Spine & Nerve Brian Joves, M.D.

In this episode of the Spine & Nerve podcast, join Brian Joves, MD for an enlightening conversation with Mike Ochoa, DPT, a passionate advocate for fitness in aging populations.
Dr. Mike brings valuable insights into the importance of exercise, particularly weightlifting, in promoting longevity and overall well-being as we age. Discover the truth behind common misconceptions about aging and exercise, and learn how to tailor fitness routines to individual needs and goals.
Key Takeaways:

Learn why weightlifting is a powerful tool for enhancing muscle health and longevity in older adults.
Understand the importance of challenging, albeit sometimes uncomfortable, exercise for optimal improvement.
Explore the benefits of resistance training in preventing age-related conditions like sarcopenia and osteoporosis.
Gain insights into debunking myths surrounding aging and exercise, fostering a mindset of empowerment and possibility.
Discover practical strategies for creating personalized exercise programs that cater to individual abilities and aspirations.

Tune in to gain valuable wisdom and actionable advice from Dr. Mike Ochoa, and embark on a journey toward maximizing fitness and vitality in your golden years.


find Dr. Mike on YouTube, IG, TikTok @MovewithDrMike (https://www.youtube.com/@MovewithDrMike  )


Connect with Dr. Joves on Linkedin or X

Follow @spinenerve on Youtube, IG


This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve.

Episode Summary:Join Dr. Jason Kung and Dr. Brian Joves for an in-depth discussion on the latest in neuromodulation. This episode covers a range of topics from the North American Neuromodulation Society 2024 Annual Meeting highlights to a journal club traversing the topics of spinal cord stimulation, closed-loop technology, and the impact of paraspinal muscle atrophy on vertebral endplates. With a blend of expert insights and a review of recent studies, this episode offers a comprehensive look into the advancements and challenges within the field of neuromodulation.

Key Points Discussed:
North American Neuromodulation Society Meeting Recap: Dr. Kung shares his experiences and key takeaways from the event, highlighting the growing interest in SI joint fusion and the lack of major announcements in neuromodulation waveforms.

MRI Compatibility in Neuromodulation Devices: The hosts delve into the importance of MRI compatibility, discussing the implications for patient care and device selection.

The Evoke Study and Closed-Loop Stimulation: An in-depth review of the 36-month data from the Evoke trial, which compares closed-loop spinal cord stimulation to traditional open-loop systems. The study's findings on pain relief and the potential for closed-loop technology to revolutionize patient outcomes are explored.

Paraspinal Muscle Atrophy and Spinal Health: A discussion on a recent study examining the association between paraspinal muscle atrophy and vertebral endplate degeneration, underscoring the importance of physical therapy and core strength in pain management.

Notable Quotes:"
The development of the space is not just about this waveform versus that waveform, but understanding that there are many factors that play into patient success." - Dr. Brian Joves
"With ECAPs, we're moving towards a two-way feedback system in spinal cord stimulation, akin to how a pacemaker works." - Dr. Jason Kung
Closing Thoughts:The episode wraps up with reflections on the potential of neuromodulation technologies and the importance of continued innovation to improve patient care. The hosts also express interest in seeing how closed-loop stimulation and other advancements will perform in real-world settings.

Connect with Us:
Find Dr. Jason Kung or Dr. Brian Joves on LinkedIn
Connect with the podcast on YouTube, IG and Facebook @ SpineNerve

Be sure to share, like and subscribe!

Upcoming Episodes:Stay tuned for future discussions on groundbreaking studies in pain management and neuromodulation, along with guest appearances from leaders in the field.

References:
Mullins CF, Harris S, Pang D. A retrospective review of elevated lead impedances in impedance-dependent magnetic resonance-conditional spinal cord stimulation devices. Pain Pract. 2024; 24: 270–277. https://doi.org/10.1111/papr.13301.

Mekhail NA, Levy RM, Deer TR, et al ECAP-controlled closed-loop versus open-loop SCS for the treatment of chronic pain: 36-month results of the EVOKE blinded randomized clinical trial Regional Anesthesia & Pain Medicine Published Online First: 27 August 2023. doi: 10.1136/rapm-2023-104751

Schönnagel, Lukas et al. Understanding the Interplay Between Paraspinal Muscle Atrophy and Lumbar Endplate Degeneration: A 3-Year Longitudinal Study. Spine 48(23):p 1627-1634, December 1, 2023. | DOI: 10.1097/BRS.0000000000004826

Pritzlaff et al. A Review of the Factors and Outcomes of Institutional Interdisciplinary Neuromodulation Committees: A Multicenter Experience. Neuromodulation. February 06, 2024

Disclaimer:

Reminder that the information provided is for educational purposes and is not intended as medical advice. Always consult with a healthcare professional.

In this episode of The Spine & Nerve Podcast, Dr. Dr. Jason Kung and Dr. Brian Joves have a reflective and forward-looking discussion as we transition from 2023 into 2024, sharing our podcast's journey, personal insights, biggest happenings in pain medicine, and anticipations for the new year.

1. Podcast Journey and Global Reach:

Transitioning through 2023: The evolution of our podcast through the year.

Spotify Wrapped Insights: A deep dive into our audience demographics, celebrating a significant international listenership with a special shoutout to our friends in New Zealand, India, Spain, Brazil, and Hungary.

2. Engaging Medical Discussions:

Spotlight Episode - Spinal Stenosis: Discussion on why our spinal stenosis episode resonated with so many listeners and the importance of addressing prevalent health issues.
Medical Innovations and Literature: A look back at the year's significant advancements in radiofrequency ablation and the evolving landscape of pain management.

3. Personal Reflections and Resolutions:

Embracing Challenges: The team's participation in a Spartan Race, symbolizing our dedication to personal growth and community engagement.

4. Community Impact and Listener Engagement:

Top 10 Recognition: Celebrating being in the top 10 of listeners' favorite podcasts and what it means to us.
Listener Interaction: Encouraging feedback, stories, and engagement from our global audience.

5. Looking Forward to 2024:

Medical Community and Conferences: Anticipation for upcoming medical conferences, new technologies, and the continuing battle against the opioid crisis.

Optimism for the Future: Our commitment to staying informed, optimistic, and ready to tackle the challenges and opportunities the new year brings.

Closing Thoughts:

A heartfelt thank you to all our listeners for their continued support and engagement. We look forward to another year of learning, growth, and community.


Contact Information:

We Encourage listeners to stay connected through our social media channels (LinkedIn, YouTube, Twitter (X), and Facebook are the easiest), website, and Spotify Podcast page for feedback, questions, and community stories.

Disclaimer:

Reminder that the information provided is for educational purposes and is not intended as medical advice. Always consult with a healthcare professional.

In this episode of the Spine & Nerve Podcast, Dr. Brian Joves has the distinct pleasure to welcome Dr. Andrea Furlan to the show. Dr.
Furlan is a pain specialist in Toronto Canada. She is a physiatrist (specialist in Physical Medicine & Rehabilitation). She holds a
medical degree from the University of Sao Paulo and a Ph.D. degree from the University of Toronto. She has 30 years of experience helping people
with chronic pain to get better quality of life.

In this insightful conversation, Dr. Furlan shares her vast experience in managing chronic pain, addressing key aspects of pain management that
are crucial for medical providers to understand.

Key Takeaways:

1. The Complexity of Chronic Pain:

Chronic pain is a multifaceted condition with complex neurobiological and psychosocial components. Understanding the diverse factors
contributing to chronic pain is essential for medical providers to provide effective care.

2. The Role of Empathy and Communication:

Dr. Furlan emphasizes the importance of empathy and active listening when interacting with patients in pain. Effective communication skills
are crucial for building trust and facilitating patient-doctor relationships.

3. Educating Patients:

Educating patients about their condition and treatment options is a fundamental aspect of pain management. Medical providers should learn
how to explain complex medical concepts in simple terms to ensure patient comprehension.

4. The Value of Multidisciplinary Approaches:

Chronic pain often requires a multidisciplinary approach, involving various healthcare professionals such as physiatrists, psychologists,
and physical therapists.

5. The Impact of Lifestyle Modifications:

Lifestyle modifications, including diet, exercise, sleep, and stress management, play a significant role in pain management.

6. Emotions and Pain Perception:

Emotions can influence pain perception, making it essential for medical students to consider the emotional well-being of patients.

7. Patient Support and Online Communities:

Dr. Furlan discusses the value of patient support groups and online communities, where individuals with chronic pain can share their
experiences and learn from one another. Medical providers can explore these resources to better understand patient perspectives.

8. Dr. Furlan's Book - A Resource for providers:

Dr. Furlan's book, which outlines eight steps for managing chronic pain, is recommended for medical providers looking to deepen their knowledge
of pain management. The book provides practical insights and strategies for patient care.



Medical providers should embrace the holistic approach to chronic pain management, considering both the physical and emotional aspects of the
condition. Dr. Furlan's expertise and insights shared in this episode offer valuable lessons for aspiring healthcare professionals in the
field of pain medicine.


This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain
to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not
represent the views of Spine & Nerve.

You can find Dr. Furlan at:
https://www.youtube.com/ @DrAndreaFurlan 
https://www.doctorandreafurlan.com/
X  @adfurlan 
IG @dr.andrea.furlan

In this episode of the Spine & Nerve Show, Dr. Robert Bowers joins Dr. Brian Joves to discuss the progression of young athletes in throwing sports, such as baseball. He emphasizes the importance of allowing children to play multiple sports and avoid specializing too early. Dr. Bowers also highlights the risks associated with overuse injuries and the need for rest periods. He discusses the role of mechanics and training programs in preventing injuries and increasing velocity. Dr. Bowers also touches on the use of biologics, such as PRP, in the treatment of injuries in young athletes.​

About The Guest: Dr. Robert Bowers is a sports medicine physician at Emory in Atlanta, Georgia. He specializes in the treatment of throwing athletes and has a particular interest in baseball injuries. Dr. Bowers has extensive experience working with athletes at all levels, including professional baseball players and college athletes. He is passionate about helping athletes optimize their performance and prevent injuries.​

Key Takeaways:
- Young athletes should play multiple sports to develop athleticism and motor skills.
- Rest periods are crucial for preventing overuse injuries in young athletes.- Proper mechanics and training programs can help prevent injuries and increase velocity.
- Weighted ball programs can increase velocity but also carry an increased risk of injury.
- Biologics, such as PRP, can be used to treat certain injuries in young athletes.​

Quotes:
"If these kids can take three months of throwing off, four months, even better, that should be good to allow their arm to rest."-
"The harder you throw, the more at risk your arm is."
"Velocity gets kids noticed, but it also increases injury risk."
"Weighted ball programs increase velocity but also increase injury risk."
"The way to deal with increased intensity is to decrease volume."

In this episode of the Spine & Nerve podcast, Dr. Jason Kung and Dr. Brian Joves delve into a comprehensive discussion surrounding anticoagulation guidelines and their implications in interventional pain procedures.

With over a hundred thousand downloads and over 1,000 YouTube subscribers, we would like to express our sincere gratitude to all the listeners for your engagement and support. Please continue to share and subscribe to help more people discover the podcast.



Today's episode focuses on the safety of epidural steroid injections and the critical role of anticoagulation management.Understanding the rationale behind a patient's anticoagulation therapy is vital for interventional pain physicians. This approach empowers clinicians to make informed decisions about whether to continue or withhold anticoagulation medications prior to procedures. There is a delicate balance between patient-specific risks and the benefits of these interventions.



One of the things that must be known and emphasized is the remarkable safety profile of epidural steroid injections. Approximately nine million epidural steroid injections are administered annually, resulting in an adverse event rate of about one in 780,000. This reassuring statistic is attributed to the collaborative efforts of medical societies and the implementation of strict anticoagulation guidelines. The hosts emphasize the role of fluoroscopic guidance, non-particulate steroids, and avoidance of deep sedation in enhancing the safety of these procedures.



The episode further delves into the nuances of assessing bleeding risks in patients undergoing interventional pain procedures. As always, we must underscore the importance of a comprehensive physical examination, with a specific focus on identifying signs of easy bruising and mucosal bleeding. The hosts discuss the relevance of specific medications, including aspirin and NSAIDs, and their implications for procedural safety.



The hosts engage in an insightful exploration of the guidelines for managing anticoagulation medications pre- and post-procedure. They stress the need for pain physicians to consider the anatomical location of the intervention and evaluate the potential risks versus benefits.



The doctors conclude the episode by highlighting the crucial role of shared decision-making and patient education. By fostering collaboration between patients and physicians, the hosts emphasize the creation of a safe and informed healthcare environment.In this thought-provoking episode, the doctors try to help you navigate the complexities of anticoagulation management in interventional pain procedures, and offer some insights for practitioners seeking to provide the highest level of care to their patients.



References:



Anesthesia Quality Institute Closed Claims Database Review 2011 through 2021 for Epidural Steroid Complications. Naeem Haider. Pain Physician 26 (3), E251, 2023

Stephen Endres, MD and others, The Risks of Continuing or Discontinuing Anticoagulants for Patients Undergoing Common Interventional Pain Procedures, Pain Medicine, Volume 18, Issue 3, March 2017, Pages 403–409, https://doi.org/10.1093/pm/pnw108

Narouze S, Benzon HT, Provenzano D, et alInterventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications (Second Edition): Guidelines From the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, the American Academy of Pain Medicine, the International Neuromodulation Society, the North American Neuromodulation Society, and the World Institute of PainRegional Anesthesia & Pain Medicine 2018; 43:225-262.

The ASRA App: https://www.asra.com/the-asra-family/asra-app