good cervical injection course

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
A

AndyDufrane

Member
20+ Year Member
Joined
Sep 6, 2003
Messages
292
Reaction score
15
Members don't see this ad.
hi I am interested in attending a cervical injection course, I already do lumbar injections, are there any good alternatives besides ISIS, I see I missed the most recent one. thank you
 
AndyDufrane said:
hi I am interested in attending a cervical injection course, I already do lumbar injections, are there any good alternatives besides ISIS, I see I missed the most recent one. thank you
Click to expand...

Do a fellowship. Really. The risk is exponentially higher with cervical and thoracic injections, and doing a cadaver course will NOT adequately prepare you for the first time you get into trouble.
 
Sounds like a sh** fellowship if you have to learn RFA and cervical epidurals at weekend courses.

Not personal just amazing the varibility in in training.
 
RUOkie said:
Do a fellowship. Really. The risk is exponentially higher with cervical and thoracic injections, and doing a cadaver course will NOT adequately prepare you for the first time you get into trouble.
Click to expand...

already did a spine fellowship, but one year out of fellowship, am looking to add more injection types to my services, had a little exposure to cervical injections in fellowship, but not overwhelming like the lumbar stuff
 
nvrsumr said:
Sounds like a sh** fellowship if you have to learn RFA and cervical epidurals at weekend courses.

Not personal just amazing the varibility in in training.
Click to expand...

couldn't agree with you more, but its a fancy name institute whose name I have on my CV, and for marketing purposes, it works great, plus I am thinking if I am to move into private practice world, there is no way I can get away with not doing RFA or at least cervical ILESI or MBB or facet blocks
 
AndyDufrane said:
already did a spine fellowship, but one year out of fellowship, am looking to add more injection types to my services, had a little exposure to cervical injections in fellowship, but not overwhelming like the lumbar stuff
Click to expand...

nvrsumr said:
Sounds like a sh** fellowship if you have to learn RFA and cervical epidurals at weekend courses.

Not personal just amazing the varibility in in training.
Click to expand...


this. I'm sorry, but there is no way you are going to be competent to do cervical injections after a weekend course. Where are you going to get your numbers for credentialing? IMO if you wanted to do those types of procedures, you should have ensured you could learn them during your fellowship. That is what the fellowship was for. NOT for the piece of paper. For the training.

It is really unfortunate the way that "Pain" fellowships are set up by ACGME.
 
not surprised - after all, we have interventional spine fellowship under the guise of ACGME sports medicine.

https://www.ossortho.com/for-physicians/interventional-spine-sports-medicine-fellowship-york.php

ACGME: The OSS Health/Sinai Hospital of Baltimore Sports Medicine Fellowship is accredited by the Accreditation Council for Graduate Medical Education (ACGME program #3424100012). For more information about the ACGME, please visit www.ACGME.org. There are currently three accredited positions. Satisfactory completion of this 12 month fellowship meets the educational requirements to sit for the Sports Medicine subspecialty examination recognized by the American Board of Physical Medicine and Rehabilitation (ABPMR) and the American Board of Medical Specialties (AMBS).
 
RUOkie said:
this. I'm sorry, but there is no way you are going to be competent to do cervical injections after a weekend course. Where are you going to get your numbers for credentialing? IMO if you wanted to do those types of procedures, you should have ensured you could learn them during your fellowship. That is what the fellowship was for. NOT for the piece of paper. For the training.

It is really unfortunate the way that "Pain" fellowships are set up by ACGME.
Click to expand...

yeah it was a non ACGME spine fellowship with some sports exposure, and at the time of applying for fellowships a couple of years ago I did not realize that not all fellowships are created equally and ACGME accreditation was going to matter down the line, some have very scant procedure volume and variety and alot more emphasis on seeing patients in the clinic, plus at the time of application I did not really want to do a hard core pain fellowship and lose the ability to do EMGs or MSK ultrasound or general MSK stuff, so I went with a non ACGME spine/sports,
 
no MBBs? wtf?

sounds like it was all just epidurals, probably all interlaminars.

ISIS offers the best courses, but there is only so much you can learn in a weekend.
 
AndyDufrane said:
yeah it was a non ACGME spine fellowship with some sports exposure, and at the time of applying for fellowships a couple of years ago I did not realize that not all fellowships are created equally and ACGME accreditation was going to matter down the line, some have very scant procedure volume and variety and alot more emphasis on seeing patients in the clinic, plus at the time of application I did not really want to do a hard core pain fellowship and lose the ability to do EMGs or MSK ultrasound or general MSK stuff, so I went with a non ACGME spine/sports,
Click to expand...


Then when applying for jobs, why not emphasize your strengths. With changing models of health care, your skill set will be in high demand. You just won't be doing as many procedures. Possibly you will be the entry point for spine cases and can send to partners for the other "pain" procedures. At the same time, you can continue to do your lumbar procedures on your own patients. Your US skills will be in demand as well.
 
RUOkie said:
Then when applying for jobs, why not emphasize your strengths. With changing models of health care, your skill set will be in high demand. You just won't be doing as many procedures. Possibly you will be the entry point for spine cases and can send to partners for the other "pain" procedures. At the same time, you can continue to do your lumbar procedures on your own patients. Your US skills will be in demand as well.
Click to expand...

yeah my spine fellowship was geared to work as entry point into spine center and basically doing preop eval for spine surgeons, triaging to various treatment options, but I did learn and feel comfortable doing and am currently doing lumbar MBB, L facet joint injections, LESI, LTESI, Caudal, SI, and Hip. but the cervical injections were not ordered very frequently and if they were it was referred to our pain medicine department or very few of our attendings did cervical injections, and the fellows did get exposure to cervical procedures, but it was basically just cervical facet injections or cervical ILESI, and very scant hands on time
 
OK, I just found this thread after posting about RF courses.

Not to bring you down, but I"m really amazed you didn't learn this in fellowship.
The supposed advantage of the non-ACGME fellowships is that most of them offer an amazing procedural experience, which is better than half the ACGMGE fellowships.

I have friends who did non-ACGME fellowships because their choice was between a shiite ACGME fellowship with a poor procedural experience or a non-ACGME interventional spine fellowship where they did 1000 cases of each bread and butter procedure, plus a 40-80 stim, pump, kypho, disco cases each.

Seriously though, cervical epidurals and RF, particularly cervical RF, are just not the things you learn from a course. You need to see 50 of them done, and then do a few hundred yourself while your attending helps your modify your technique, and you deal with complications. You can really hurt people if you're not comfortable doing these, and I mean give them a spinal cord injury or permanently paralyze one of their spinal nerves

Then when applying for jobs, why not emphasize your strengths. With changing models of health care, your skill set will be in high demand. You just won't be doing as many procedures. Possibly you will be the entry point for spine cases and can send to partners for the other "pain" procedures. At the same time, you can continue to do your lumbar procedures on your own patients. Your US skills will be in demand as well.
Click to expand...

Agree with what RUOkie said
 
Last edited:
bedrock said:
OK, I just found this thread after posting about RF courses.

Not to bring you down, but I"m really amazed you didn't learn this in fellowship.
The supposed advantage of the non-ACGME fellowships is that most of them offer an amazing procedural experience, which is better than half the ACGMGE fellowships.

I have friends who did non-ACGME fellowships because their choice was between a shiite ACGME fellowship with a poor procedural experience or a non-ACGME interventional spine fellowship where they did 1000 cases of each bread and butter procedure, plus a 40-80 stim, pump, kypho, disco cases each.

Seriously though, cervical epidurals and RF, particularly cervical RF, are just not the things you learn from a course. You need to see 50 of them done, and then do a few hundred yourself while your attending helps your modify your technique, and you deal with complications. You can really hurt people if you're not comfortable doing these, and I mean give them a spinal cord injury or permanently paralyze one of their spinal nerves



Agree with what RUOkie said
Click to expand...

your right, risk is not worth it, I will stick with what I know already and feel comfortable with, the lumbar stuff, MSK U/S, EMGs, I do not want to risk my license to add a few more spine procedures to my toolbox,
 
OP, how many did you do of each cervical porcedure in fellowship? There is an ISIS in amsterdam this fall.
 
Ok. I should be constructive. I think do a weekend cervical course then see if someone in the community will proctor you for 50 epidurals/ facets. This should be more than enough for hospital privileges and with your already developed needle skills will be adequate. This should allow you to treat 90% of spine issues.

I know a number of older Pmr attendings who were proficient performing ctfesi then switched to ilcesi several years back over safety concerns. They had to then pick up a technique, LOR that they had no experience using, on the fly. I think most perform them safely.

I had a similar experience going from Pmr residency (Go Blue) with excellent resident exposure to ctfesi but maybe 2 lumbar LOR illesi and no cervical then a gas fellowship with lots of ilcesi. There is a learning curve. It is more of a " touch" technique. Performing many "Blind" was helpful for me but hard to get training in these days. You could also perform some lower risk lumbar illesi on your own to get a feel.
 
nvrsumr said:
Ok. I should be constructive. I think do a weekend cervical course then see if someone in the community will proctor you for 50 epidurals/ facets. This should be more than enough for hospital privileges and with your already developed needle skills will be adequate. This should allow you to treat 90% of spine issues.

I know a number of older Pmr attendings who were proficient performing ctfesi then switched to ilcesi several years back over safety concerns. They had to then pick up a technique, LOR that they had no experience using, on the fly. I think most perform them safely.

I had a similar experience going from Pmr residency (Go Blue) with excellent resident exposure to ctfesi but maybe 2 lumbar LOR illesi and no cervical then a gas fellowship with lots of ilcesi. There is a learning curve. It is more of a " touch" technique. Performing many "Blind" was helpful for me but hard to get training in these days. You could also perform some lower risk lumbar illesi on your own to get a feel.
Click to expand...
like I said I already I do ILESI and LTFESI fine and comfortable, the dilemma I am trying to weigh is that is it worth the risk/time/money spent on courses of doing CILESI or C MBB or C Facet block after a weekend course and proctor time (by the way I have befriended a local PMR interventionalist who is a cervical ISIS instructor and has said many times he would be happy to have me tag along with him) vs not, I am thinking maybe not, my current hospital employer is not really pressuring me or anything about doing cervical injections or RFA, and they just agreed to buy a MSK U/S machine, so I think my time might be better spent polishing up my MSK U/S skills, versus spending time/money on doing cervical courses
 
You must log in or register to reply here.

Similar threads

D
Peripheral, imaged-guided injections, employment and credentialing
Replies
4
Views
1K
runfastnow
runfastnow
Sea Otter
Mayo Clinic Oral Board Review Course
Replies
2
Views
2K
rehab ready
R
1
Baylor Residents or Anyone Participating in the Board Review Course
Replies
0
Views
1K
15MD
1
M
Which residencies provide good MSK training?
Replies
5
Views
3K
nerve zapper
N
O
Anyone recommend any good articles?
Replies
2
Views
917
drg123
D
Top