Self-Assessment: Neuromodulation in Pain Management | Lifestyle Medicine for Common Conditions Encountered in the EDX Laboratory-Dr. Gage Presentation

Dr. Gage Presentation

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The document details a presentation on "Neuromodulation in Pain Management" by Dr. Emmanuel Gage and Dr. Monica Carrion-Jones of Jax Spine and Pain Centers and Centurion Spine and Pain Centers. Dr. Gage's financial disclosures reveal consultancy roles with various companies including Boston Scientific and Genesys Spine. The main objectives of the presentation are to describe the indications, warnings, and benefits of Spinal Cord Stimulation (SCS) for managing chronic pain.<br /><br />Dr. Gage outlines that SCS is primarily indicated for managing chronic, intractable pain of the trunk or limbs, citing conditions such as Failed Back Syndrome, radiculopathies, degenerative disc disease, and diabetic peripheral neuropathy. Contraindications include diathermy and potential complications for patients with diabetes or implanted cardiac devices. The presentation also discusses MRI conditionality of SCS components, ensuring safety during MRI procedures when proper protocol is followed.<br /><br />Clinical studies such as the WAVER WRITER, HALO, and LUMINA have shown high efficacy rates with a responder rate of 85%, significant disability improvement, and high patient satisfaction. Proper patient selection criteria are emphasized including the exclusion of active substance abuse, thorough psychological screening, and extensive patient education on risks and benefits.<br /><br />The trial for SCS should show at least a 50% reduction in pain or analgesic medication use and some functional improvement. Permanent SCS placement is to be done in accredited surgical centers, requiring physicians to be subspecialty boarded in Pain Medicine by the American Board of Anesthesiology.<br /><br />Potential complications include lead fracture, migration, infection, and rare neurological injury, which can be minimized through adequate physician training and careful patient selection.<br /><br />Finally, the document encourages feedback via the AANEM app and provides instructions for claiming continuing education credits. The overall aim is to enhance meeting quality and ensure the effectiveness of pain management techniques shared during the presentation.

Keywords

Neuromodulation

Pain Management

Spinal Cord Stimulation

Chronic Pain

Failed Back Syndrome

Diabetic Peripheral Neuropathy

Clinical Studies

Patient Selection

Complications

Continuing Education