This two-day course is an intensive, hands-on program that will elevate the attendee’s knowledge and skills in the evaluation and management of spasticity and other forms of muscle overactivity. Strategies to differentiate and identify patterns of presentation and different focal and regional interventions that include neurolytic agents, neurotoxins and intrathecal medications will be discussed. World class faculty will guide small groups during hands-on training sessions. Upon completion of this course, attendees should be capable of planning and executing these procedures with a higher degree of confidence and efficiency.
(SUBJECT TO CHANGE)
Directors
Alberto Esquenazi, MD and Michael F. Saulino, MD, PhD
Faculty
Kristin E. Caldera, DO
Reza Farid, MD
Nicholas A. Godby, MD
Nicholas C. Ketchum, MD
Michael C. Munin, MD
Marilyn S. Pacheco, MD
Andrea P. Toomer, MD
Monica Verduzco-Gutierrez, MD
Thomas K. Watanabe, MD
Learning Objectives
At the completion of this course, participants will be able to:
- Identify and apply interventional techniques for management of upper and lower extremity spasticity patterns
- Utilize ultrasound, EMG and electrical stimulation guidance to perform focal chemodenervation techniques
- Identify and apply interventional techniques for management of spasticity with intrathecal baclofen therapy
- Describe various imaging techniques to troubleshoot intrathecal delivery systems
Agenda
(SUBJECT TO CHANGE)
Tuesday, November 10
7:15am – 8:00am Registration / Light Breakfast Available
8:00am – 8:15am Welcome and Introduction
Alberto Esquenazi, MD and Michael F. Saulino, MD, PhD
8:15am – 8:45am Incidence and Presentation Based on Diagnosis
Thomas K. Watanabe, MD
8:45am – 9:45am Focal Interventional Treatment Considerations
Michael C. Munin, MD
9:45am – 10:15am Case-based Discussion: Diplegic Cerebral Palsy Leading to Lower
Extremity Neurolysis
Marilyn S. Pacheco, MD
10:15am – 10:30am Break
10:30am – 11:00am Case-based Discussion: Hemiplegic Stroke Leading to Upper Extremity
Chemodenervation
Marilyn S. Pacheco, MD
11:00am – 11:30am Case-based Discussion: Paraplegic Spinal Cord Injury Leading to
Intrathecal Baclofen Therapy
Andrea P. Toomer, MD
11:30am – 12:00pm Case-based Discussion: Quadriparetic Multiple Sclerosis Leading to
Intrathecal Baclofen Disruption
Michael F. Saulino, MD, PhD
12:00pm – 1:00pm Lunch
1:00pm – 2:00pm Hands-On Skills Training: Session 1
2:00pm – 3:00pm Hands-On Skills Training: Session 2
3:00pm – 3:15pm Break
3:15pm – 4:15pm Hands-On Skills Training: Session 3
4:15pm – 5:15pm Hands-On Skills Training: Session 4
5:15pm – 6:15pm Adjournment/Networking Reception
Wednesday, November 11
7:15am – 8:00am Light Breakfast Available
8:00am – 9:00am Hands-On Skills Training: Session 5
9:00am – 10:00am Hands-On Skills Training: Session 6
10:00am – 10:15am Break
10:15am – 11:15am Hands-On Skills Training: Session 7
11:15am – 12:15pm Hands-On Skills Training: Session 8
12:15pm – 1:15pm Lunch
1:15pm – 3:00pm Focused Skills Training Sessions
3:00pm – 3:15pm Break
3:15pm – 4:45pm Focused Skills Training Sessions
4:45pm – 5:00pm Debriefing with Q&A
Hands-on Training Sessions
Tuesday afternoon and Wednesday morning will focus on:
- Pump refill with visual / palpation techniques as well as drug preparation
- Pump basic and advanced programming
- Catheter port access with visual / palpation techniques
- Lumbar puncture on a simulation model
- Ultrasound guidance for reservoir and catheter access port
- Radiographic review of pump troubleshooting techniques
- Upper and lower limb muscle identification focusing on commonly encountered patterns with simulated injections on simulation models
- Ultrasound guidance for upper and lower limb muscle and nerve localization
- Upper and lower limb nerve localization with electrical stimulation
Wednesday afternoon will feature two (2) focused training sessions. Attendees will select one to attend:
- Advanced lumbar puncture training with fluoroscopic (utilizing a C-Arm) and ultrasound guidance, and pump programming and refilling using a second system available in the market.
- Unusual chemodenervation and neurolytic techniques when severe deformities are present (toxin dilution and volume adjustment to optimize effect, motor point vs nerve block, individual finger flexor fascicles, and importance of toe flexors on gait improvement) and cervical dystonia treatment with ultrasound guided muscle identification and simulated injections.
Meals
Light continental breakfast items and lunch will be served on both days of the course.
Attire
Attendees are encouraged to dress comfortably. Scrubs are not required.
Registration
This course is Step 2 of the STEP Interventional Spasticity Certificate Program. To attend the course you must register for the full STEP program. A la carte registration for this course is not available. Click here to view program details and to register for the STEP program.