The lumbar modules are the building blocks for all interventional pain physicians. As an SIS member*, you can purchase this educational offering and dive into these topics. For an optimal learning experience, it is highly recommended that you view the videos in order.

Topics covered in the lumbar modules are:

• Anatomy, Technique, and the Evidence Base
  • Interlaminar Epidural Injections
  • Transforaminal Epidural Steroid Injections(Supraneural)
  • Medial Branch Blocks
  • S1 Transforaminal Epidural Injections
• Lumbar Anatomy for the Pain Management Physician
• Needlecraft
• Principles of Fluoroscopy and Radiation Safety
• Steroid Preparations for Transforaminal Epidural Injections: Safety and Efficacy
• Procedural Safety: Risk Mitigation in Basic Lumbar Procedures

Copyright 
Materials presented in this activity have been made available by the Spine Intervention Society for educational purposes only. We reserve all rights to such material.

*Continual membership is expected to access the modules in your member profile.

Educational Objectives
Upon completion of this activity, participants should be able to:

• Analyze the imaging depiction of the relevant anatomy;
• Relate patient history and physical exam findings with imaging to achieve a likely diagnosis of the spinal pathology causing the patient’s pain or dysfunction;
• Describe the literature support for the efficacy of the procedures;
• Identify the risks and benefits of each procedure, as well as assessment, prevention, and treatment of potential complications;
• Apply technically correct performance of the spinal procedures using safe fluoroscopic guidance with minimal tissue injury or discomfort.

Speaker Disclosure Information
None of the planners or speakers had relevant financial relationships with ACCME-defined ineligible companies.

References
References are provided within the speakers presentations.

Commercial Support
No commercial support was received for this activity.

Accreditation Statement
The Spine Intervention Society (SIS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement
SIS designates this enduring material for a maximum of 5.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Date of Activity Release: 01/20/2023
Date of Activity Expiration: 01/19/2026

See why Dr. Felix Diehn, a neuroradiologist from the Mayo Clinic, is ready when the epidural gods are not smiling upon his initial plan, in a clip from the “Using MRI to Plan Transforaminal Epidural Steroid Injection” module.

The SIS Core Curriculum for Interventional Physicians: Advanced Lumbar online CME credit course provides SIS members* with exclusive access to detailed modules on:

• Advanced Lumbar Anatomy: Using MRI to Plan Transforaminal Epidural Steroid Injections
• Infraneural Transforaminal Epidural Steroid Injections: Anatomy, Technique, and Evidence Base
• Selective Nerve Root Blocks: Anatomy, Technique, and Evidence Base
• Intra-articular Facet Access: Anatomy, Technique, and Evidence Base
• Percutaneous Lumbar Z-Joint Cyst Rupture: Technique and Evidence Base
• Multi-depth, Multi-site Lateral Sacral Blocks: Anatomy, Technique, and Evidence Base
• Lumbar Transforaminal Epidural Steroid Injections: The Evidence Basis
• The Philosophical and Statistical Basis of Diagnostic Blocks
• Risk Mitigation in Lumbar Interventional Procedures
• The Evidence Basis Supporting the Use of Non-Particulate Steroids in Transforaminal Epidural Steroid Injections
• Contrast Flow Patterns in Transforaminal Epidurals: Maximizing Target Specificity and Minimizing Risk

For the optimal learning experience, it is highly recommended that you view the videos in order.

© 2023 Spine Intervention Society Materials presented in this activity have been made available by the Spine Intervention Society for educational purposes only. We reserve all rights to such material. 

*Continual membership is expected to access the modules in your member profile.

Educational Objectives
Upon completion of this activity, participants should be able to:

• Analyze the imaging depiction of the relevant anatomy;
• Relate patient history and physical exam findings with imaging to achieve a likely diagnosis of the spinal pathology causing the patient’s pain or dysfunction;
• Describe the literature support for the efficacy of the procedures;
• Identify the risks and benefits of each procedure, as well as assessment, prevention, and treatment of potential complications;
• Apply technically correct performance of the spinal procedures using safe fluoroscopic guidance with minimal tissue injury or discomfort.

Speaker Disclosure Information 

RELEVANT FINANCIAL RELATIONSHIPS WITH ACCME-DEFINED INELIGIBLE COMPANIES
Michael B. Furman, MD, MS
Grant and research support: Mesoblast/Cascade 

None of the other planners or speakers had relevant financial relationships with ACCME-defined ineligible companies.
All relevant financial relationships have been mitigated.

References
References are provided within the speakers presentations.

Commercial Support 
No commercial support was received for this activity.

Accreditation Statement  
The Spine Intervention Society (SIS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement  
SIS designates this enduring material for a maximum of 4.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Date of Activity Release: 07/05/2020  
Date of Activity Expiration: 07/04/2023

Sessions Available for Streaming

• Orthobiologics for the Treatment of Spine Pain - Moderator: Byron J. Schneider, MD
  • SIS Systematic Review on Intradiscal Biologic Treatments for Discogenic Pain - Byron J. Schneider, MD
  • Intradiscal Biologics: Pro - David Levi, MD
  • Intradiscal Biologics: Con - D. Scott Kreiner, MD
  • Biologics for Epidural Use - Nathaniel M. Schuster, MD
  • Biologics for Zygapophysial Joint  Pain- Christine Hunt, DO, MS
• SIS Systematic Review on Basivertebral Nerve Radiofrequency Neurotomy - Speaker: Aaron Conger, DO

• Coding Quick Hit: Basivertebral Nerve Radiofrequency Neurotomy - Speaker: Scott Horn, DO

• Gluteal Pain or "Pain in the Butt" - Evaluation and Ultrasound Applications - Moderator: Zachary L. McCormick, MD
  • Challenges of Sacroiliac Joint (SIJ) Pain Diagnosis - Haewon Jennifer Lee, MD
  • Posterior SIJ Complex Pain - Marzena Buzanowska, MD
  • Other Causes of Gluteal Pain - Danielle Sarno, MD
  • Ultrasound Applications-Piriformis/Ischial Bursa/Cluneal Nerve - Kate Sully, MD

• Neuromodulation in the Treatment of Non-Spinal Lower Limb Pain - Moderator: Yusef Sayeed, MD
  • Patient Selection for Dorsal Root Ganglion (DRG) Stimulation: Indications and Contraindications - Brian Boies, MD
  • DRG Stimulation: Imaging Before, During, and After Lead Placement - Lynn Kohan, MD
  • SIS Systematic Review on DRG Stimulation - Ameet Nagpal, MD, MS, MEd
  • Patient Selection for Peripheral Nerve Stimulation: Indications and Contraindications - Mark Hurdle, MD
  • Peripheral Nerve Stimulation: Imaging Before, During, and After Lead Placement - Mark Hurdle, MD
• Top Research Abstract Presentations - Moderator: David Levi, MD
  • Best Resident Abstract: Dual Medial Branch Blocks and Progression to Radiofrequency Neurotomy for Cervical Zygapophysial Arthropathy - Evan Berlin, MD
  • Best Fellow Abstract: Dual Medial Branch Blocks and Progression to Radiofrequency Neurotomy for Lumbar Zygapophysial Arthropathy - David Sherwood, DO 
  • Best Basic Science Abstract:  MRI Imaging of Cooled Radiofrequency Ablation Lesions Demonstrates Consistent Lesion Size in Respective Anatomical Locations - Mehul J. Desai, MD, MPH
  • Best Basic Science Abstract:  An Assessment of the Minimal Clinically Important Difference for the Pain Disability Quality-Of-Life Questionnaire-Spine - Robert S. Burnham, MD
  • Best Clinical Abstract: Effectivity of Platelet Rich Plasma Injection in the Intervertebral Disc - Scott Horn, DO

• Nuances of the Cervical Spine - Speakers: Timothy Maus, MD and Felix E. Diehn, MD

• Lumbar Decompression: Interspinous Spacers vs Percutaneous Decompressive Laminotomy - Moderator: D. Scott Kreiner, MD
  • Interspinous Spacer - Kam Assil, MD
  • Percutaneous Image-Guided Lumbar Decompression (PILD) - Farzad Karkandeian, DO
• Achieving Health Equity in Pain Medicine - Moderator: Joshua Rittenberg, MD
  • Introduction and Group Exercise - Yusef Sayeed, MD
  • Race and Disparities in Pain Medicine - Oludare Olatoye, MD
  • Gender and Disparities in Pain Medicine - Kate Sully, MD
  • Solutions and Suggestions for Overcoming Barriers - Marzena Buzanowska, MD
• Advances in Spinal Cord Stimulation (SCS) - Moderator: Javier De Andrés Ares, MD, PhD
  • SCS: Modes of Action - Ricardo Vallejo, MD, PhD
  • Different Waveforms: Does It Make a Clinical Difference? - David Provenzano, MD
  • Spinal Cord Evoked Potentials - Scott F. Lempka, PhD
  • SIS Systematic Review on SCS - To-Nhu Vu, MD
• COVID-19 Update - Moderator: Clark C. Smith, MD, MPH
  • Introduction - Clark C. Smith, MD, MPH
  • Reopening and Practice Pattern Changes - Lisa Huynh, MD
  • Vaccinations and Corticosteroid Injections - Haewon Jennifer Lee, MD
  • The Impact on Physician Well-Being - Akhil Chhatre, MD
• Research Abstract Podium Presentations - Moderator: David Levi, MD
  • The Incidence of Ischemic and Hemorrhagic Complications Associated with Ceasing vs Maintaining Anticoagulant and /or Antiplatelet Agents for Spine Pain Interventions Targeting the Facet Joint - Gene Tekmyster, DO
  • Wirelessly Powered, Battery-Free Peripheral Neurostimulation for the Treatment of Craniofacial Pain: Interim Results of a Prospective Randomized Controlled Trial - Nameer Haider, MD
  • Does the Severity of Neuroforaminal Stenosis Impact Short-Term Pain and Functional Outcomes After Cervical Transforaminal Epidural Steroid Injection? An Exploratory Analysis of Prospective Cohort Data - Dustin J. Randall, BS
  • Viable Disc Tissue Allograft Supplementation in the Treatment of Painful Degenerated Intervertebral Discs: The One Year Results of a Randomized Controlled Trial - Meredith Langhorst, MD
  • The Viable Disc Tissue Allograft Supplementation (VAST) Randomized Controlled Trial in Patients with Chronic Discogenic Low Back Pain: Correlating Age with Clinical Outcome - Meredith Langhorst, MD
  • Cooled Radiofrequency Ablation Provides 24 Month Durability in the Management of Osteoarthritic Knee Pain. Results from a Prospective, Multicenter, Randomized Trial - Lynn Kohan, MD
  • Rate of Discontinuation for Cervical Transforaminal Epidural Steroid Injections Using the Modified Approach in an Office-Based Setting Without Sedation - David Levi, MD
    Results of Cervical Epidural Steroid Injections Stratified by the Specialty of the Referring Physician - Joshua Levin, MD
• Influential Papers of 2020 - Moderators: W. Evan Rivers, DO and Taylor Burnham, MD
  •  Allogeneic mesenchymal precursor cells treatment for chronic low back pain associated with degenerative disc disease: a prospective randomized, placebo-controlled 36-month study of safety and efficacy. Spine J 2020. [ePub ahead of print] - Amirdelfan K, Bae H, McJunkin T, DePalma M, Kim K, Beckworth WJ, Ghiselli G, Bainbridge JS, Dryer R, Deer TR, Brown RD.
  •  Long-term outcomes following intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: 5-year treatment arm results from a prospective randomized double-blind sham-controlled multi-center study. Eur Spine J 2020;29(8):1925-1934. - Fischgrund JS, Rhyne A, Macadaeg K, Moore G, Kamrava E, Yeung C, Truumees E, Schaufele M, Yuan P, DePalma M, Anderson DG, Buxton D, Reynolds J, Sikorsky M.
• Role of Ultrasound (US) in Interventional Spine Procedures - Moderator: Richard G. Chang, MD, MPH
  • Review of the Evidence Base - Byron J. Schneider, MD
  • Hybrid SIJ Injections Are Better - Alison Stout, DO
  • Fluoroscopically-Guided SIJ Injections Are Better - D. Scott Kreiner, MD
  • Use of US In Other Sacrococcygeal Disorders - Jonathan Kirschner, MD
  • Use of US In Cervical Transforaminal Epidural Steroid Injections - Samer Narouze, MD, PhD
  • Use of US In Lumbar Facet Pain - Paul Lin, MD

In addition to these CME products, we have included the following videos for streaming:

• Presidential Address - Matthew Smuck, MD

• Charles N. Aprill, MD Tribute
• Welcome Remarks - Matthew Smuck, MD
• Contributions to Spine Science - David J. "D.J." Kennedy, MD
• The Man: His Influence and Effect on People - Timothy Maus, MD
• The Teacher - Fred DeFrancesch, MD

• Society Awards - David J. "D.J." Kennedy, MD

• Education Division Update - Alison Stout, DO

• Health Policy Division Update - D. Scott Kreiner, MD

• Research Division Update - David Levi, MD

• Standards Division Update - Milan P. Stojanovic, MD

• Fundraising Committee Update - Zachary L. McCormick, MD

Educational Objectives
Upon completion of this activity, participants should be able to:

• Identify best practices to ensure patient safety during interventional pain procedures
• Apply new research finding to the practice of ethical, evidence-based interventional pain care
• Define important patient-centered outcome measures in practice settings

Disclosure Information
Disclosure information provided in the 'Handouts' section of this product.

References
References are provided within the speakers presentations.

Accreditation Statement 
The Spine Intervention Society (SIS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement
SIS designates this enduring material for a maximum of 12.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Commercial Support
No commercial support was received for this activity.

Date of Activity Release: 10/11/2021 
Date of Activity Expiration: 10/10/2024

Description
Learn about the important elements in the safe performance of interventional pain procedures.  Adherence to these practices will help decrease the risk of preventable complications.

Authors
D. Scott Kreiner, MD; Jatinder Gill, MD; Milan P. Stojanovic, MD; and Yakov Vorobeychik, MD, PhD on behalf of the Spine Intervention Society’s Standards Division and Evidence Analysis Committee   

Copyright
Materials presented in this activity have been made available by the Spine Intervention Society for educational purposes only. We reserve all rights to such material.

Educational Objectives
Upon completion of this activity, participants should be able to:

• List contraindications to the procedure, and
• Identify best practices to ensure patient safety during interventional pain procedures.

Author Disclosure Information
None of the authors had relevant financial relationships with ACCME-defined ineligible companies.

References
References are provided within the PDF.

Accreditation Statement
The Spine Intervention Society (SIS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement
SIS designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Date of Activity Release: 8/10/2020
Date of Activity Expiration: 8/09/2023

Description
Learn about the important elements in the safe performance of interventional pain procedures. Adherence to these practices will help decrease the risk of preventable complications.

Authors
Fred DeFrancesch, MD; Milton H. Landers, DO, PhD; Kevin Martinez, MD; George Rappard, MD; Milan P. Stojanovic, MD; and Yakov Vorobeychik, MD, PhD on behalf of the Spine Intervention Society’s Standards Division and Evidence Analysis Committee   

Copyright
Materials presented in this activity have been made available by the Spine Intervention Society for educational purposes only. We reserve all rights to such material.

Educational Objectives
Upon completion of this activity, participants should be able to:

• List contraindications to the procedure, and
• Identify best practices to ensure patient safety during interventional pain procedures.

Author Disclosures Information 
RELEVANT FINANCIAL RELATIONSHIPS WITH ACCME-DEFINED INELIGIBLE COMPANIES
Kevin Martinez, MD
Stock Options: Discgenics

None of the other authors had relevant financial relationships with ACCME-defined ineligible companies.
All relevant financial relationships have been mitigated.

References
References are provided within the PDF.

Accreditation Statement
The Spine Intervention Society (SIS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement
SIS designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Date of Activity Release: 8/14/2020
Date of Activity Expiration: 8/13/2023

Educational Objectives
Upon completion of this activity, participants should be able to:

• List contraindications to the procedure, and
• Identify best practices to ensure patient safety during interventional pain procedures.

Author Disclosure Information 
None of the authors had relevant financial relationships with ACCME-defined ineligible companies.

References
References are provided within the PDF.

Accreditation Statement
The Spine Intervention Society (SIS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement
SIS designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Date of Activity Release: 8/14/2020
Date of Activity Expiration: 8/13/2023

Educational Objectives
Upon completion of this activity, participants should be able to:

• List contraindications to the procedure, and
• Identify best practices to ensure patient safety during interventional pain procedures.

Author Disclosure Information
None of the authors had relevant financial relationships with ACCME-defined ineligible companies.

References
References are provided within the PDF.

Accreditation Statement
The Spine Intervention Society (SIS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement
SIS designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Date of Activity Release: 8/10/2020
Date of Activity Expiration: 8/09/2023

Educational Objectives 
Upon completion of this activity, participants should be able to:

• List contraindications to the procedure, and
• Identify best practices to ensure patient safety during interventional pain procedures.

Author Disclosure Information 
None of the authors had relevant financial relationships with ACCME-defined ineligible companies.

References
References are provided within the PDF.

Accreditation Statement
The Spine Intervention Society (SIS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement
SIS designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Date of Activity Release: 8/10/2020
Date of Activity Expiration: 8/09/2023

Educational Objectives 
Upon completion of this activity, participants should be able to:

• List contraindications to the procedure, and
• Identify best practices to ensure patient safety during interventional pain procedures.

Author Disclosure Information 
None of the authors had relevant financial relationships with ACCME-defined ineligible companies.

References
References are provided within the PDF.

Accreditation Statement
The Spine Intervention Society (SIS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement
SIS designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Date of Activity Release: 8/12/2020
Date of Activity Expiration: 8/11/2023

Educational Objectives 
Upon completion of this activity, participants should be able to:

• List contraindications to the procedure, and
• Identify best practices to ensure patient safety during interventional pain procedures.

Author Disclosures Information  
None of the authors had relevant financial relationships with ACCME-defined ineligible companies.

References
References are provided within the PDF.

Accreditation Statement
The Spine Intervention Society (SIS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement
SIS designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Date of Activity Release: 8/12/2020
Date of Activity Expiration: 8/11/2023