Ebook Atlas of pain medicine procedures: Part 1

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Thisatlasisdedicatedto:
MymotherLateRanibaDiwanforteachingmethemeaningoflife
MyfamilyIndira,Sneh,Kaushal,andShirafortheirloveandunconditional
support
MygrandchildrenJonathonandBelenforbringingjoytoourlives
Myfriendsandmymentorswhosupportedmeandguidedmetothepathof
knowledge
Myco-editorPeterStaatsforhisunwaveringfriendshipandbeingatrusted
counselor
And,
DepartmentofAnesthesiologyandPainMedicine
WeillCornellMedicalCollegeandNewYorkPresbyterianHospitalofCornell

University
Forbeinganintegralpartofmypersonalandprofessionalsuccess
SudhirDiwan
ToMomandDad.Youtaughtmehowtochangetheworldtomakeitabetter
place,
onepatientatatime,andmoregloballythroughtheoryandresearch.
Tomychildren,Alyssa,DylanandRachel.Iamsoproudofallthreeofyouand
the
pathsthatyouareforging.Iamconfidentthateachofyouwillmake
theworldabetterplaceinyourownway.
Mostofall,tomywifeNancy,Thankyouforyourunderstandingand
compassion.
Yourunwaveringsupporthasmadethisbookpossible.Youmakeme,and
everyonewhoknowsyou,abetterperson.
PeterS.Staats


Contents
SectionEditors
Contributors
Preface
Introduction

SECTIONI:BasicApplicationsMarkJ.Lema
1.FluoroscopyinInterventionalPainMedicine
DavidM.Schultz
2.ComputedTomographyGuidanceinPainManagement
RonilV.Chandra,Thabele-LeslieMazwi,DanielOh,AlbertJ.Yoo,
andJoshuaA.Hirsch
3.UltrasoundGuidanceforInterventionalPainManagement

HariharanShankarandKanishkaRajput
4.RadiationSafety
VikramB.Patel
5.EquipmentUsedinPainManagement
VikramB.Patel
6.Corticosteroids:Indications,Pharmacology,andRisksin
InterventionalPainManagement
CarolynKimandChristopherGharibo
7.LocalAnesthetics
ChristopherVoscopoulosandMarkJ.Lema
8.BotulinumToxins
CharlesE.ArgoffandHowardSmith
9.Infection:Prevention,Diagnosis,andManagement
DawoodSayedandSudhirDiwan
10.AnticoagulationGuidelines


NirmalaR.Abraham,CathyD.Trame,andSudhirDiwan
11.SedationforInterventionalPainProcedures
NancyStaats
12.EMGandNerveConductionStudies
BridgetT.Carey
13.Documentation,Billing,andCoding
LaxmaiahManchikanti

SECTIONII:HeadandNeckInjectionsSudhirDiwan
14.Atlanto-OccipitalJointInjections
AndreaTrescot
15.Atlanto-AxialJointInjections
AndreaTrescot

16.CervicalNerveRootBlocks
StanleyGolovac
17.TrigeminalGanglionandNerveBlock
MilesDayandKennethD.Candido
18.SphenopalatineGanglionBlock
SamerNarouze
19.OccipitalNerveBlocks
AndreaTrescotandLawrenceKamhi
20.PeriorbitalNerveBlocks(Supraorbital,Supratrochlear,and
InfraorbitalNerves)
SanfordSilverman

SECTIONIII:SpinalInterventionsVikramB.Patel
21.InterlaminarEpiduralSteroidInjections:Cervical,Thoracic,Lumbar,
andCaudal
RajDoshi,VikramB.Patel,andSalahadinAbdi
22.TransforaminalEpiduralSteroidInjection


VikramB.Patel
23.FacetJointInterventions:Intra-ArticularInjections,MedialBranch
Blocks,andRadiofrequencyAblations
VikramB.PatelandSukdebDatta
24.LumbarFacetJointCystDrainageandInjection
GerardP.Varlotta,ChristopherGharibo,andZ.T.Traeger
25.DorsalRootGanglionBlocksandRadiofrequencyProcedures
SethA.WaldmanandVladimirKramskiy
26.SacroiliacJointInjections
SheetalKerkarPatil,HonorioT.Benzon,andSudhirDiwan
27.SacroiliacJointDenervationUsingSynergySystem

LeonardoKapuralandAmandaToye
28.SacroiliacJointDenervationbyUsingSimplicityIII
SudhirDiwanandNimishDavé
29.PercutaneousSacroplasty
HaroldCordnerandMichaelE.Frey
30.PercutaneousFacetFusion
RinooV.Shah
31.ProvocativeDiscogram
VikramB.PatelandSudhirDiwan
32.PercutaneousDiscDecompressions
SanjayBakshiandGerardW.Abrahamsen
33.HydrosurgeryofDisc
DidierDemesminandSagarParikh
34.PercutaneousRadiofrequencyDiscectomyWithDiskIT
SamyadevDattaandVikramB.Patel
35.IntradiscalElectrothermalTherapy
JasonE.PopeandNagyMekhail
36.IntradiscalBiacuplasty
MarkYelleandLeonardoKapural


37.EndoscopicDiscectomy
SudhirDiwan,KiranPatel,KennethChapman,andVikramB.Patel
38.MinimallyInvasiveLumbarDecompression(MILDprocedure)
LoraL.Brown
39.VertebralAugmentation
RamsinBenyamin,RicardoVallejo,AtiqRehman,andAllenBurton
40.EpiduralLysisofAdhesions
RinooV.Shah
41.VascularComplicationsofSpinalInterventions

ScottE.Glaser,RinooV.Shah,andPeterS.Staats

SECTIONIV:SympatheticBlocksAndreaTrescot
42.StellateGanglionBlock
RichardS.Epter
43.Thoracic(T2-3)GanglionBlock
MichaelStanton-Hicks
44.SplanchnicNerveBlocks
AndreaTrescot
45.CeliacPlexusBlockUsingCTGuidance
KennethD.CandidoandNebojsaN.Knezevic
46.CeliacPlexusBlockUsingFluoroscopicGuidance
KennethD.Candido,PeterS.Staats,CoreyW.Hunter,andSudhir
Diwan
47.LumbarSympatheticBlock
JoshuaP.Prager
48.SuperiorandInferiorHypogastricPlexusBlocks
AgnesStogicza
49.GanglionImparBlock
CoreyW.HunterandSudhirDiwan


SECTIONV:MusculoskeletalInjectionsVijayVad
50.FluoroscopyandUltrasound-GuidedJointInjections
JenniferSolomon,ChristineRoque-Dang,andJamesWyss
51.ViscosupplementsandSteroidInjections
JenniferSolomonandVijayVad
52.TriggerPointInjections
RicardoA.NievesandRinooV.Shah
53.NeuromaInjections

RinooV.ShahandRicardoA.Nieves
54.MyofascialInjections(TriggerPoint,Piriformis,Iliopsoas,and
ScaleneInjections)
ClarkC.Smith,FarooqKhan,JuanFranciscoAsenjo,andHonorioT.
Benzon
55.Intra-ArticularJointInjections
MichaelN.Brown
56.TendonInjections
RobertBalchIII

SECTIONVI:PeripheralNerveBlocksChristopher
Gharibo
57.IntercostalNerveBlock
AmitabhGulati
58.SupraclavicularandInfraclavicularNerveBlocks
DavidB.Albert,RobertAltman,andLisaDoan
59.IlioinguinalandIliohypogastricNerveBlocks
PaulJ.HubbellIII
60.GenitofemoralNerveBlock
AndreaTrescot
61.LateralFemoralCutaneousNerveBlock
GerardP.VarlottaandAnyaMyers


62.PudendalNerveBlock
SusantiChowdhaury,GailGray,andAndreaTrescot
63.ObturatorNerveBlock
ArthurAtchabahian
64.SuprascapularNerveBlock
ChristopherGhariboandSteveAydin

SECTIONVII:IntrathecalDrugDeliveryPeterS.
Staats
65.CommerciallyAvailableReservoirOptionsforIntrathecalDrug
Delivery
CoreyW.HunterandDavidCaraway
66.ChoosingIntrathecalMedication
PhilipS.KimandSudhirDiwan
67.IntrathecalDrugDeliveryTrialingProcedures
RichardBowman,TimothyR.Deer,andJasonE.Pope
68.PermanentImplant
SeanLiandPeterS.Staats

SECTIONVIII:NeuroaugmentationTechniques
SudhirDiwan
69.SpinalCordStimulation:HardwareSpecifications
SudhirDiwan,KarinaGritsenko,andNeelMehta
70.SpinalCordStimulation:TrialingProcedure
RichardB.North
71.SpinalCordStimulation:ImplantationTechniques
EliasVeiziandSalimM.Hayek
72.AnterogradeVersusRetrogradeLeadPlacement
MarshallD.Bedder
73.DorsalRootGanglionStimulation:Anatomy,Physiology,and


PotentialforTherapeuticTargetinginChronicPain
JefferyKramer,ChristineE.Draper,TimothyR.Deer,JasonE.Pope,
RobertLevy,andEricJ.Grigsby
74.OccipitalNerveStimulation

ErichO.Richter,MarinaV.Abramova,andKennethM.Alo
75.PercutaneousPeripheralNerveandFieldStimulation
JasonE.Pope,TimothyR.Deer,andEricJ.Grigsby
76.SurgicalTreatmentofTrigeminalNeuralgia
MichaelG.Kaplitt

SECTIONIX:NeurolyticProceduresRinooV.Shah
77.NeurolyticBlocks
KennethD.CandidoandNebojsaNickKnezevic
78.ChemicalNeurolysis
MichaelM.BottrosandMichaelA.Erdek
79.Cryoneuroablation
DavidIrwinandAndreaTrescot
80.RadiofrequencyNeurolysis
AnandThakurandPeterS.Staats


SectionEditors
SectionI:BasicApplications-MarkJ.Lema,MD,PhD
Professor and Chair of Anesthesiology of Anesthesiology, Critical Care, and
PainMedicine,RoswellParkCancerInstitute
StateUniversityofNewYorkatBuffaloSchoolofMedicine
Buffalo,NewYork
SectionII:HeadandNeckInjections-SudhirDiwanMD,DABIPP,FIPP
ExecutiveDirector
ManhattanSpineandPainMedicine
AssociateProfessorofAnesthesiology
SUNYDownstateMedicalCenter
Attending,LenoxHillHospital
NewYork,NewYork

SectionIII:SpinalInterventions-VikramB.Patel,MD,FIPP,DABIPP
Director,PhoenixInterventionalCenterforAdvancedLearning
Algonquin,Illinois
SectionIV:SympatheticBlocks-AndreaTrescot,MD,ABIPP,FIPP
MedicalDirector
PainandHeadacheCenter
Wasilla,Anchorage,Kenai,Alaska
SectionV:MusculoskeletalInjections-VijayVad,MD
AssistantProfessor
RehabilitationandSportsMedicine
WeillCornellMedicalCollege
HospitalforSpecialSurgery
NewYork,NewYork
SectionVI:PeripheralNerveBlocks-ChristopherGharibo,MD
AssociateProfessor


DepartmentofAnesthesiologyandOrthopedics
NewYorkUniversitySchoolofMedicine
NewYork,NewYork
SectionVII:IntrathecalDrugDelivery-PeterS.Staats,MD,andMBA
AdjunctAssociateProfessor
JohnsHopkinsUniversity
DepartmentofAnesthesiologyandCriticalCareMedicine
PremierPainCenters,LLC
Shrewsbury,NewJersey
SectionVIII:NeuroaugmentationTechniques-SudhirDiwan,MD,DABIPP,
FIPP
ExecutiveDirector
ManhattanSpineandPainMedicine

AssociateProfessorofClinicalAnesthesiology
SUNYDownstateMedicalCenter
PainAttending,LenoxHillHospital
NewYork,NewYork
SectionIX:NeurolyticProcedures-RinooV.Shah,MD
ClinicalProfessorofAnesthesiology
Director,ChronicPain
LSUHealthScienceCenter
Shreveport,Louisiana


Contributors
SalahadinAbdi,MD,PhD(Chapter21)
ProfessorandChair
DepartmentofPainMedicine—Unit409
TheUniversityofTexasMDAndersonCancerCenter
Houston,Texas
NirmalaR.Abraham,MD,FABPM(Chapter10)
SycamorePainManagementCenter
KetteringHealthNetwork
Miamisburg,Ohio
GerardW.Abrahamsen,PA-C(Chapter32)
PhysicianAssistant,ManhattanSpineandPainMedicine
PhysicianAssistant,LenoxHillHospital
NewYork,NewYork
MarinaV.Abramova,MD(Chapter74)
DepartmentofNeurosurgery
LSUHealthSciencesCenter
NewOrleans,Louisiana
DavidB.Albert,MD(Chapter58)

DepartmentofAnesthesiology
NYULangoneMedicalCenter
NewYork,NewYork
KennethM.Alo,MD(Chapter74)
PainManagement,TheMethodistHospitalResearchInstitute
Houston,Texas
RobertAltman,MD(Chapter58)
AssociateClinicalProfessorofAnesthesiaNYUMedicalSchool


DirectorofAmbulatoryAnesthesiaServicesNYU-HJD
DirectorRegionalAnesthesiaFellowship
NewYork,NewYork
CharlesE.Argoff,MD(Chapter8)
ProfessorofNeurology,AlbanyMedicalCollege
Director,ComprehensivePainCenter,AlbanyMedicalCenter,Albany
NewYork,NewYork
JuanFranciscoAsenjo,MD,FRCPC(Chapter54)
AssociateProfessor
DepartmentofAnesthesiaandAlanEdwardsMcGillPainTreatmentUnit
McGillCancerPainClinic
McGillUniversityHealthCenter
Montréal,Quebec
Canada
ArthurAtchabahian,MD(Chapter63)
AssociateProfessor
DepartmentofAnesthesiology
NewYorkUniversitySchoolofMedicine
NewYork,NewYork
SteveM.Aydin,DO(Chapter64)

Clinical Assistant Professor in PM&R at Hofstra North Shore-LIJ School of
Medicine,Manhassett,NewYork
DirectorofMusculoskeletalMedicineatManhattanSpineandPain
NewYork,NewYork
SanjayBakshi,MD,D.A.B.P.M(Chapter32)
President,ManhattanSpineandPainMedicine
President,NYSocietyofInterventionalPainPhysicians
AttendingPhysician,LenoxHillHospital
NewYork,NewYork
AttendingPhysician,BethIsraelMedicalCenter
NewYork,NewYork
AttendingPhysician,BayshoreMedicalCenter


Holmdel,NewJersey
Member,InternationalSpineInterventionSociety
NewYork,NewYork
RobertBalchIII,DO(Chapter56)
DiplomateoftheAmericanBoardofPM&R
FellowshipTrainedandBoardCertifiedinPainMedicine
FortWorth,Texas
MarshallD.Bedder,MD,FRCP(C)(Chapter72)
DirectorInterventionalPain
PacificMedicalCenters(PacMed)
Seattle,Washington
RamsinBenyamin,MD,DABIPP(Chapter39)
President,AmericanSocietyofInterventionalPainPhysicians
President,MillenniumPainCenter,Illinois
Clinical Assistant Professor of Surgery, College of Medicine, University of
Illinois,Urbana-ChampaignIllinois

HonorioT.Benzon,MD(Chapters26and54)
ProfessorofAnesthesiology
NorthwesternUniversityFeinbergSchoolofMedicine
Chicago,Illinois
MichaelM.Bottros,MD(Chapter78)
Assistant Professor of Anesthesiology and Critical Care Medicine, Department
ofAnesthesiologyandCriticalCareMedicine,WashingtonUniversity
St.LouisSchoolofMedicine
St.Louis,Missouri
LoraL.Brown,MD(Chapter38)
MedicalDirector
TruWell,anewhealth
PastPresident,FloridaSocietyofInterventionalPainPhysicians
St.Petersburg,Florida
MichaelN.Brown,MD(Chapter55)


PrivatePractice
Seattle,Washington
AllenBurton,MD(Chapter39)
HoustonPainCenters
Houston,Texas
KennethD.Candido,MD(Chapters17,45,46and77)
Chairman,DepartmentofAnesthesiology
ProfessorofClinicalAnesthesiology-UniversityofIllinois,Chicago
AdvocateIllinoisMasonicMedicalCenter
Chicago,Illinois
DavidCaraway,MD,PhD(Chapter65)
MedicalDirector
CenterforPainRelief,TriState,PLLC

Huntington,WestVirginia
BridgetT.Carey,MD(Chapter12)
AssistantProfessorofNeurology
andNeuroscience,
WeillCornellMedicalCollege
NewYork,NewYork
RonilV.Chandra,MBBS,FRANZCR(Chapter2)
Neuroradiology and Neurovascular Surgery, Department of Imaging, Monash
Health
DepartmentofSurgery,MonashUniversity
Melbourne,Australia
KennethChapman,MD,FIPP(Chapter37)
Director,PainManagement
StatenIslandUniversityHospital
StatenIsland,NewYork
SusantiChowdhaury,MD(Chapter62)
MedicalDirector,AdvancedPainManagementConsultants
Largo,Florida


HaroldCordner,MD,FIPP(Chapter29)
FloridaPainManagementAssociates
AssistantClinicalProfessor,FloridaStateUniversitySchoolofMedicine
Sebastian,Florida
SukdebDatta,MD,MBA(Chapter23)
President
DattaEndoscopicBackSurgeryandPainCenter
ProfessorialLecturer
MountSinaiSchoolofMedicine
DepartmentofAnesthesiology

NewYork,NewYork
SamyadevDatta,MD,FRCA(Chapter34)
CenterforPainManagement
Hackensack,NewJersey
NimishDavé,MD,MPH(Chapter28)
KaiserPermanenteSouthernCalifornia
DepartmentofAnesthesiology
SanDiego,California
MilesDay,MD,FIPP,DABIPP(Chapter17)
Traweek-RaczEndowedProfessorinPainResearch
Director—ThePainCenteratGraceClinic
PainManagementFellowshipDirector
DepartmentofAnesthesiology
TexasTechUniversityHSC
Lubbock,Texas
TimothyR.Deer,MD(Chapters67,73and75)
President and CEO, The Center For Pain Relief, and Clinical Professor of
Anesthesiology,WestVirginiaUniversitySchoolofMedicine
Charleston,WestVirginia
DidierDemesmin,MD(Chapter33)
UniversityPainManagementCenter


Somerset,NewJersey
SudhirDiwan,MD,DABIPP,FIPP(Chapters9,10,26,28,31,37,46,49,65
and69)
ExecutiveDirector,ManhattanSpine
andPainMedicine
AssociateProfessorofClinicalAnesthesiology
SUNYDownstateMedicalCenter

PainAttending,LenoxHillHospital
NewYork,NewYork
LisaDoan,MD(Chapter58)
DepartmentofAnesthesiology
NYULangoneMedicalCenter
NewYork,NewYork
RajDoshi,MD(Chapter21)
BethIsraelDeaconessMedical
DepartmentofAnesthesiaandCriticalCare
Boston,Massachusetts
ChristineE.Draper,PhD(Chapter73)
SpinalModulation
MenloPark,California
RichardS.Epter,MD,DABAPM,DABIPP,DABPM,FIPP(Chapter42)
AugustaPainCenter
Augusta,Georgia
MichaelA.Erdek,MD(Chapter78)
Associate Professor of Anesthesiology, Oncology, and Critical Care Medicine,
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins
UniversitySchoolofMedicine
Baltimore,Maryland
MichaelE.Frey,MD(Chapter29)
AdvancedPainManagementandSpecialist
FortMyers,Florida


AdjunctClinicalProfessor
VirginiaCommonwealthUniversity
DepartmentofPhysicalMedicineandRehabilitation
FortMyers,Florida

ChristopherGharibo,MD(Chapters6,24and64)
AssociateProfessor
DepartmentofAnesthesiology&Orthopedics
NYUSchoolofMedicine
NewYork,NewYork
ScottE.Glaser,MD,DABIPP(Chapter41)
President,PainSpecialistsofGreaterChicago,
BoardMember,AmericanSocietyofInterventionalPainPhysicians
Chicago,Illinois
StanleyGolovac,MD(Chapter16)
FloridaPain
MerrittIsland,Florida
GailGray,ARNP(Chapter62)
AdvancedInterventionalSpineConsultants
Largo,Florida
EricJ.Grigsby,MD(Chapters73and75)
FoundingPartner,NapaPainInstitute,Napa,California;FounderandPresident,
Neurovations
Napa,California
KarinaGritsenko,MD(Chapter69)
AssistantProfessorofAnesthesiology
RegionalAnesthesia,InterventionalPainMedicine
MontefioreMedicalCenter
DepartmentofAnesthesiology
NewYork,NewYork
AmitabhGulati,MD,FIPP(Chapter57)
DirectorofAmbulatoryPain


Co-DirectoroftheCornellSchoolofMedicinePainManagementFellowship

AssistantAttending
MemorialSloanKetteringCancerCenter
NewYork,NewYork
SalimM.HayekMD,PhD(Chapter71)
Professor,DepartmentofAnesthesiology
CaseWesternReserveUniversity
Chief,DivisionofPainMedicine
UniversityHospitalCaseMedicalCenter
Cleveland,Ohio
JoshuaA.Hirsch,MD,FACR,FSIR(Chapter2)
Director:InterventionalNeuroradiologyand
EndovascularNeurosurgery
MassachusettsGeneralHospitaland
HarvardMedicalSchool
Boston,Massachusetts
PaulJ.Hubbell,III,MD,DDS(Chapter59)
SouthernPainandAnesthesia
Metairie,Louisiana
CoreyW.Hunter,MD(Chapters46,49and65)
AinsworthInstituteofPainManagement
NewYork,NewYork
DavidIrwin,DO(Chapter79)
ChiefofPainMedicine
UPMCHamotMedicalCenter
Erie,Pennsylvania
LawrenceKamhi,MD,FIPP(Chapter19)
SpineandInterventionalPainManagement
Warwick,NewYork
MichaelG.Kaplitt,MD,PhD(Chapter76)
Director of Stereotactic and Functional Neurosurgery and Vice-Chairman for

Research
DepartmentofNeurologicalSurgery
WeillCornellMedicalCollege
NewYork,NewYork
LeonardoKapural,MD,PhD(Chapters27and36)
ProfessorofAnesthesiology,WakeForestUniversitySchoolofMedicine
CarolinasPainInstituteandCenterforClinicalResearch
Winston-Salem,NorthCarolina
FarooqKhan(Chapter54)
PrivatePractice
Chicago,Illinois
CarolynKim,MD(Chapter6)
DepartmentofAnesthesiology
NYULangoneMedicalCenter
NewYork,NewYork
PhilipS.Kim,MD(Chapter66)
MedicalDirector,CenterforInterventionalPainSpineLLC
Newark,Delaware
NebojsaNickKnezevic,MD,PhD(Chapters45and77)
DirectorofAnesthesiologyResearch
ClinicalAssistantProfessor-UniversityofIllinois,Chicago
DepartmentofAnesthesiology
AdvocateIllinoisMasonicMedicalCenter
Chicago,Illinois
JefferyKramer,PhD(Chapter73)
SpinalModulation,MenloPark,California
DepartmentofPharmacologyandCancerBiologyUniversityofIllinois
Peoria,Illinois

VladimirKramskiy,MD(Chapter25)
Director,AmbulatoryRecuperativePainMedicine
Attending,PainMedicine,Neurology


HospitalforSpecialSurgery
NewYork,NewYork
MarkJ.Lema,MD,PhD(Chapter7)
Professor and Chair of Anesthesiology, Critical Care, and Pain Medicine,
RoswellParkCancerInstitute,StateUniversityofNewYorkatBuffaloSchool
ofMedicine
Buffalo,NewYork
RobertLevyMD,PhD(Chapter73)
Professor of Neurosurgery, College of Medicine-Jacksonville, University of
Florida
Jacksonville,Florida
SeanLi,MD(Chapter68)
PremierPainCenters,LLC
Shrewsbury,NewJersey
LaxmaiahManchikanti,MD(Chapter13)
MedicalDirector,PainManagementCenters,PaducahKentucky
ClinicalProfessorofAnesthesiologyandPerioperativeMedicine,Universityof
Louisville
Louisville,Kentucky
Thabele-LeslieMazwi,MD(Chapter2)
DepartmentsofInterventionalNeuroradiologyandEndovascularNeurosurgery
MassachusettsGeneralHospitalandHarvardMedicalSchool
Boston,Massachusetts
NeelMehta,MD(Chapter69)
MedicalDirector,DivisionofPainMedicine

AssistantProfessorofAnesthesiology
WeillCornellMedicalCollege
NewYorkPresbyterianHospital
NewYork,NewYork
NagyMekhail,MD,PhD(Chapter35)
ClevelandClinic