In the past, this might have been a philosophical question to be considered. Recent advances in technique and equipment, combined with the severity of the Opioid Crisis have encouraged the development of a new strategy that focuses on curing pain. The pressure from government and insurance companies to control narcotic use is changing the emphasis of a “pain practice” from managing pain to curing it when possible. The current concept of pain “management” may not even be a viable strategy for the future.
What would it be like for you and your patients if you could “cure” many painful conditions of the spine? Is it even possible? I believe the answer to this question is-Yes.
There are many painful spine conditions that can be cured with endoscopic spine surgery. These conditions include lumbar, thoracic, cervical facet syndrome as well as annular tears. These are the conditions that have been “managed” temporarily in the past by using ablation, injections or medications. However, endoscopic spine surgery can permanently eliminate or considerably reduce the pain from these conditions.
These courses are designed primarily for the pain management doctor who wants to bring endoscopic surgery into their practice to cure pain instead of managing it. Government, Insurance companies and Big Pharma are making it known that “Pain Management” with opioids is no longer a viable practice strategy and patients want alternatives to fusion surgery. Failed back surgery is something that needs to be avoided at all costs.
When I say “primarily designed for pain management doctors”, I want to clarify a few things:
One, these courses are primarily designed to treat painful conditions of the spine frequently seen in a pain management office.
Two, many of these painful problems are not typically of much interest to spine surgeons as they are not located inside of the spinal canal.
Three, these conditions can be difficult to diagnose since there is usually no imaging study that shows the source of pain.
Four, these painful conditions are usually diagnosed with a block of some sort, typically done by a pain management doctor.
Five, these courses show how to use endoscopic spine surgery to cure these “soft tissue” problems rather than managing them.
I’ve taught many courses over the years for various companies at their meetings and they are good instructional courses, but they didn’t show a clear pathway of progression from easy to more difficult. The other component missing was the “how to” element needed to implement the techniques and procedures into a pain practice. If you didn’t do a procedure within a few weeks of attending a course, it probably wouldn’t happen because, until now, there was no easy way to review the procedure in detail.
This is a series of four courses designed to establish a pathway for the pain management doctor to follow to become an endoscopic specialist. The pathway should begin with a low risk, confidence building procedure, like lumbar facet debridement, to begin your endoscopic experience. These courses show how to treat problems that most fellowship trained spine surgeons aren’t interested in. You will learn how to treat painful conditions of the spine that are not in the spinal canal. This will allow you to introduce a unique skill set (endoscopic spine surgery) into your community and avoid unnecessary conflict with the existing hierarchy.
Each course is comprised of 9 modules and designed to elevate your confidence by showing you all the details necessary to perform an endoscopic procedure. These details are never revealed in company courses or meetings, but are very necessary for you to get going and succeed. These details are the CPT codes for your office staff, pick sheets for your operating room, your facility needs in terms of consent, equipment, room setup and anesthesia requirements. We even include a video that demonstrates the ideal positioning of the endoscope. When you have this information at your fingertips, your resistance to doing these cases will be reduced considerably, even if you haven’t done one in a while. Module 6 in each course shows a detailed video of a surgical procedure that you can review as often as you like.
Finally, there must be some discussion about marketing and the benefits of treating a problem that is already experienced by patients in your office.
I’ve had a 100% endoscopic spine surgery practice since 1998, purchased my first transforaminal instrument tray in 2001, and have never performed a fusion. I have performed thousands of these procedures and instructed endoscope techniques around the world. Over the years, I was able to combine state-of-the-art endoscopic equipment with some basic science to develop a “cure” for facet syndrome and annular tears in many cases. The procedure and results were published in a paper I co-authored (International Journal of Medical Sciences) in 2010. Properly implemented, these courses can transform the lives of your patients and your practice, whether it is a legal, insurance or cash practice.
Jason Capra, M.D.
I have been performing endoscopic spine procedures for 7 years and have attended a multitude of training workshops and conferences. The cervical facet course taught by Dr. Mork was one of the best educational experiences I have had in the field of spinal endoscopy. Nothing is left out of this training series, as Dr. Mork takes you from diagnosis, to selective injection, to the procedure, and finishes with the specifics of documentation and coding. This is truly a complete curriculum for cervical facet treatment with the endoscope, and I have put his technique into effect immediately in my practice. I leave most courses with inspiration and hope regarding a new technique, but I finished his course with confidence and a complete knowledge of the procedure including tips on complication avoidance. Thanks to the online aspect of his course, I can continually check back to watch the procedure videos as well as refresh my memory on the specifics of documentation, coding, and anatomy. This is essential since there is often a delay between a training course and the application of the technique, which can be a significant barrier to performing a new procedure. Prior to my first case I reviewed the anatomical and procedural videos and found a renewed sense of confidence that allowed me to perform a safe and effective endoscopic intervention.
In summary, this course is essential for anyone that has basic endoscopic experience with the spine and is looking to expand their practice into the cervical area. I cannot stress enough how impressed I was with the straightforward and comprehensive manner in which this course was laid out. I look forward eagerly to continued training by Dr. Mork through his online endoscopic academy!
Jason Capra, M.D.
George Rappard, M.D.
Cervical facet pain is a common problem encountered by physicians who treat spinal pain. Endoscopic cervical facet debridement is an intriguing method to treat facet pain by directly addressing the injured or pain generating anatomy. Potential targets for endoscopic treatment are the posterior joint capsule, the posterior synovium and hypertrophied joint margins.
Dr. Mork’s course addresses all aspects of the procedure from A to Z. While many courses focus on patient selection and technical procedure aspects, Dr. Mork’s course covers important topics not usually seen elsewhere like scheduling and consent, draping and OR disposables, dictation and billing. The meat and potatoes of the course though is the intraoperative presentation. This is well covered and the endoscopic portion of the procedure plays well to an educational medium that uses video.
There is a lack of comprehensive endoscopic learning materials. Dr. Mork’s Endoscopic Spine Academy fills a badly needed void in standardizing endoscopic spine surgery education and will nicely complement vendor and professional society sponsored courses.
George Rappard, MD
Neurointerventional Surgery and Endoscopic Spine Surgery
Los Angeles Minimally Invasive Spine Institute
• Course #1 in the Series • 9 video modules guide you through the entire process of a Lumbar Facet Debridement and Rhizotomy for Facet Syndrome. • ESA Members-only Forum • Safe, Beginner Level Course * If you purchase an online course and then decide that you want to attend a lab intensive, you will receive a $1497 credit that will be applied to the lab intensive.
• Course #2 in the Series • 9 video modules to guide you through the entire process of a Cervical Facet Debridement and Rhizotomy for Facet Syndrome • ESA Members-only Forum * If you purchase an online course and then decide that you want to attend a lab intensive, you will receive a $1497 credit that will be applied to the lab intensive.
• Course #3 in the Series • 9 video modules guide you through the entire process of a Thoracic Facet Debridement and Rhizotomy for Facet Syndrome • Exclusive Members only Forum * If you purchase an online course and then decide that you want to attend a lab intensive, you will receive a $1497 credit that will be applied to the lab intensive.
• Course #4 in the Series • 9 video modules to guide you through the entire process of a Transforaminal Facet Debridement and Rhizotomy for Facet Syndrome • ESA Members-only Forum * If you purchase an online course and then decide that you want to attend a lab intensive, you will receive a $1497 credit that will be applied to the lab intensive.
Each course is comprised of 9 modules that include the following: 1. Overview of Problem 2. Diagnostics 3. Schedule and Consent 4. Instruments 5. Anesthesia and Positioning 6. Video of Procedure 7. Post Op Care 8. How to do Dictation 9. Billing.
Each course has video of the actual surgery being performed with live audio. It's like you're right there!
Do you ever go to a meeting and come home with a new skill set? I’ve attended several and taught many. While valuable in the informational sense, there are a few common problems with using a corporate or organizational meeting to learn a new skill set.
No single focus. There are a wide variety of people with vastly different experiences that show up at meetings or courses, so numerous topics must be presented to accommodate various levels of experience. There just isn't enough time to present a topic from A-Z. This means that you can spend thousands of dollars for a meeting, take off the time to travel and attend, and still not come home with a new, accessible skill set. Corporate offerings are great but often try to show too much without a guided pathway from easy to difficult.
Experience of Instructors. We’ve all heard it, “see one, do one, teach one”. You also know that the level of instruction is very different from one person to another and between the instructor who has done 10 cases or the fellow with1000 cases over 20 years. The intricate details of a procedure can be the difference between average and great outcomes.
Lack of billing information. You and your office must have a clear idea of the correct billing codes and financial expectations of a surgical procedure before investing in equipment, not to mention your time. The correct dictation has a big effect on reimbursement too.
What your facility needs to know. There is nothing worse than showing up for a procedure and then not knowing how to properly set the room up or not having a critical piece of equipment. Your facility relies on you to provide them with your needs and the optimal set up. We provide you with the information they need.
Information retention. How many times have you been to a course or meeting and learned something that you wanted to try back at home? However, by the time you saw that particular problem in the office, too much time had passed and you didn’t remember all the details of a particular procedure, so you never implemented it. Wouldn’t an online course that you could access 24/7 be nice?
You can take time off work to attend expensive courses, but how often do you return home with an in-depth knowledge of a specific endoscopic skill set that is appropriate for your level of progression and with the expectation of reasonable reimbursement?
It took me 20 years to learn these skills that I can teach you in a few hours and shorten your time needed to become an endoscopic spine specialist.
Why not be the first in your area to offer a cure for pain instead of managing it? The Opioid Crisis insures that government and insurance companies will continue to apply pressure against using narcotics to manage pain. More importantly, patients want a “cure” not management of their pain. Patients don’t want a fusion and are searching for alternatives. One great alternative for you and your patients is endoscopic spine surgery. These courses are a great way to provide you with positive options.