Course Outline
HOUR 1 | 10:00-10:50
I. Epidural Steroid Injections (“ESI’s”) [0.2 HRS]
A. Defining ESI’s
Three Types of ESI’s
1. Interlaminar
2. Transforaminal
3. Caudal
(i) X-ray / fluoroscopy and C-Arm
B. History of Epidural Medication Injections
C. Stated Goal for ESI’s
II. Acute vs. Chronic Conditions [0.2 HRS]
A. Defining Acute Conditions
B. Defining Chronic Conditions
C. Why is it important to differentiate between these two Conditions?
III. How Do You Pronounce That? [0.2 HRS]
A. Spinal Stenosis
B. Spondylosis
1. Spondylitis
2. Spondylolithesis
C. Herniated / Degenerative Discs
IV. Common Conditions Treated by ESI’s [0.2 HRS]
A. Spinal Stenosis
B. Spondylosis
C. Herniated / Degenerative Discs
D. Sciatica
V. Degenerative Disc Disease Overview [0.2 HRS]
A. “The Degenerative Cascade” of Degenerative Disc Disease
B. Demographics
HOUR 2 | 11:00-11:50
VI. Osteoarthritis (OA) / Rheumatoid Arthritis (RA) / Disc Desiccation / Osteophytes [0.2 HRS]
A. What is OA (i.e. degenerative disc disease)?
1. Who has OA?
2. How does OA affect people?
3. What areas of the body does OA affect?
4. Where are most ESI’s performed?
B. What is RA (i.e. immune system attacks)?
C. What is disc desiccation?
D. What are bone spurs (osteophytes)?
VII. Initial Proactive Analysis [0.2 HRS]
A. Determine “acute” vs. “chronic” as the injury or injuries are documented in the medical records.
B. How is the pain documented? AXIAL vs. RADICULAR (RADICULOPATHY)
C. What causes most radicular pain?
D. Orthopedic/Neurological Tests
VIII. Case Studies [0.5 HRS]
A. Case 1: Typical ESI Buildup
B. Case 2: Impeachment through social media posts
C. Case 3: Excerpt from deposition of expert witness regarding measurement variances in MRI readings.
D. Case 4: Aging-associated diseases presented as acute conditions.
IX. Legal News: In re Allstate [0.1 HRS]
A. Effect: Proving up past medical expenses by affidavit much more difficult than under approach previously applied.