see if they’re having significant pain or if they’re really overdependent on opioids,” he says.
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“I’ll talk to them about potentially incorporating nerve blocks to their care to try to alleviate some of that pain. Make that a standard part of the discussion.”
He also thinks training programs need to add segments or rotations on pain management. “That would be a very useful skill for interventional radiologists to have, not just in terms of delivering treatments to alleviate pain, but in terms of discussing pain with patients, learning about different types of pain and what types of pain may be best managed by the different treatment modalities that we have.”
It’s also up to the IR specialty to get the word out about these pain therapies, by talking to referring doctors, hosting continuing education programs and talking to local news media. (For tips, see the sidebar.)
Getting back to normal Johnson had his procedure in August 2018. Afterward, he was surprised when he didn’t need a nurse’s help getting out of bed. The pain was gone—and it hasn’t returned. A month after surgery, at age 71, he and his wife drove to Washington, to tell their story at a Capitol Hill briefing organized and hosted by SIR. They love taking road trips together in the summer but hadn’t been able to do that for about five years. After spending only a couple of nights in D.C., they drove to Colorado and then Las Vegas before driving home to Georgia.
When he was in pain, Johnson says, he never meant to be “ugly” to people, but “I didn’t enjoy anything. I didn’t enjoy being around people because you had
The book, which is expected to be available in 2019, will be the first VA book in 10 years. It will include updates on the science and techniques of VA, as well as present case studies. Dr. Beall is soliciting subchapters from “masters” of VA treatment around the world to provide their expertise and experience, which will include their own innovative techniques and unusual cases. “It’s a very exciting time and a very exciting topic,” Dr. Beall says.
Look for more information on the book in 2019 from SIR.
to put on a good face. Now I’m getting back to normal.
“I wake up every morning, and the first thing I do is check to see if the pain’s back,” he says. He thinks eventually that impulse will go away. Seven weeks after the surgery, he had taken a total of two Tylenol for soreness. Ideally, he would love to return to his education job.
Johnson still can’t believe the pain just disappeared all at once. “I wasn’t expecting to get rid of all my pain,” he says. “I said, ‘Just get it to 5.’ It’s been a different world. Dr. Prologo treated the problem; he didn’t just cover it up.”
Dr. Beall says IR is primed to potentially help millions of people in pain. “We’re talking about approaches that are demonstrably effective at treating some of the things that are the scourge of our society,” he says. “This is just the start of the revolution.”
More online
See the online version at
bit.ly/ irqpainkillers for a video of patient Gene Johnson's story of how IR changed his life.
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