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American Society of Interventional Pain PhysiciansTHE VOICE OF INTERVENTIONAL PAIN MANAGEMENT
LUMBAR ENDOSCOPIC SPINAL DECOMPRESSIONREVIEW COURSE AND CADAVER WORKSHOPDesignated for 15.5 AMA PRA Category 1 Credits™
JULY 12-13, 2019 | HILTON MEMPHIS
ASIPP® Educational Services | Excellence in the education of Interventional Pain Physicians
COURSE VENUEHILTON MEMPHIS 939 Ridge Lake Blvd, Memphis, TN 38120Phone: 901-684-6664
WORKSHOP VENUEMEDICAL EDUCATION & RESEARCH INSTITUTE44 South Cleveland, Memphis, TN 38104901-722-8001 | 800-360-6374http://www.meri.org
THIS COURSE IS OPEN TO PHYSICIANS ONLY
American Society of Interventional Pain Physicians2
LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION REVIEW COURSE AND CADAVER WORKSHOPJULY 12-13, 2019 | HILTON MEMPHIS
YOU’RE INVITED On behalf of the Board of the American Society of Interventional Pain Physicians (ASIPP®),
it is our privilege and pleasure to invite you to attend this Lumbar Endoscopic Spinal
Decompression Comprehensive Review Course and Hands-On Cadaver Workshop. The 1/2
day didactic course is July 12 at the Hilton Memphis and the 1 1/2 day Cadaver Workshop is
July 12-13 at the Medical Education Research Institute facility. This course meets the needs of
interventionalists based on input and needs assessment.
EDUCATIONAL OBJECTIVES/TARGET AUDIENCEThis comprehensive review course and cadaver workshop for Lumbar Endoscopic Spinal Decompression are targeted to interventional pain physicians seeking CME credit hours and an introduction or review of proven interventional techniques, as well as skills improvement.
EDUCATIONAL OBJECTIVES • Provide high-quality, competent, safe, accessible, and cost-efficient services to your patients• Improve existing skills and/or develop new skills in the delivery of Lumbar Endoscopic Spinal Decompression• Incorporate interventional techniques in treating your patients so that patients have better outcomes and reduced side effects
AMERICANS WITH DISABILITIES ACT AND SPECIAL SERVICESOrganizers fully comply with the legal requirements of the Americans with Disabilities Act and the rules and regulations thereof. If any participant in this educational activity is in need of accommodations, please contact the organizers at (270) 554-9412 at least 10 days prior to the conference.
ACCREDITATION STATEMENTThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of The Institute for Medical Studies and the American Society of Interventional Pain Physicians (ASIPP®). The Institute for Medical Studies is accredited by the ACCME to provide continuing medical education for physicians.
CATEGORY I CREDITThe Institute for Medical Studies designates the Lumbar Endoscopic Spinal Decompression Review Course and Cadaver Workshop live activity for a maximum of 15.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
ASIPP® is now an ABA Registered CME Provider.
Duplication or distribution of materials or recording of lectures without express written permission from ASIPP® is prohibited. There is NO commercial support for this course.
Laxmaiah Manchikanti, MDChairman of the Board and Chief Executive Officer, ASIPP®
Jason Capra, MD, PhDEditorial Board, Pain Physician
Sukdeb Datta, MDVice President - Strategic Alliances, ASIPP®
INVITEDFACULTY
Jason Capra, MD Hurlburt Field, FL
Sukdeb Datta, MD New York, NY
Craig Flinder, MD Clarkson, WA
George Rappard, MD Los Angeles, CA
Baher Yanni, MD East Windsor, NJ
ACCOMMODATIONS
HILTON MEMPHIS939 Ridge Lake BoulevardMemphis, TN 38120TEL: +1-901-684-6664 FAX: +1-901-762-7496
Enjoy rooms with luxurious bedding, 49-inch
flat-screen TVs, WiFi and large work desks. A
true gem among hotels in Memphis, TN, the
Hilton Memphis hotel is in the heart of the East
Memphis business district, a short distance
from top attractions. This hotel is located just
a few miles from the upscale shops, cinemas
and restaurants on Poplar Avenue. Downtown
Memphis is just a 20-minute drive and the
airport is just 15 minutes away.
COURSEDIRECTORS
American Society of Interventional Pain Physicians 3
LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION REVIEW COURSE AND CADAVER WORKSHOP
JULY 12-13, 2019 | HILTON MEMPHIS
FRIDAY | JULY 12, 2019
REVIEW COURSE FOR LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION
6:30am– 7:30am Registration and Breakfast
7:30am – 11:00am Session Chair – Jason Capra, MD
7:30am – 7:40am Introduction to Session – Jason Capra, MD
7:40am – 8:00am Patient selection in Endoscopic Spinal Decompression – George Rappard, MD
8:00am – 8:20am Identifying and Managing Complications of Lumbar Endoscopic Surgery – George Rappard, MD
8:20am – 9:00am Technical Consideration of Needle and Endoscope Placement and Manipulation – Sukdeb Datta, MD
9:00am – 9:30am BREAK
9:30am – 10:00am Patient Selection and Technical Considerations of Transforaminal Endoscopic Surgery Inside Out and Outside In – Jason Capra, MD
10:00am – 10:30am Technical Considerations of Disc Protrusion versus Extrusion
Gabriel Jasper, MD
10:30am – 11:00am Technical Considerations of Disc and Spine Decompression for Spondylolisthesis and Stenosis – Baher Yanni, MD
11:00am – 12:00am LUNCH
WORKSHOP FOR LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION
12:15pm Buses Depart from Hotel to MERI
12:45pm – 1:45pm Introduction Lecture – Laxmaiah Manchikanti, MD
2:00pm – 5:00pm HANDS-ON CADAVER WORKSHOP
5:15pm Buses Leave
6:00pm-8:00pm DINNER AND COCKTAIL RECEPTION (non-cme lecture sponsored by Legally Mine, Inc.)
American Society of Interventional Pain Physicians4
LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION REVIEW COURSE AND CADAVER WORKSHOPJULY 12-13, 2019 | HILTON MEMPHIS
SATURDAY | JULY 13, 2019
WORKSHOP FOR LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION
7:00am Buses Depart Hotel to MERI
7:30am – 7:45am REGISTRATION AND BREAKFAST
7:45am – 8:45am Introduction and Discussion – Laxmaiah Manchikanti, MD
9:00am – 12:00pm HANDS-ON CADAVER WORKSHOP
12:00pm – 1:00pm LUNCH
1:00pm – 5:00pm HANDS-ON CADAVER WORKSHOP
5:15pm Buses Depart to Hotel
CADAVER LAB COURSE LEVELS FORLUMBAR ENDOSCOPIC
SPINAL DECOMPRESSION
1. Discography
2. Needle Placement for endoscopy
3. Scope manipulation and equipment use
4. Endoscopic decompression L4/5: prone
5. Endoscopic decompression L5/S1: prone and lateral
6. Endoscopic decompression annular tear: prone
7. Free form practice
American Society of Interventional Pain Physicians 5
LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION REVIEW COURSE AND CADAVER WORKSHOP
JULY 12-13, 2019 | HILTON MEMPHIS
REGISTRANT INFORMATIONIMPORTANT. Please answer all the questions:
MEDICAL DEGREE:
m MD m DO m PhDm List other: ____________________________
PRIMARY SPECIALTY CERTIFICATION:
m Anesthesiology m Physiatrym Neurosurgery m Other: _______________________________
PAIN MEDICINE SUBSPECIALTY CERTIFICATION:
mAmerican Board of Anesthesiology m American Board of Pain Medicinem American Board of Interventional Pain Physiciansm Fellow of Interventional Pain Practice (FIPP)m Competency in Interventional Pain Management m Competency in Regenerative Medicine
SPECIALTY DESIGNATION:
m 09 - Interventional Pain Managementm 72 - Pain Managementm Other: ______________________________________
FELLOWSHIP TRAINING:
mPain Medicine m Spine Surgery m Sports Medicinem Other: ______________________________________
YEARS IN INTERVENTIONAL PAIN MANAGEMENT PRACTICE:m 0 m 1-5 m 6-10 m > 10
NUMBER OF YEARS EXPERIENCE IN LUMBAR SPINAL ENDOSCOPIC DECOMPRESSION:m 0 m 1-5 m 6-10 m > 10
TOTAL NUMBER OF PROCEDURES PERFORMED DURING PAST YEAR:
PROCEDURE TOTAL
Lumbar Discography * _________
Percutaneous Disc Decompression * _________
Lumbar Transforaminal Epidural * _________
Lumbar Interlaminar Epidural Injections * _________
Endoscopic Lumbar Disc Decompression * _________
Endoscopic Lumbar Spinal Decompression for Spinal Stenosis * _________
Endoscopic Decompression for Spondylolisthesis * _________
Endoscopic Spinal Decompression for Disc Extrusion * _________
CHOOSE YOUR CADAVER WORKSHOP LEVEL:
m Endoscopic Spinal Decompression*
m Advanced
* To participate at the Advanced Cadaver Workshop level you must have attended 2 previous ASIPP® Lumbar Endoscopic Spinal Decompression courses and performed at least 20 basic edoscopic cases. Please provide proof.
Please indicate the number of Lumbar Endoscopic Spinal Decompression courses you have attended with ASIPP and at which level; two are required for the advanced level of this course:
NUMBER OF ASIPP® LUMBAR SPINAL ENDOSCOPIC DECOMPRESSION COURSES BY LEVEL:
Basic m 0 m 1 m 2 m 3 m Other ____
Intermediate m 0 m 1 m 2 m 3 m Other ____
Advanced m 0 m 1 m 2 m 3 m Other ____
REGISTRATION PLEASE PRINT EXACTLY AS YOU WISH YOUR NAME TO APPEAR:
___________________________________________________________________________________________________NAME (FIRST) (MIDDLE INITIAL) (LAST)
_________________________________________________________________________________________ORGANIZATION
_________________________________________________________________________________________ADDRESS
_________________________________________________________________________________________CITY STATE ZIP
_________________________________________________________________________________________PHONE CELL FAX
_________________________________________________________________________________________E-MAIL
PAYMENT METHOD (Please check one):m MASTERCARD m VISA m AMERICAN EXPRESS m DISCOVER
________________________________________________________________________________________CREDIT CARD NUMBER SECURITY CODE (Back of Card) EXP. DATE
________________________________________________________________________________________NAME ON CARD
________________________________________________________________________________________AUTHORIZED SIGNATURE (required on all credit card orders)
(Your application will not be processed if payment does not accompany registration form)
RETURN COMPLETED FORM TO:ASIPP®, 81 Lakeview Drive, Paducah, KY 42001 or Fax to 270-554-5394
CANCELLATION POLICY:ASIPP reserves the right to cancel this course upon reasonable notice and will assume no financial obligation to registrants for cancellation for reasons beyond its control. Registration fees will be refunded, however, costs incurred by the registrants, such as airline or hotel fees or penalties, are the responsibility of the registrants. ASIPP requires a 30-day notice of cancellation. Cancellations must be submitted in writing by June 12, 2019. Cancellations after June 12, 2019 but prior to June 26, 2019 will forfeit 50% of their registration fee. No refunds can be made after June 26, 2019.
REGISTER ONLINE AT http://www.asipp.org/ASIPP-National-Meetings.html
LUMBAR ENDOSCOPIC DECOMPRESSION REVIEW COURSE AND CADAVER WORKSHOPPhysicians only- All registrations must be approved
* To participate at the Advanced Cadaver Workshop level you must have attended 2 previous ASIPP® Lumbar Endoscopic Spinal Decompression courses and performed at least 20 basic edoscopic cases. Please provide proof by submitting below.
Review Course and Cadaver Workshop
m $4,650 Member m $4,950 Non-Member
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