Spasticity in Focus: Expert Conversations in PM&R, Ways to Build a Successful Interventional Spasticity Practice-Session Recording

Video Transcription

Video Summary

In this comprehensive webinar hosted by the AAPM&R, Dr. Zachary Bohart and Dr. Michael Salino share expert insights on building a successful interventional spasticity practice. They emphasize spasticity as a common but underserved condition, highlighting the importance of a comprehensive approach including botulinum toxins, baclofen pumps, and orthopedic EMGs. Dr. Bohart stresses mastering all botulinum toxin types and using guidance tools like EMG and ultrasound for injections to optimize outcomes and billing. He details managing intrathecal baclofen pumps, advocating for academic partnerships to share call duties and access resources, and discusses marketing strategies focused largely on therapists and rehabilitation facilities. He illustrates care principles through a patient case involving MS treated with tailored toxin doses, baclofen trials, and pump management.<br /><br />Dr. Salino complements this by discussing the three pillars of interventional spasticity practice: localization techniques (visual, EMG/e-STIM, ultrasound, fluoroscopy), deliverables (botulinum toxins, baclofen, anesthetics), and disposables needed for procedures. He reviews handheld versus traditional ultrasound devices, emerging AI technology, and billing considerations. Both speakers caution about financial viability, insurance complexities, and the challenges of home infusion services for baclofen pump refills, preferring direct physician-managed care. They also address acute baclofen withdrawal management, underscoring the limited role of oral baclofen and the need for prompt IV treatment.<br /><br />They encourage leveraging AAPM&R resources, spasticity member communities, and continuing education while emphasizing the rewarding impact and growing opportunities in spasticity care. The session closes with Q&A and highlights calls for filling knowledge gaps, optimizing billing, and integrating conventional and interventional treatments for best patient outcomes.

Keywords

interventional spasticity practice

botulinum toxins

baclofen pumps

orthopedic EMG

ultrasound guidance

intrathecal baclofen management

localization techniques

AI in ultrasound

billing strategies

acute baclofen withdrawal