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

Video Transcription

Video Summary

The webinar "Spasticity in Focus" hosted by Carolyn Millett from the American Academy of Physical Medicine and Rehabilitation (AAPM&R) featured experts Dr. Zachary Bohart and Dr. Michael Salino discussing building a successful interventional spasticity practice. They highlighted key resources such as spasticity guides for patients, on-demand education, spasticity member community, and updated Medicare botulinum toxin policies.<br /><br />Dr. Bohart emphasized comprehensive spasticity management using botulinum toxins (Botox, Dysport, Xeomin), intrathecal baclofen pumps, and guidance techniques like EMG or ultrasound to optimize treatment. He underscored the importance of understanding coding, billing, and financial viability, especially medication acquisition and reimbursement strategies. Marketing to local therapists, neurologists, pediatric hospitals, and rehab facilities is crucial for building a practice. Dr. Bohart illustrated practical management with a long-term MS patient case progressing from botulinum toxin to baclofen pump therapy, highlighting the importance of multi-disciplinary support, academic affiliations, and emergency triage protocols.<br /><br />Dr. Salino expanded on building interventional practices by focusing on three components: localization methods (landmark, EMG/e-stim, ultrasound, fluoroscopy), deliverables (botulinum toxins, baclofen, neurolytic agents), and disposables required for procedures. He highlighted innovation in portable devices, AI-assisted ultrasound, and upcoming treatments like cryoneurolysis. He stressed coupling procedural interventions with comprehensive conventional management including rehabilitation.<br /><br />In Q&A, both experts preferred in-office baclofen pump refills over home healthcare due to complexity and patient safety but recognized home care for remote patients. For baclofen withdrawal, intravenous benzodiazepines and monitoring are preferred over oral baclofen. Overall, interventional spasticity practice is a rewarding field with high patient need, requiring mastery of clinical, procedural, and financial skills, supported by organizations like AAPM&R.

Keywords

Spasticity management

Botulinum toxins

Intrathecal baclofen pumps

EMG guidance

Ultrasound guidance

Coding and billing

Interventional spasticity practice

Cryoneurolysis

Rehabilitation therapy

AAPM&R resources