Episodes

  • Ep. 67 Introduction to Treatment of Discogenic Back Pain with Dr. Olivier Clerk-Lamalice

    Ep. 67 Introduction to Treatment of Discogenic Back Pain with Dr. Olivier Clerk-Lamalice
    Feb 4 2025
    Degenerative disc disease, a major cause of low back pain, is the most common musculoskeletal issue worldwide, affecting an estimated 15-30% of the population. In this episode of BackTable MSK, interventional radiologists Dr. Olivier Clerk-Lamalice and Dr. Jacob Fleming cover symptomatic degenerative disc disease, focusing on its diagnosis and treatment with anesthetic injections. This is the first episode in a two-part series on discogenic back pain. --- This podcast is supported by: Medtronic Interventional https://www.medtronic.com/interventional --- SYNPOSIS Dr. Clerk-Lamalice begins by explaining the pathophysiology of disc degeneration, which can lead to painful annular tears and loss of disc height. The doctors also reflect on the history of discography, from provocative discograms to the more recent anesthetic and CT discograms. They review the modified Dallas Discogram Classification for annular tears, the vacuum disc phenomenon, and the importance of dynamic imaging to assess treatment candidacy. Dr. Clerk-Lamalice emphasizes the need to correlate imaging with physical examination to better identify the symptomatic disc level. The episode also discusses the challenges of managing multi-level disc degeneration and underscores the importance of early-stage intervention. --- TIMESTAMPS 00:00 - Introduction 02:44 - Pathophysiology of Disc Degeneration 06:49 - Evolution of Discography 12:55 - Classification of Annular Tears 09:01 - Diagnostic Tools and Techniques 14:00 - CT Discogram and Annular Tear Classification 17:12 - Dynamic Aspects and Instability 22:20 - Identifying Symptomatic Disc Level 28:25 - Treatment Approaches and Patient Selection --- RESOURCES BackTable MSK Ep. 13- Basivertebral Nerve Ablation with Dr. Olivier Clerk-Lamalice: https://www.backtable.com/shows/msk/podcasts/13/basivertebral-nerve-ablation Modified Dallas Discogram Classification System: https://pubmed.ncbi.nlm.nih.gov/2954226/
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    39 mins
  • Ep. 66 Dr. Kieran Murphy on Creativity in Medicine

    Ep. 66 Dr. Kieran Murphy on Creativity in Medicine
    Jan 28 2025
    Many physicians are perfectly positioned to recognize areas of clinical need, so why are so few of them involved in medical innovation? In this episode of BackTable MSK, Dr. Kieran Murphy discusses the ideal circumstances and critical characteristics of physician innovators. Dr. Murphy is an interventional neuroradiologist, a professor at the University of Toronto, and a medical device innovator who has made significant contributions to the field, including the development of the Murphy needle for vertebral augmentation. --- This podcast is supported by an educational grant from: Medtronic https://www.medtronic.com/ --- SYNPOSIS Dr. Murphy talks about his recent book, “The Essence of Invention: Medicine and the Joy of Creativity,” which chronicles key innovations in interventional radiology. The book focuses specifically on the characteristics and circumstances of the innovators themselves. Dr. Murphy became interested in this topic after noticing patterns of innovation that clustered around certain institutions and leaders. He shares his insights on innovation, including the idea that innovation peaks during fellowship, the importance of uninterrupted reflective time for creativity, and how building long-term relationships can be essential for generating ideas and gaining support. He also discusses his work on ozone therapy, the development of the Murphy needle, and the significance of securing small-scale funding through patient donations for research. Additionally, Dr. Murphy touches on his upcoming books and explores the essential fusion of medicine and the liberal arts. --- TIMESTAMPS 00:00 - Introduction to the Podcast 02:05 - The Role of Creativity in Interventional Radiology 09:52 - Inspiration Behind The Book 14:51 - Environments for Inventors to Flourish 25:18 - Use of Honey in Biopsies 31:32 - Advice for Physician Innovators 45:02 - Balancing Career and Family 51:23 - Upcoming Book 56:31 - Innovations in Radiation Protection 59:45 - The Future of Medical Education --- RESOURCES The Essence of Invention: Medicine and the Joy of Creativity: https://www.amazon.com/Essence-Invention-Medicine-Joy-Creativity/dp/1459754034
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    1 hr and 6 mins
  • Ep. 65 Robotics Revolution in Interventional Radiology with Dr. Sean Tutton and Dr. Raj Narayanan

    Ep. 65 Robotics Revolution in Interventional Radiology with Dr. Sean Tutton and Dr. Raj Narayanan
    Jan 21 2025
    Robot-assisted technology has revolutionized surgical fields such as general surgery and urology—could interventional radiology be the next frontier? In this episode of the BackTable podcast, host Dr. Jacob Fleming explores the transformative potential of robotic-assisted percutaneous biopsies and ablations with experts Dr. Govindarajan “Raj” Narayanan from the Miami Cancer Institute and Dr. Sean Tutton from UC San Diego. --- This podcast is supported by: Quantum Surgical https://www.quantumsurgical.com/ --- SYNPOSIS Dr. Narayanan begins by sharing his initial interest in robotic applications for tumor ablations, aiming to maximize efficiency in his practice. Dr. Tutton then highlights the advantages of robotics for probe placement, especially in challenging cases. The two doctors discuss the logistics of the robotic system, including setup, imaging, and access choices. They also reflect on the learning curve associated with robotics and how it gradually enhances procedural efficiency while reducing mental fatigue. This improvement allows them to take on more complex cases with confidence. Overall, both experts agree that robotics has the potential to democratize minimally invasive procedures, offering new opportunities for skill development and advancement within the field of interventional radiology. --- TIMESTAMPS 00:00 - Introduction to the Podcast 03:30 - Developing an Interest in Robotics 10:44 - Integration of Robotics in the Procedural Suite 13:27 - Logistics of Robot System 18:38 - Planning for Percutaneous Access 22:39 - Future Implications of Robotics on Training Programs 35:51 - Efficiency and Volume Management with Robotics 40:39 - Learning Curves for Robotic Procedures 48:09 - Conclusion and Final Thoughts --- RESOURCES Quantum Surgical Epione Robot: https://www.quantumsurgical.com/epione/ ACCLAIM Trial: https://www.sio-central.org/ACCLAIM-Trial
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    56 mins
  • BackTable Brief: Genesis 2 Trial Design and Challenges for GAE with Dr. Mark Little

    BackTable Brief: Genesis 2 Trial Design and Challenges for GAE with Dr. Mark Little
    Jan 7 2025
    What evidence is currently available regarding the use of genicular artery embolization (GAE) for treating knee osteoarthritis? Principal investigator Dr. Mark Little discusses the GENESIS 2 trial, a large randomized controlled study aimed at assessing the outcomes of embolizing abnormal genicular arteries to reduce pain in patients with mild to moderate knee osteoarthritis. Dr. Little explains the trial’s design, methodology, and the significance of key data points such as the Knee Injury and Osteoarthritis Outcome Score (KOOS), cost-effectiveness, and quality of life measures. He also covers the materials and techniques used in both the GENESIS 1 and 2 trials, the neuropsychological tests integrated into the study, and potential geographic and anatomical challenges encountered during GAE. Dr. Little highlights the importance of high-quality research and data to support the procedure's efficacy and safety. TIMESTAMPS 00:00 - Overview of GENESIS 2 Trial 04:42 - Embolic Materials and Techniques 09:10 - Challenges in Patient Anatomy & Comorbidities 12:40 - Final Thoughts CHECK OUT THE FULL EPISODE Exploring GAE: Clinical Insights & Outcomes with Dr. Mark Little https://www.backtable.com/shows/msk/podcasts/50/exploring-gae-clinical-insights-outcomes
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    15 mins
  • BackTable Brief: Getting Started with MSK Embolizations with Dr. Mark Little

    BackTable Brief: Getting Started with MSK Embolizations with Dr. Mark Little
    Dec 31 2024
    For patients suffering from intractable pain due to knee osteoarthritis, genicular artery embolization (GAE) offers a minimally invasive treatment with potential long-term benefits. Dr. Mark Little, an interventional radiologist at Royal Berkshire NHS Foundation Trust, joins us to provide an introduction to GAE. He shares his experience with the procedure and compares it to other treatments, such as steroid injections and surgery. Dr. Little also discusses the disease process of osteoarthritis and explains how GAE targets abnormal blood vessels to reduce inflammation and alleviate pain. TIMESTAMPS 00:00 - Introduction 03:38 - Understanding Knee Osteoarthritis 06:57 - Patient Selection for GAE 08:57 - Challenges and Opportunities in GAE 12:18 - Safety and Procedure Details CHECK OUT THE FULL EPISODE Exploring GAE: Clinical Insights & Outcomes with Dr. Mark Little https://www.backtable.com/shows/msk/podcasts/50/exploring-gae-clinical-insights-outcomes
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    15 mins
  • Ep. 64 Advanced Kyphoplasty Techniques with Dr. Glade Roper

    Ep. 64 Advanced Kyphoplasty Techniques with Dr. Glade Roper
    Dec 20 2024
    How can we ensure long-term spine health after tumor ablation? In this follow-up to our previous discussion, Dr. Glade Roper returns to the show to focus on early kyphoplasty treatment for ablation patients, aiming to prevent kyphosis and postural fatigue syndrome. --- This podcast is supported by an educational grant from: Medtronic https://www.medtronic.com/ --- SYNPOSIS Dr. Roper provides detailed advice on performing kyphoplasty effectively, including methods to ensure optimal cement fill and the use of various tools. He also discusses the challenges of treating irradiated bones, the importance of restoring sagittal alignment for patients, and the need to accurately assess fracture morphologies on imaging. --- TIMESTAMPS 00:00 Kyphoplasty Tips and Tools 10:05 Impact of Radiation Therapy on the Spine 15:43 Cement Injection Techniques 25:00 Prevention of Postural Fatigue Syndrome 30:12 Fracture Morphology on Imaging 34:33 Balancing Work and Personal Life --- RESOURCES BackTable MSK Ep. 63- Building a Bone Tumor Ablation Practice, Part 1: https://www.backtable.com/shows/msk/podcasts/63/building-a-bone-tumor-ablation-practice-part-1 BackTable VI Ep. 211- Extra-Spinal Augmentation & The Future of Vertebral Augmentation: https://www.backtable.com/shows/vi/podcasts/211/extraspinal-augmentation-the-future-of-vertebral-augmentation Kyphon V System: https://www.medtronic.com/en-us/healthcare-professionals/products/spinal-orthopedic/vertebral-augmentation/vertebroplasty/kyphon-v-premium-vertebroplasty-platform.html
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    41 mins
  • Ep. 63 Bone Tumor Ablation: Techniques and Insights with Dr. Glade Roper

    Ep. 63 Bone Tumor Ablation: Techniques and Insights with Dr. Glade Roper
    Dec 17 2024
    Spine metastases are often painful and can impair a patient's ability to lie flat for radiation therapy. However, radiofrequency ablation (RFA) can address the bulk of the tumor and provide significant pain relief, enabling the patient to undergo radiation therapy. In this episode of BackTable MSK, musculoskeletal radiologist Dr. Glade Roper discusses his experience with spinal tumor RFA, his role on a multidisciplinary oncology team, and key considerations when planning for ablation. --- This podcast is supported by an educational grant from: Medtronic https://www.medtronic.com/ --- SYNPOSIS Dr. Roper emphasizes that RFA should be viewed as an adjunct to radiation therapy rather than a replacement. He reviews the procedural steps for RFA and explains the basic mechanisms of the device. Additionally, Dr. Roper shares his experience with placing intrathecal pain pumps post-ablation to manage residual pain. Finally, he offers advice on patient and caregiver education, focusing on how to deliver comprehensive, easily understandable information. --- TIMESTAMPS 00:00 - Introduction 01:57 - Building Relationships with Radiation Oncologists 01:42 - Overview of Bone Tumor Ablation 06:23 - Pre-Procedural Considerations 09:13 - The Role of Pain Pumps 14:04 - Stepwise Patient Education 19:57 - Procedural Technique --- RESOURCES OPuS One Study: https://pubmed.ncbi.nlm.nih.gov/33129427/ BackTable VI Ep. 211- Extra-Spinal Augmentation & The Future of Vertebral Augmentation: https://www.backtable.com/shows/vi/podcasts/211/extraspinal-augmentation-the-future-of-vertebral-augmentation
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    34 mins
  • BackTable Brief: Why Cryoneurolysis to Treat Pain? with Dr. Aron Chary

    BackTable Brief: Why Cryoneurolysis to Treat Pain? with Dr. Aron Chary
    Dec 10 2024
    With the breadth of minimally invasive pain management techniques that are now available, it can be challenging to sort through the options and determine the most appropriate treatment for your patient. In this BackTable Brief, Dr. Aron Chary provides an overview of cryoneurolysis and its role in interventional pain management. He describes the advantages of cryoneurolysis compared to other methods, including its potential for longer-term pain relief and unique ability to promote nerve regeneration. He also delves into procedural protocols, including the use of diagnostic nerve blocks before cryoneurolysis, and the importance of managing patient expectations and follow-up care. TIMESTAMPS 00:00 - Understanding Cryoablation for Pain 01:38 - Comparing Cryoablation with Other Modalities 04:41 - Patient Expectations and Outcomes 06:22 - Case Studies and Clinical Experiences 08:35 - Challenges in Pain Management CHECK OUT THE FULL EPISODE BackTable MSK Podcast Episode #49 Chilling Solutions: Cryoneurolysis in Clinical Practice with Dr. Aron Chary: https://www.backtable.com/shows/msk/podcasts/49/chilling-solutions-cryoneurolysis-in-clinical-practice
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    15 mins