New Endoscopic Spine Fellowship expands training in most advanced pain interventions

The Division of Pain Medicine at UF Health has added a new fellowship that will allow interventional pain physicians to gain additional skills in the most advanced endoscopic spine surgery techniques. The comprehensive Endoscopic Spine Fellowship was added in response to the division’s success using minimally invasive techniques to treat patients with acute and chronic spine problems.

The fellowship was approved in February and aims to begin in the 2022-23 academic year, with a goal of enrolling one to two fellows per year. Physicians who have completed an ACGME-approved pain medicine fellowship will be eligible for the nonaccredited 14-month fellowship. It will include patient care, research, and education, including didactics focused on imaging and cadaver workshops, as well as an opportunity to gain certification.

“The need for physicians who are competent in advanced minimally invasive spine interventions such as spine endoscopy is increasing significantly due to our aging population and the opioid crisis,” said Sanjeev Kumar, M.D., an associate professor of anesthesiology who pioneered endoscopic spine surgeries at UF Health and will direct the fellowship. “I am thrilled that we will now be able to provide this training to decrease the gap between clinical needs and available specialists.”

Physicians can enter the fellowship from various training backgrounds but must have advanced surgical skills. Anyone interested can contact Kumar to learn more about the application process.

Successful outcomes

To date, the Division of Pain Medicine at UF Health has completed more than 130 endoscopic spine surgeries for various spine pathologies, with successful outcomes. As demand has been growing, the division has added dedicated time for these cases. UF Health has also purchased and installed a scope tower, a neuromonitoring machine, and other surgical equipment including an irrigation system and high-speed so that the cases can be performed at UF Health Pain Medicine – Ayers, an ambulatory interventional pain facility.

UF Health Pain Medicine is one of the very few academic pain medicine programs in the country to offer the full spectrum of endoscopic spine procedures for patients and trainees. These procedures involve microscopic instruments and tiny incisions and are performed on an outpatient basis, allowing patients to recover faster and experience less postoperative pain than they would from a more traditional surgery. The surgeries also result in less trauma to the surrounding spine structures, particularly muscle.

“The new fellowship will enhance our reputation as a spine center of excellence,” Kumar said. “It will also have a positive impact on other trainees and programs, such as neurosurgery, orthopedics, and neurology, by providing a dedicated training pathway.”

Kumar, who is also medical director of the Springhill Pain Clinic, has been honing his expertise in endoscopic spine surgery for the past several years. In 2019, he received a Faculty Enhancement Opportunity (FEO) grant to attend a Lumbar Endoscopic Spinal Decompression Review Course and cadaver workshop hosted by the American Society of Interventional Pain Physicians. He also attended a workshop on endoscopic spine surgery put on by medical device company Elliquence, which is contributing funding to the new fellowship and will facilitate cadaver workshops.

Building on excellence of infrastructure

Trainees will benefit from the expertise of other internationally known faculty in the Division of Pain Medicine, including Rene Przkora, M.D., Ph.D., professor of anesthesiology and chief of the division. Przkora, who directs the ACGME-accredited Multidisciplinary Pain Medicine Fellowship, will be assistant program director of the new Endoscopic Spine Fellowship.

The new fellowship represents another way the division has innovated and grown as it seeks to prepare exceptional pain physicians to become leaders in the field, Przkora said. In the 2021-22 academic year, the fellowship added an interventional spine subspecialty elective track. The fellowship has grown to include six trainees, and endoscopic spine fellows will be able to take advantage of the existing infrastructure in the main fellowship.

“It is my hope that the Endoscopic Spine Fellowship provides a pathway for highly skilled interventional pain physicians to succeed in private or academic practice after graduation and meaningfully contribute to advancing patient care,” Przkora said.