ASIPP Educational Services Excellence in the education of Interventional Pain Physicians LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION COMPREHENSIVE REVIEW COURSE 7 AMA PRA Category 1 Credits (Plus Free Online Lectures) AND CADAVER WORKSHOP 11 AMA PRA Category 1 Credits OCTOBER 5-7, 2018 MEMPHIS COURSE VENUE HILTON MEMPHIS 939 Ridge Lake Boulevard, Mephis, TN TEL: 1-901-684-6664 FAX: 1-901-762-7496 CADAVER WORKSHOP VENUE MEDICAL EDUCATION & RESEARCH INSTITUTE 44 South Cleveland, Mephis, TN 38104 (901) 722-800 (800) 360-6374 SPECIALS Special roo rates through Septeber 13, 2018 AMERICAN SOCIETY OF INTERVENTIONAL PAIN PHYSICIANS The Voice of Interventional Pain Manageent
YOU RE INVITED On behalf of the Board of the Aerican Society of Interventional Pain Physicians (ASIPP ), it is our privilege and pleasure to invite you to attend this Lubar Endoscopic Spinal Decopression Coprehensive Review Course and Hands-On Cadaver Workshop. The 1 day didactic course is October 5 at the Mephis Hilton and the 1.5 day Cadaver Workshop is October 6-7 at the Medical Education Research Institute facility. This course eets the needs of interventionalists based on input and needs assessent. EDUCATIONAL OBJECTIVES/TARGET AUDIENCE This coprehensive review course and cadaver workshop for Lubar Endoscopic Spinal Decopression are targeted to interventional pain physicians seeking CME credit hours and an introduction or review of proven interventional techniques, as well as skills iproveent. EDUCATIONAL OBJECTIVES Provide high-quality, copetent, safe, accessible, and cost-efficient services to your patients Iprove existing skills and/or develop new skills in the delivery of Lubar Endoscopic Spinal Decopression Incorporate interventional techniques in treating your patients so that patients have better outcoes and reduced side effects AMERICANS WITH DISABILITIES ACT AND SPECIAL SERVICES Organizers fully coply with the legal requireents of the Aericans with Disabilities Act and the rules and regulations thereof. If any participant in this educational activity is in need of accoodations, please contact the organizers at (270) 554 9412 at least 10 days prior to the conference. ACCREDITATION STATEMENT This activity has been planned and ipleented in accordance with the accreditation requireents and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of The Institute for Medical Studies and the Aerican Society of Interventional Pain Physicians (ASIPP ). The Institute for Medical Studies is accredited by the ACCME to provide continuing edical education for physicians. CATEGORY I CREDIT The Institute for Medical Studies designates the Lubar Endoscopic Spinal Decopression Review Course live activity for a axiu of 7 AMA PRA Category 1 Credits and the Lubar Endoscopic Spinal Decopression Cadaver Workshop live activity for a axiu of 11 AMA PRA Category 1 Credits. Physicians should clai only the credit coensurate with the extent of their participation in the activity. ASIPP is now an ABA Registered CME Provider. Duplication or distribution of aterials or recording of lectures without express written perission fro ASIPP is prohibited. There is NO coercial support for this course. ACCOMMODATIONS HILTON MEMPHIS 939 Ridge Lake Boulevard Mephis, TN 38120 TEL: +1-901-684-6664 FAX: +1-901-762-7496 Enjoy roos with luxurious bedding, 49-inch flat-screen TVs, WiFi and large work desks. A true ge aong hotels in Mephis, TN, the Hilton Mephis hotel is in the heart of the East Mephis business district, a short distance fro top attractions. This hotel is located just a few iles fro the upscale shops, cineas and restaurants on Poplar Avenue. Downtown Mephis is just a 20-inute drive and the airport is just 15 inutes away. In order to ake your hotel reservation is with the ASIPP roo block rate let the hotel know you are with the ASIPP Meeting. COURSE DIRECTORS Laxaiah Manchikanti, MD Chairan of the Board and Chief Executive Officer, ASIPP Frank J.E. Falco, MD First Executive VP, ASIPP Jason Capra, MD, PhD Editorial Board, Pain Physician Sukdeb Datta, MD Vice President - Strategic Alliances, ASIPP FACULTY Sheri Albers, DO Sacraento, CA Jason Capra, MD Hurlburt Field, FL Sukdeb Datta, MD New York, NY Frank Falco, MD Newark, DE Laxaiah Manchikanti, MD Paducah, KY Kent Reley, MD Newnan, GA Doug Spiel, MD Edison, NJ Baher Yanni, MD East Windsor, NJ 2 Aerican Society of Interventional Pain Physicians
FRIDAY, OCTOBER 5, 2018 REVIEW COURSE FOR LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION 7:00 a 8:00 a BREAKFAST AND REGISTRATION 8:00 a 9:30 a Morning Session Chairperson - Frank Falco, MD 8:00 a 8:30 a Introduction - Frank Falco, MD 8:30 a 9:00 a Spinal Stenosis: Overview, Diagnosis, and Classification - Kent B. Reley, MD 9:00 a 9:30 a Lubar Disc Pathology: Overview, Diagnosis, and Classification - Sheri L. Albers, DO 9:30 a 10:30 a BREAK 10:30 a 12:00 p Session Chairperson : Sukdeb Datta, MD 10:30 a 11:00 a Technical Considerations: Needle Placeent and Manipulation Sukdeb Datta, MD 11:00 a 11:30 a Technical Considerations: Endoscope Placeent and Manipulation - Jason Capra, MD 11:30 a 12:00 p Technical Considerations: Transforainal Endoscopic Surgery: Inside Out Frank Falco, MD 12:00 p 12:55 p LUNCH 1:00 p 3:00 p Afternoon Session Chairperson - Jason Capra, MD 1:00 p 1:30 p Technical Considerations: Transforainal Endoscopic Surgery: Outside In Frank Falco, MD 1:30 p 2:00 p Indications & Efficacy: Transforainal Endoscopic Surgery - Sukdeb Datta, MD 2:00 p - 2:30 p Technical Considerations: Disc Protrusions vs. Extrusion - Frank Falco, MD 2:30 p 3:00 p Technical Considerations: Disc Decopression L4/5 and L5/S1 -Sukdeb Datta, MD 3:00 p 3:30 p BREAK 3:30p 5:30p Session Chairperson - Jason Capra, MD 3:30 p 4:00 p Technical Considerations: Lubar Endoscopic Facet Joint Rhizotoy - Kent Reley, MD 4:00 p 4:30 p Technical Considerations: Disc & Spinal Decopression for Spondylolisthesis - Jason Capra, MD 4:30 p 5:00 p Technical Considerations: Other Applications - Obesity & Elderly - Sukdeb Datta, MD 5:00 p 5:30 p Panel Discussion Panel Chair - Jason Capra, MD Panelists - Kent Reley, MD, Frank Falco, MD, Sukdeb Datta, MD 5:30 p 7:00 p MEET & GREET WITH EXHIBITORS Aerican Society of Interventional Pain Physicians 3
SATURDAY, OCTOBER 6, 2018 CADAVER WORKSHOP FOR LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION SHUTTLE TO CADAVER WORKSHOP FACILITY REGISTRATION AND BREAKFAST 8:00 a 8:45 a Overview of Cadaver Workshop - Laxaiah Manchikanti, MD 9:00 a 12:00 p HANDS-ON CADAVER WORKSHOP 12:00 p 1:00 p LUNCH 1:00 p 5:00 p HANDS-ON CADAVER WORKSHOP SHUTTLE TO HOTEL SUNDAY, OCTOBER 7, 2018 CADAVER WORKSHOP FOR LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION SHUTTLE TO CADAVER WORKSHOP FACILITY REGISTRATION AND BREAKFAST 9:00 a 12:00 p HANDS-ON CADAVER WORKSHOP SHUTTLE TO HOTEL LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION CADAVER LAB COURSE PROCEDURES INTERMEDIATE ADVANCED 1. Discography 2. Percutaneous disc decopression 3. Needle placeent for endoscopy 4. Scope anipulation and equipent use 5. Endoscopic decopression L4/5 6. Endoscopic decopression L5/S1 7. Endoscopic decopression for annular tear 8. Free foru practice 1. Endoscopic decopression L4/5 2. Endoscopic decopression L5/S1 3. Endoscopic decopression for annular tear 4. Interlainar Approach 5. Decopression for spinal stenosis 6. Decopression for spondylolisthesis 7. Free foru practice 4 Aerican Society of Interventional Pain Physicians
REGISTRATION REGISTRANT INFORMATION IMPORTANT. Please answer all the questions: MEDICAL DEGREE: MD DO PhD List other: _ PRIMARY SPECIALTY CERTIFICATION: Anesthesiology Neurosurgery Physiatry Other: PAIN MEDICINE SUBSPECIALTY CERTIFICATION: Aerican Board of Anesthesiology Aerican Board of Pain Medicine Aerican Board of Interventional Pain Physicians Fellow of Interventional Pain Practice (FIPP) Copetency in Interventional Pain Manageent Copetency in Regenerative Medicine PLEASE PRINT EXACTLY AS YOU WISH YOUR NAME TO APPEAR: NAME (FIRST) (MIDDLE INITIAL) (LAST) ORGANIZATION ADDRESS CITY STATE ZIP PHONE FAX E-MAIL SPECIALTY DESIGNATION: 09 - Interventional Pain Manageent 72 - Pain Manageent Other: FELLOWSHIP TRAINING: Pain Medicine Spine Surgery Sports Medicine Other: YEARS IN INTERVENTIONAL PAIN MANAGEMENT PRACTICE: 0 1-5 6-10 > 10 NUMBER OF YEARS EXPERIENCE IN LUMBAR SPINAL ENDOSCOPIC DECOMPRESSION: 0 1-5 6-10 > 10 TOTAL NUMBER OF PROCEDURES PERFORMED DURING PAST YEAR: PROCEDURE Lubar Discography Lubar Transforainal Epidural Lubar Interlainar Epidural TOTAL LUMBAR ENDOSCOPIC DECOMPRESSION REVIEW COURSE AND CADAVER WORKSHOP Physicians only- All registrations ust be approved 1 day Review Course and 1.5 day Cadaver Workshop 1 day Review Course only $4,650 Meber $4,950 Non-Meber $1,000 Meber $1,100 Non-Meber PAYMENT METHOD (Please check one): MASTERCARD VISA AMERICAN EXPRESS DISCOVER CREDIT CARD NUMBER SECURITY CODE (Back of Card) EXP. DATE NAME ON CARD Endoscopic Lubar Disc Decopression Endoscopic Lubar Decopression for Spinal Stenosis Endoscopic Decopression for Lubar Spondylolisthesis Endoscopic Lubar Decopression for Disc Extrusion Percutaneous Disc Decopression AUTHORIZED SIGNATURE (required on all credit card orders) (Your application will not be processed if payent does not accopany registration for) 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 assue 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 ust be subitted in writing by Septeber 6, 2018. Cancellations after Septeber 6, 2018 but prior to Septeber 21, 2018 will forfeit 50% of their registration fee. No refunds can be ade after Septeber 21, 2018. REGISTER ONLINE AT http://www.asipp.org/asipp-national-meetings.htl Aerican Society of Interventional Pain Physicians 5
Aerican Society of Interventional Pain Physicians 81 Lakeview Drive, Paducah, KY 42001 LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION COMPREHENSIVE REVIEW COURSE 7 AMA PRA Category 1 Credits (Plus Free Online Lectures) AND CADAVER WORKSHOP 11 AMA PRA Category 1 Credits OCTOBER 5-7, 2018 MEMPHIS COURSE VENUE HILTON MEMPHIS 939 Ridge Lake Boulevard, Mephis, TN TEL: 1-901-684-6664 FAX: 1-901-762-7496 CADAVER WORKSHOP VENUE MEDICAL EDUCATION & RESEARCH INSTITUTE 44 South Cleveland, Mephis, TN 38104 (901) 722-800 (800) 360-6374 SPECIALS Special roo rates through Septeber 13, 2018 PRSRT STD U.S. POSTAGE PAID PADUCAH, KY PERMIT #44