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This presentation introduces the concept of osteogenic pain, emphasizing that bone is more than a structural tissue—it is richly innervated with nociceptive fibers, making it a significant pain generator. Evidence from human and animal studies shows dense sensory innervation in bone, similar to skin, involving C fibers. Conditions such as metastasis, fractures, and osteoedema can disturb this nociceptive system. Clinical implications include minimally invasive strategies like polymethylmethacrylate (PMMA) applications, vertebral stabilization, and combined approaches (e.g., RF ablation with PMMA) to reduce pain and enhance stability. The talk calls for further research and the adoption of new diagnostic and therapeutic methods for bone pain.
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New Concept Osteogenic Pain
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How to Think about New Wave Forms
Dr. Corey Hunter discusses the evolving landscape of neuromodulation for chronic pain management. Highlighting the shift from limited options pre-2015 to today's expanding field, he emphasizes individualized therapy selection based on condition, features, and patient preferences. Hunter critiques reliance solely on waveform efficacy and encourages considering device attributes like battery type, MRI compatibility, and remote monitoring. He introduces a decision-making framework tailored to patient needs and demonstrates that switching between neuromodulation modalities can restore effectiveness. The talk concludes with a strong message: failure of one system doesn't mean failure of the therapy—innovation and patient-centered customization are key.
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The Functional Unit
This presentation highlights the concept of biotensegrity—the interconnected nature of muscles, ligaments, fascia, and joints—and its role in chronic pain management. Dr. George Chien emphasizes that pain often arises from multiple structures, not a single pathology, requiring a shift from isolated treatments to a comprehensive approach targeting the entire functional unit. Using examples like spine degeneration, SI joint dysfunction, and knee or shoulder injuries, he advocates for precision techniques such as ultrasound-guided injections, regenerative therapies (PRP, BMAC), and fascial considerations. The key message: pain management should address the system holistically, acknowledging the structural and biomechanical relationships that contribute to persistent pain.
Device Company CEO Panel: Industry Thoughts from Company Presidents
This panel brings together top executives from leading neuromodulation and minimally invasive spine companies to discuss the current and future state of interventional pain therapies. Each leader shares insights on growth, innovation, compliance, and the need for collaboration across the industry to combat negative public perceptions, regulatory hurdles, and payer resistance. Key themes include expanding patient access, building objective data to validate therapies, elevating compliance standards, and strategically investing in advocacy and education. Panelists emphasize that while competition fuels progress, unity is essential to protect and grow the field for the benefit of patients worldwide.
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Current Advances in Closed Loop Stimulation
Dr. Cory Hunter, President of NANS, presents an in-depth overview of closed-loop spinal cord stimulation (SCS) and the breakthrough potential of ECAP-controlled therapy. He contrasts traditional open-loop systems with real-time, adaptive stimulation that adjusts automatically to patient movement and physiology. Dr. Hunter highlights the EVOKE study’s durable, long-term results and explains how ECAPs may serve as predictive biomarkers, allowing for trial-less implantation and objective pain assessment. He emphasizes the clinical implications for improving outcomes, reducing trial failure, and enhancing patient trust. This presentation signals a new era in neuromodulation and the emerging role of "electroceuticals" in pain medicine.
Watch Now
Watch Now
Watch Now
New Concept Osteogenic Pain
This presentation introduces the concept of osteogenic pain, emphasizing that bone is more than a structural tissue—it is richly innervated with nociceptive fibers, making it a significant pain generator. Evidence from human and animal studies shows dense sensory innervation in bone, similar to skin, involving C fibers. Conditions such as metastasis, fractures, and osteoedema can disturb this nociceptive system. Clinical implications include minimally invasive strategies like polymethylmethacrylate (PMMA) applications, vertebral stabilization, and combined approaches (e.g., RF ablation with PMMA) to reduce pain and enhance stability. The talk calls for further research and the adoption of new diagnostic and therapeutic methods for bone pain. Watch Now
Dr. Corey Hunter discusses the evolving landscape of neuromodulation for chronic pain management. Highlighting the shift from limited options pre-2015 to today's expanding field, he emphasizes individualized therapy selection based on condition, features, and patient preferences. Hunter critiques reliance solely on waveform efficacy and encourages considering device attributes like battery type, MRI compatibility, and remote monitoring. He introduces a decision-making framework tailored to patient needs and demonstrates that switching between neuromodulation modalities can restore effectiveness. The talk concludes with a strong message: failure of one system doesn't mean failure of the therapy—innovation and patient-centered customization are key.
How to Think about New Wave Forms
Watch Now
This presentation highlights the concept of biotensegrity—the interconnected nature of muscles, ligaments, fascia, and joints—and its role in chronic pain management. Dr. George Chien emphasizes that pain often arises from multiple structures, not a single pathology, requiring a shift from isolated treatments to a comprehensive approach targeting the entire functional unit. Using examples like spine degeneration, SI joint dysfunction, and knee or shoulder injuries, he advocates for precision techniques such as ultrasound-guided injections, regenerative therapies (PRP, BMAC), and fascial considerations. The key message: pain management should address the system holistically, acknowledging the structural and biomechanical relationships that contribute to persistent pain.
The Functional Unit
Watch Now
This panel brings together top executives from leading neuromodulation and minimally invasive spine companies to discuss the current and future state of interventional pain therapies. Each leader shares insights on growth, innovation, compliance, and the need for collaboration across the industry to combat negative public perceptions, regulatory hurdles, and payer resistance. Key themes include expanding patient access, building objective data to validate therapies, elevating compliance standards, and strategically investing in advocacy and education. Panelists emphasize that while competition fuels progress, unity is essential to protect and grow the field for the benefit of patients worldwide.
Device Company CEO Panel: Industry Thoughts from Company Presidents
Watch Now
Dr. Cory Hunter, President of NANS, presents an in-depth overview of closed-loop spinal cord stimulation (SCS) and the breakthrough potential of ECAP-controlled therapy. He contrasts traditional open-loop systems with real-time, adaptive stimulation that adjusts automatically to patient movement and physiology. Dr. Hunter highlights the EVOKE study’s durable, long-term results and explains how ECAPs may serve as predictive biomarkers, allowing for trial-less implantation and objective pain assessment. He emphasizes the clinical implications for improving outcomes, reducing trial failure, and enhancing patient trust. This presentation signals a new era in neuromodulation and the emerging role of "electroceuticals" in pain medicine.
Current Advances in Closed Loop Stimulation
Published on July 25, 2019
Dr. Jan Van Zundert discusses recent events that have caused the loss of insurance coverage for radiofrequency ablation for facet pain. He explains how JAMA’s Mint RCT findings has caused...
