American Society of Interventional Pain PhysiciansThe Voice of Interventional Pain Management since 1998

SpinaL Cord StimuLation

Comprehensive review Course and Cadaver workshop

up to 14.75 AMA PRA Category™ 1 Credits

oCt 21-22, 2016 | orLando, FLorida

HoSt HoteL:Caribe royale

8101 world Center drive, orlando FL 32821407-238-8000 direct | 800-823-8300 reservation

Cadaver WorkSHop LoCation:university of Central Florida, College of medicine

6850 Lake nona Blvd., orlando, FL 32827

SpeCiaLS:• $100 (per book) for Interventional Techniques in

• Chronic Spinal Pain and Chronic Non-Spinal Pain at Meeting for Attendees• 50% Off Meeting Fee to Fellows & Residents

• Special Early Bird room rates

ASIPP® Educational Services | Excellence in education of Interventional Pain Physicians

AmericAn Society of interventionAl PAin PhySiciAnS2

SpinaL Cord StimuLation Comprehensive review Course and Cadaver workshopoCt 21-22, 2016 | orlando, Florida

From tHe CHairman oF tHe Board and Ceo

The American Society of Interventional Pain Physicians (ASIPP®) is pleased to bring you a comprehensive review course on spinal cord stimulation. We invite you to attend this unique didactic and hands-on cadaver workshop October 21-22, 2016 in Orlando, Florida.

We have created a state-of-the-art educational program featuring didactics covering key aspects of intermediate and advanced spinal cord stimulation followed by a comprehensive hands-on cadaver workshop utilizing the newest SCS technology.

You will be exposed to techniques that are rarely taught at other courses. This in-depth review course and comprehensive spinal cord stimulation cadaver workshop will cover all the important aspects of these techniques and provide a comprehensive overview of the subject, with extensive case discussions, and interaction with renowned and expert faculty.

It is planned as a CME activity to prepare physicians seeking credentialing and as an excellent introduction to emerging technology in spinal cord stimulation. During this 2-day event, you can not only improve existing skill but also learn new skills.

We are confident that you will find this comprehensive review course and hands-on cadaver workshop to be beneficial, as it is essential to learn new and relevant information to survive in today’s medical environment.

We hope you will make plans to attend. The seminar will be conducted at the Caribe Royale and the university of Central Florida, College of medicine. Make your plans early to attend. We look forward to seeing you in Orlando. If you have any questions, please feel free to contact me at 81 Lakeview Drive, Paducah, KY 42001, phone: 270-554-9412 or e-mail: drm@asipp.org

Thank you,

Laxmaiah manchikanti,mdChairman of the Board and Chief Executive Officer, ASIPP®

C o u r S e d i r e C t o r S

Laxmaiah manchikanti, mdChairman of the Board and Chief Executive Officer, ASIPP®

ramsin m. Benyamin, mdpast president, asipp®

aaron k. Calodney, mdpresident, asipp®

AmericAn Society of interventionAl PAin PhySiciAnS 3

SpinaL Cord StimuLation Comprehensive review Course and Cadaver workshopoCt 21-22, 2016 | orlando, Florida

deSCription

This 2-day comprehensive review course and hands-on cadaver workshop will describe and demonstrate the techniques of spinal cord stimulation. The desired outcome is for physicians to integrate various aspects of the interventional pain management techniques of spinal cord stimulation into the treatment of patients in order to provide better outcomes and reduced side effects for patients.

The cadaver workshop includes a hands-on learning experience in the interventional techniques used for spinal cord stimulation through the utilization of cadavers. Participants will experience a comprehensive and thorough learning opportunity, focusing on the evolution of spinal cord stimulation.

This program is designed for interventional pain physicians as a review, skills improvement, or to assist in obtaining credentials. It is the most in-depth, comprehensive, and individualized program available for spinal cord stimulation in the United States, featuring maximum hands-on training with cadavers in a state-of-the-art facility and maximum ability to interact with other participants with pre and post-didactic courses.

C-arms and state-of-the-art equipment are utilized in this course. Participants are requested to dress in casual attire or scrubs. Leaded aprons and thyroid shields will be provided, however, participants are advised to bring their own protective eyewear.

Lab Stations:1. thoracic placement, traditional2. Cervical placement3. ipG implantation and tunneling4. retrograde lead placement5. Wireless

oBjeCtiveS

Describe the delivery of multiple aspects of spinal cord stimulation and demonstrate improved skill levels. Outcome: integration of multiple aspects of spinal cord stimulation in treating patients for better outcomes and reduced side effects.

tarGet audienCe/purpoSe

The ASIPP Spinal Cord Stimulation Review Course and Hands-on Cadaver Workshop is designed for interventional pain physicians. The seminar is planned as a CME activity as an in-depth review of interventional techniques. This review course will be based on the specifications of the cadaver workshop. The cadaver workshop is offered to improve the delivery of multiple aspects of interventional pain management. The desired outcome is to integrate multiple aspects of spinal cord stimulation in treating your patients so that patients have better outcomes and reduced side effects.

ameriCanS WitH diSaBiLitieS aCt and SpeCiaL ServiCeS

Organizers fully comply with the legal requirements of the Americans with Disabilities Act and the rules and regulations thereof. If any participant in this educational activity is in need of accommodations, please contact the organizers at (270) 554-9412 at least 10 days prior to the conference.

aCCreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of The Institute for Medical Studies and the American Society of Interventional Pain Physicians (ASIPP®). The Institute for Medical Studies is accredited by the ACCME to provide continuing medical education for physicians.

ASIPP® is now an ABA Registered CME Provider.

CateGory i Credit

The Institute for Medical Studies designates this live activity for a maximum of 14.75 AMA PRA Category 1 Credits ™ for the Spinal Cord Stimulation Comprehensive Review Course and Cadaver Workshop. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Physicians of Osteopathic Medicine — the American Osteopathic Association (AOA) accepts AMA PRA Category 1 Credits™ as aoa Category 2-B credit.

ameriCanS WitH diSaBiLitieS aCt and SpeCiaL ServiCeS

Organizers fully comply with the legal requirements of the Americans with Disabilities Act and the rules and regulations thereof. If any participant in this educational activity is in need of accommodations, please contact the organizers at (270) 554-9412 at least 10 days prior to the conference.

duplication or distribution of materials or recording of lectures without express written permission from aSipp® is prohibited. there is no commercial support for this course.

aCCommodationSCariBe royaLe8101 world Center drive, orlando FL 32821407-238-8000 direct | 800-823-8300 reservationAt the Caribe Royale All-Suite Hotel and Convention Center, business and pleasure go hand in hand. From the very beginning, they’ve redefined and elevated the standards of the meeting, conference and family vacation experience in Florida. Inform the agent that you are booking for ASIPP. We have secured a group room rate of $159. Reserve rooms early—room block cutoff date: October 5, 2016.

AmericAn Society of interventionAl PAin PhySiciAnS4

SpinaL Cord StimuLation Comprehensive review Course and Cadaver workshopoCt 21-22, 2016 | orlando, Florida

SPINAL CORD STIMULATION COMPREHENSIvE REvIEW COURSEFriday OCTOBER 21, 2016

SPINAL CORD STIMULATION CADAvER WORKSHOPSaturday OCTOBER 22, 2016

7:00 am – 8:00 am ContinentaL BreakFaSt in exHiBit HaLL

8:00 am – 8:30 am Introduction of the course and ASIPP® – ramsin m. Benyamin, md

8:30 am – 9:00 am SCS: Past, Present, and Future – peter S. Staats, md

9:00 am – 9:30 am Mechanism of Action of SCS – ramsin Benyamin, md

9:30 am – 10:00 am Indications and Contraindications of SCS – Harold Cordner, md

10:00 am – 10:30 am Break WitH exHiBitorS

10:35 am – 11:05 am Technical Aspects of SCS –rafael justiz, md

11:05 am – 11:35 am Preoperative and Postoperative Care of SCS – Frank j. e. Falco, md

11:35 am – 12:05 pm SCS Complications and How to Avoid Them – ramsin Benyamin, md

12:05 pm – 1:25 pm LunCH and preSentation – “SCS Reimbursement Primer” mark roy. Sponsored by Medtronic (No CMEs)

1:25 pm – 1:35 pm Introduction of Session by Chairperson - peter S. Staats, md

1:35 pm – 1:50 pm High Density SCS – aaron Calodney, md

1:50 pm – 2:05 pm Constant voltage vs Constant Current, and Beyond! – andrea trescot, md

2:05 pm – 2:20 pm Dorsal Root Ganglion Stimulation - rafael justiz, md

2:20 pm – 2:35 pm High Frequency Stimulation – ramsin Benyamin, md

2:35 pm – 2:50 pm Wireless Technology in SCS – Standiford Helm, ii, md

2:50 pm – 3:05 pm The Next Generation SCS System – Harold Cordner, md

3:05 pm – 3:35 pm Break WitH exHiBitorS

3:35 pm – 3:45 pm Introduction of Session by Chairperson

3:45 pm – 4:00 pm Feedback control stimulation and Burst - peter S. Staats, md

4:00 pm – 4:15 pm SCS for Complex Regional Pain Syndrome – andrea trescot, md

4:15 pm – 4:30 pm SCS for Headache and Cervical Pain – Frank j. e. Falco, md

4:30 pm – 4:45 pm SCS for Abdominal, Pelvic, and Coccyx Pain – Leland Lou, md

4:45 pm – 5:15 pm Approved and Off-Label Indications for SCS: What is the Evidence? – Standiford Helm, ii, md

5:15 pm adjourn

6:30am SHUTTLES DEPART FROM HOTEL TO THE CADAvER FACILITY

7:15am–8:00am REGISTRATION AND BREAKFAST

8:00am–9:00am INTRODUCTION - ramsin Benyamin, md

9:00am–12:30pm HAndS-on CAdAvEr WorkSHoP

12:30pm–1:30pm LunCH

1:30pm–5:00pm HAndS-on CAdAvEr WorkSHoP

5:00pm SHUTTLES DEPART FROM CADAvER FACILITY TO THE HOTEL & TO THE AIRPORT

AmericAn Society of interventionAl PAin PhySiciAnS 5

SpinaL Cord StimuLation Comprehensive review Course and Cadaver workshopoCt 21-22, 2016 | orlando, Florida

SPINAL CORD STIMULATION REvIEW COURSE

reGiStration Form

reGiStration inFormation

Please complete the enclosed registration

form and return to ASIPP with payment

(your application will not be processed if

payment does not accompany registration

form).

ASIPP reserves the right to cancel this Workshop

and/or Review Preparation Course upon

reasonable notice and will assume no financial

obligation to registrants for cancellation of the

course for reasons beyond its control. Registration

fees will be refunded. However, costs incurred

by the registrants, such as airline or hotel fees or

penalties, are the responsibility of the registrants.

registrants who are not accepted into this

workshop will receive notice by mail with

their returned check.

important. Please answer all the questions:

medical degree:m md m do m PhD

m Other: _______________________________

primary Specialty Certification:m Anesthesiology m Physiatry

m Neurosurgery

m Other: _______________________________

pain medicine Subspecialty Certification:m American Board of Anesthesiology

m American Board of Pain Medicine

m American Board of Interventional Pain Physicians

m Fellow of Interventional Pain Practice (FIPP)

Specialty designation:m 09 - Interventional Pain Management

m 72 - Pain Management

m Other: __________________________________

years in interventional pain management practice:m 0 m 1-5 m 6-10 m > 10

pLeaSe print exaCtLy aS you WiSH your name to appear:

_______________________________________________________________________________________________NAME (FIRST) (MIDDLE INITIAL) (LAST)

_______________________________________________________________________________________________ORGANIzATION

_______________________________________________________________________________________________address

_______________________________________________________________________________________________CITY STATE zIP

_______________________________________________________________________________________________phone CeLL Fax

_______________________________________________________________________________________________e-maiL

Comprehensive Spinal Cord Stimulation review Course and Hands-on Cadaver Workshop m $2,500 Member m $2,800 Non-MemberFellows:* m 50% Discount***

* If registering as a fellow, please list below the name of fellowship program, university or hospital and fax or e-mail a letter from the program director verifying your status. Your application for registration cannot be processed and you will not receive the 50% discount until ASIPP receives this letter. Fax the letter to 270-554-5394 or e-mail to crogers@asipp.org

______________________________________________________________________________________________name oF FeLLowship program

payment metHod (Please check one):m MASTERCARD m visa m ameriCan express m disCover

______________________________________________________________________________________________CREDIT CARD NUMBER SECURITY CODE (Back of Card)

______________________________________________________________________________________________ExP. DATE

______________________________________________________________________________________________name on Card

______________________________________________________________________________________________AUTHORIzED SIGNATURE (required on all credit card orders)

(Your application will not be processed if payment does not accompany registration form)

return CompLeted Form to:aSipp, 81 Lakeview Drive, Paducah, KY 42001 or Fax to (270) 554-5394

CanCeLLation poLiCy:ASIPP reserves the right to cancel this course upon reasonable notice and will assume no financial obligation to registrants for cancellation for reasons beyond its control. Registration fees will be refunded however, costs incurred by the registrants, such as airline or hotel fees or penalties, are the responsibility of the registrants. ASIPP requires a 30-day notice of cancellation. Cancellations must be submitted in writing by September 21, 2016. Cancellations after September 21, 2016 but prior to October 7, 2016 will forfeit 50% of their registration fee. No refunds can be made after October 7, 2016.

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