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Fluoroscopically guided IASIJ injection is associated with minimal adverse effects. The most common immediate adverse event was vasovagal reaction, and the most common delayed adverse event was injection-site soreness. Younger age is significantly related to reported delayed adverse events.

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A 39-year-old female runner presents with episodic low back pain that is becoming more frequent. In the past, she has used chiropractic care with some limited temporary success. She experiences pain in her lower lumbar region and denies any leg pain. Results of her physical examination reveal pain with forward flexion. Results of her neurologic examination are normal. She has negative dural tension tests in all positions. Her sacroiliac provocation maneuvers are also negative. However, she has a positive prone instability test. (Posterior to anterior pressure is exerted in the prone position. If pain is elicited in this position and then less pain with spinal extensor muscle activation, this would be considered a positive test). Physical therapy has been recommended to her, but she remains confused as to the proper course of therapy. She has heard the term core strength multiple times from her personal trainer and health care providers. Should she go full bore on a core strengthening program to improve her back pain and/or prevent further exacerbations or should she engage in some other form of therapeutic exercise?

The comprehensive 2-day course teaching the skills and concepts of spinal interventions for physiatry residents enhances medical knowledge as an introduction to interventional spine care. Those who benefited the most were the residents who had the greatest deficit of medical knowledge on this topic before the course. This course curriculum does not replace fellowship training or closely monitored mentorship in the performance of spinal procedures.