Development of interdisciplinary spinal interventional pain centers

Abstract

The lifetime prevalence of spinal pain has been reported as 65% to 80% in the neck and low back. In the US each year, 500,000 - 1,000,000 spine surgeries and 2 to 5 million interventional procedures are estimated to be performed. The burden created by chronic pain is enormous on the patient and society. Thus, the somatic, psychological, and physical manifestations of pain must be addressed in the overall assessment and treatment of these patients. A myriad of treatment options exist for patients in pain however, with none of the modalities providing conclusive evidence in their effectiveness. The optimal course of care requires an integrated delivery system involving a variety of specialists. Due to the complexities of diagnosis and management, patients are best managed utilizing a multi-disciplinary approach under an umbrella of services offered by a spinal diagnostic and interdisciplinary pain center. This review identifies various pain syndromes and conditions and provides a model for the establishment of an interdisciplinary pain center as well as the resources, guidelines, and infrastructure required for operating a successful pain center in any setting; free-standing, hospital-based, or academic.