Customer Reviews

Interventional Pain Management

5 star:		(2)
4 star:		(1)
3 star:		(0)
2 star:		(1)
1 star:		(1)

 

 

This review pertains to the 2nd edition 2008 release of this title.

Per the back cover of the book:
"See exactly how to proceed via a DVD of video clips, demonstrating proper patient positioning and difficult procedures..."

This is one of the major reasons I purchased this book, and likely one of the major reasons other people are considering this book.

However, the DVD only covers THREE different procedures! They are:
1. Hypogastric Plexus Block
2. Lumbar sympathetic block
3. Splanchnic nerve block

This is all that is on the DVD!!! Out of the dozens if not hundreds of procedures in this textbook, why only videos of these three? They are by no means the most difficult pain procedures to master, nor are they very commonly employed in *most* pain practices, with the exception of the lumbar sympathetic block for CRPS/RSD.

Furthermore, these video clips were not made for this book, they are recycled videos from the University of Texas Pain Department that were filmed long ago, and sold under by the World Institute of Pain on its website on a DVD called "Instructional DVD Video #1 for interventional pain treatment techniques." So, I already had the exact same videos which I had purchased from the WIP previously! What a disappointment!

Secondly, these videos have a commercial agenda in employing only the Epimed curved blunt tip needles, which are an invention of Dr. Racz and manufactured by Epimed, whose President is Dr. Racz' son!

Other than
1. Only three techniques covered
2. Commercial bias

I think the video is quite good. But one would think there should be dozens of techniques on this DVD not just three!

Good Book!

This is no doubt the most comprehensvie interventional pain management book that has been published so far. The value of having it on your bookshelf for quick reference during practice and for continued self improvement as an interventionist is of great significance. However, it is far from perfection.

Part I, "Anantomy and Physiology of Pain: Clinical Correlates" serves as the basic review of Anantomy and Pharmacology of pain processing system. The best chapter in this part is the "Functional Anatomy of the Spine" which contains detailed description and illustration of spine innervation from Atlantooccipital joint to lumbosacral facet, intervetebral discs, spinal nerves, etc. A concise review on techniques on performing selective diagnostic injections of the spinal axis at the end of this chapter including discography, nerve root sleeve approach and facet joint makes this chapter much more clinically relavant.

Part III, "Neural Blockade and Neurolytic Blocks", describes and demonstrates A to Z interventional techniques for blocking both neuroaxial and peripheral nerves. The chapters on radiofrequency techniques are very well written, thorough and easy to follow. However, it would be much better if authors included procedure codes for such procedrues as Rhizotomy of SI joint, RF lesioning of ramus communicans nerve, Ganglionotomy of cervical, thoracic and lumbar levels, RF lesioning of lumbar disc of which the procedural codes are no where to be found. I personally have been struggling to find such codes for the above techniques in my practice. The chapters on performing sympathetic block at various levels are also clearly illustrated and easy to follow, which serve well as the guide for performing these blocks in comparion to other interventional books which lack such content. Nervertheless, Part III also has many weaknesses. In fact, some of the techniques introdueced are rather old and obsolete especially when judging from the progress achieved in interventional pain management by 2001, but unfortunately without being incorporated into this section. E.g, most well trained interventional pain specialists will agree that fluoroscopy serves as "eyes" for the intervetionist, however, some of the chapters discussing neuroaxial intervential techniques do not even have any fluoroscopic image, such as the chapter on lumbar epidural block as well as the one on Sacroiliac joint injection. The worst chapter of all is the "Sacroiliac Joint Injection and Low Back Pain". First of all as mentioned above, it does not have any fluroscopic picture. Secondly, the patient was placed "supine position" instead of prone, yet, the "PSIS" was identified? How can someone identify PSIS from front? Let's just assume this is a "typo" error. Even so, no matter how many times I read through the procedural description, I still could not figure out how this was done. For someone like me, who is Board Certified in American Board of Physical Medicine and Rehabilitation, American Board of Pain Medicine, an interventional pain management fellowship trained spine interventionist, who simply could not make sense of such a simple procedre from its description. I wonder whether the author who wrote this chapter really knew how to perform SI joint injection. Maybe it means that this portion should be re-written. This is actually the main reason that I give this book 4 stars rating despite there are many other chapters that are very well written and useful for interventional pain practice. Another shortcoming is that some of the commonly performed procedures such selective nerve root block or transforaminal epidural were nerver even mentioned in Part III, but I think, should have been done so, although in the Chapeter of "Functional Anatomy of the Spine" of part I, selective nerve root sleeve appraoch was briefly introduced, it should also be here in Part III as this is the neural blockade section. Lastly, many of the interventionists consider "Selective Nerve Root Block"(SNRB) and/or Transforaminal Epidural Injection (TFEI) "bread and butter" of spine intervention, yet, this "most comprehensive interventional pain bible" with close to 800 pages does not even have them in its word index, which undoubtedly impacts negatively on its authority.

Part IV & Part V, "Neuroaugmentation" & "Spinal Administration of Opioids & Other Analgesic Compounds" are the best work of this book. They are the best resoures available for spinal cord stimulation and intrathecal drug delivery pump. The authors did outstanding work in writing up these chpaters and introducing to readers step by step the mechanisms, patient selection, implantation techniques and complications. The chapters on intrathecal drug delivery pump has helped my practice tremendously. However, the only shortingcoming is that it does not have chapter addressing Intrathecal Baclofen pump for Spasticity and Spasticity related pain syndromes. There are quite a number of patients with spasticity disorders due to brain injury, spinal cord injury, multiple sclerosis, etc, requiring implanted intrathecal baclofen pump. However, there is severe lack of resources in guiding the long term management of such patients, ie, maximal drug concentration, maximal daily drug dosage, drug holidays, etc.

The purpose of this review is also to give the editors some of the feedback from interventional pain physicians like me so as to extract more "nutrients" from its contributors in the future and to make the Third Edition a greater success, in addition to share my experience from learning this book and utilizing what I have learned in the practice of interventional pain managent.

good book for fellows, details about most procedures, nice diagrams and pictures. I recommend it for all fellows in pain meds.

In the last 2 weeks the price has come down from $1300 to $1000. At that price it should make margaritas also. It may be a good book for fellows but only attendings can afford it.

Excellent description of each topic.No necessity to refer any further text books on the topic.Excellent description of procedure techniques. Good review of the indications, contraindications and complications of each procedure. Relevant X ray pictures and diagrams.