The exciting future for pain management from Dr. Vincent Galan

Vincent Galan, MD, director of the pain center at Southern Regional Medical Center in Riverdale, Ga., is triple board certified in pain medicine and a leader in pain management. Looking back on his tenure, Dr. Galan shared his thoughts on the future on pain management.

Dr. Galan will be speaking at the Becker's 16th Annual Future of Spine + The Spine, Orthopedic and Pain Management-Driven ASC Conference. To learn more and register, click here. Contact Maura Jodoin at mjodoin@beckershealthcare.com or Kristelle Khazzaka at Kkhazzaka@beckershealthcare.com for further information about sponsorship and exhibitor opportunities.

Question: How does pain management differ from 10 or 20 years ago?

Dr. Vincent Galan: I did my fellowship with Dr. P. Raj back in 1987. At that time our procedures were done based on anatomical landmarks. These procedures were “blind” since we did not used fluoroscopy. Then came fluoroscopy and more recently over the last 10 years the use of ultrasound has dramatically changed the field of regional anesthesia and pain. Ultrasound has expanded the field of procedures from the specialists to the all the anesthesia specialty, increasing safety, effectiveness and patient satisfaction.

Q: What new developments are coming to pain management? What does the future hold?

VG: In the field of pain management, procedures like endoscopic discectomy which prior was the sole field of ortho-spine or neurosurgeons, has open the field for interventional pain physicians. As reimbursement has decreased, some procedures like kyphoplasty are mostly done by interventional pain physicians or interventional radiologists. For elderly patients with spinal stenosis and neurogenic claudicaction, just 10 years ago, the only procedure to offer them was a posterior decompression and possible fusion. Now we decompress the posterior epidural space with the MILD procedure or with Superion from Vertiflex. These are 45-minute outpatient procedures approved by CMS with Level I evidence.

In the field of spinal cored stimulation, in the last five years there have been more improvements than in the previous 25. In the past three years, we have seen high-frequency, high-density and burst wave platforms being developed; also dorsal root ganglion stimulation for mononeuropathies. In the peripheral nerve stimulation field, the Stimrouter and the Sprint PNS offer great possibilities to treat chronic peripheral nerve pain and post-amputation pain. There are also ongoing neuromodulation studies targeting pelvic pain, gastroparesis and diabetic neuropathy.
So the future of pain medicine is exciting.

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