Leonardo Kapural, MD, PhD's portrait
Leonardo Kapural, MD, PhD
Pain Physician
Carolinas Pain Institute
Winston-Salem, NC

About Leonardo Kapural, MD, PhD

Leonardo Kapural, MD, PhD, is a Pain Physician at the Carolinas Pain Institute and Center for Clinical Research. He is also Professor of Anesthesiology at Wake Forest University’s School of Medicine. Dr. Kapural’s interests include peripheral nerve stimulation, spinal cord stimulation, discogenic low back pain, and visceral abdominal pain.

Following his Fellowship in Pain Management at the Cleveland Clinic, he stayed in Cleveland Clinic’s Pain Management Department for 10 years, also serving as Director of Clinical Research and Professor of Anesthesiology at Cleveland Clinic Lerner College of Medicine (CCLMC) of Case Western University.

Dr. Kapural is an active member of many professional organizations, including the American Society of Regional Anesthesia and Pain Medicine, North American and International Neuromodulation Societies, and World Institute of Pain. In addition, he is an invited speaker to many national and international meetings. He served as Director-At-Large of American Academy of Pain Medicine, and currently as Director-At-Large of both North American and International Neuromodulation Societies.

Dr. Kapural’s experience is broad and encompasses teaching and clinical education, extensive research, and innovations in the area of pain treatments, which earned him two Innovator Awards. His noteworthy research findings have been published in more than 100 journal articles, more than 100 abstracts, two books, and 30 book chapters. He is listed by his peers in the “Best Doctors in America.”

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Publications

Peer-Reviewed Articles
1. Mekhail N, Kapural L. Complex Regional Pain Syndrome Type 1 in Cancer Patients. Current Review of Pain 2000;4:227-233.

2. Kapural L, Mekhail N: Monitoring of the Sympathetic Blockade. Techniques in Regional Anesthesia and Pain Management 2001;5:82-87.

3. Kapural L, Mekhail N. Radiofrequency Ablation for Chronic Pain Control. Current Pain and Headache Reports 2001;5:(6): 517-525.

4. Hayek MS, Fattouh M, Dews T, Kapural L, Malak O, Mekhail N. Successful Treatment of Spontaneous Cerebrospinal Fluid Leak Headache with Fluoroscopically Guided Epidural Blood Patch: A Report of Four Cases. Pain Medicine 2003;4:373-378.

5. Kapural L, Szabova A. Intraspinal Drug Delivery Routes For Treatment of Chronic Pain and Spasticity. Seminars in Pain Medicine 2003;1(4):254-259.

6. Kapural L, Hayek SM, Stanton-Hicks M, Mekhail N. Spinal Cord Stimulation Decreased Insulin Requirements in a Diabetic Patient. Anesthesia and Analgesia 2004;98(3):745-746.

7. Kapural L, Korunda Z, Basali AH, Mekhail N. Intradiscal Thermal Annuloplasty for Discogenic Pain in Patients with Multilevel Degenerative Disc Disease. Anesthesia and Analgesia, 2004;99472-476.

8. Mekhail N, Kapural L. Intradiscal Thermal Annuloplasty for Discogenic Pain: An Outcome Study. Pain Practice, 2004;4(2):84-90.

9. McLain RF, Kapural L, Mekhail NA. Epidural Steroids for Back and Leg Pain: Mechanism of Action and Efficacy. Cleveland Clinic Journal of Medicine 71:961-970, 2004.

10. Kapural L, Hayek SM, Stanton-Hicks M, Malak O, Mekhail N. Occipital Nerve Electrical Stimulation Via Midline Approach and Subcutaneous Surgical Leads for Treatment of Severe Occipital Neuralgia: Pilot Study. Anesthesia and Analgesia 2005;101:171-174.

11. McLain RF, Kapural L, Mekhail. N. Epidural Steroid Therapy for Back and Leg Pain: Mechanisms of Action and Efficacy. Spine Journal 2005; 5(2):191-201.

12. Kapural L. Pain Management After Failed Low Back Surgery. Lijecnicki Vijesnik 2005; 127S:111-121.

13. Kapural L, Hayek S,Malak O, Arrigain S, Mekhail N. Intradiscal Thermal Annuloplasty Versus Intradiscal Radiofrequency Ablation for the Treatment of Discogenic Pain: a Prospective Matched Control Trial. Pain Medicine 2005;6(6):425-31.

14. Kapural L, Goldner JD. Interventional Pain Management- When/What Therapies are Best for Low Back Pain. Current Opinion in Anesthesiology 2005;18:569-575.

15. Hayek SM, Paige B, Girgis G, Kapural L, Fattouh M, Xu M, Stanton-Hicks M, Mekhail, NA. Tunneled Epidural Catheter Infections in Noncancer Pain: Increased Risk in Patients with Neuropathic Pain/CRPS. Clinical Journal of Pain 2006;22(1):82-89.

16. Kapural L, Janicky T, Narouze S, Mekhail N. Spinal Cord Stimulation is an Effective Treatment for the Severe Pelvic Visceral Pain. Pain Medicine 2006;7(5):440-3.

17. Kapural L, Mekhail N. A Randomized, Double-blind, Controlled Trial: Intradiscal Electrothermal Therapy Versus Placebo for the Treatment of Chronic Discogenic Low Back Pain (letter). Spine 2006;31(14):1636.

18. Stanton Hicks M, Kapural L. An Effective Treatment of Severe CRPS Type 1 in Child Using High Doses of Intrathecal Ziconotide, Journal of Pain and Symptom Management 2006;32(6):509-11.

19. Kapural L. Image is Worth a Thousand Words: Imaging for the Interventional Management of Chronic Pain. Techniques in Regional Anesthesia and Pain Medicine, 2007;11(2):43.

20. Soin A, Kapural L, Mekhail N. Imaging for Percutaneous Vertebral Augmentation. Techniques in Regional Anesthesia and Pain Medicine, 2007;11(2):90-94.

21. Kapural L, Mekhail N. Novel Transdiscal Biacuplasty for the Treatment of Lumbar Discogenic Pain: a Case Report. Pain Practice 2007;7(2):130-134.

22. Kapural L, Goyle A. Imaging for Provocative Discography and Minimally Invasive Percutaneous Procedures for Discogenic Pain. Techniques in Regional Anesthesia and Pain Medicine 2007;11(2):73-80.

23. Deer T, Kapural L. Imaging for Disc Decompression Procedures. Techniques in Regional Anesthesia and Pain Medicine 2007:11(2):81-89.

24. Kapural L, Dua S. Spinal Cord Stimulation for Visceral Pain. Periodicum Biologorum 2007;109:227-230.

25. Narouze S, Kapural L. Supraorbital Nerve Electric Stimulation for the Treatment of Intractable Chronic Cluster Headache: A Case Report. Headache 2007;47(7):1100-1102.

26. Kapural L, Cata J. Complications of Minimally Invasive Procedures for Discogenic Pain. Techniques in Regional Anesthesia and Pain Medicine, 2007;11(3):157-163.

27. Narouze SN, Yonan S, Kapural L, Malak O. Erosion of the Inferior Epigastric Artery: a Rare Complication of Intrathecal Drug Delivery System. Pain Medicine 2007;8(5);468-470.

28. Kapural L, Mekhail N, Bena J, Tetzlaff J, McLain R, Kapural M, Mekhail M, Polk S. Value of the Magnetic Resonance Imaging in Patients with Lumbosacral Stenosis Undergoing Lumbar Epidural Injections. Clinical Journal of Pain 2007;23(7):571-575.

29. Kapural L, McIntyre P, Stillman M, Kapural M, Mekhail N. Botulinum Toxin Occipital Nerve Block for the Treatment of Severe Occipital Neuralgia: a Pilot Study. Pain Practice 2007;7(4):337-340.

30. Kapural L, Rakic M. Spinal Cord Stimulation for Chronic Visceral Pain Secondary to Chronic Non-alcoholic Pancreatitis: a Case Report. In press; Clinical Gastroenterology and Hepatology.

31. Kapural L, Mekhail N, Sloan S, Moghal N, Kapural M, Hicks D, Petrinec D. Histological and Temperature Distribution Studies in the Lumbar Degenerated and Non-degenerated Human Cadaver Discs Using Novel Transdiscal Radiofrequency Electrodes. Pain Medicine 2008;9(1):68-75.

32. Kapural L. Indications for Minimally Invasive Disk and Vertebral Procedures. Pain Medicine 2008;9(S1):S65-S72.

33. Kapural L, De la Garza M, Ng A, Kapural M, Mekhail N. Novel Transdiscal Biacuplasty for the Treatment of Lumbar Discogenic Pain: a 6 Months Follow-up. Pain Medicine 2008;9(1):60-67.

34. Kapural L, Skacel M, Abdou A, Nuclear, Intradiscal Hemangioma. Pain Practice 2008;8(2):114-116.

35. Kapural L, Cywinsky J, Zovkic P, Stanton-Hicks M. Effective Cervical Spinal Cord Stimulation for Bilateral Lower Extremities Pain: Technical Report. Pain Practice 2008;8(2):117-119.

36. Kapural L. Intervertebral Disc Cooled Bipolar Radiofrequency (Intradiscal Biacuplasty) for the Treatment of Lumbar Discogenic Pain: a 12 Month Follow-up of the Pilot Study. Pain Medicine 2008;9(4):464.

Abstracts
1. Kapural L, Mekhail N. A Prospective Outcome Study of the Intradiscal Electrothermal Therapy (IDET) for Discogenic Pain. Anesthesiology 2001;94(Supp) A818.

2. Kapural L, Mekhail N. Strict Patient Selection Improves Outcome of the Intradiscal Electrothermal Therapy (IDET) Used for Treatment of Discogenic Pain: a Prospective Outcome Study. 1st Joint World Congress on Regional Anesthesia and Pain Therapy, Barcelona, Spain 2002.

3. Kapural L, Mekhail N. Predictors of the Therapeutic Success of Intradiscal Electrothermal Therapy (IDET). 1st Joint World Congress on Regional Anesthesia and Pain Therapy, Barcelona, Spain, 2002.

4. Kapural L, Narouze S, Rajagopalan S, Mekhail N. Efficacy and Complications of Surgically VS Percutaneously Implanted Spinal Cord Stimulation Systems, Anesthesiology 96: A928, 2002.

5. Kapural L, Korunda Z, Elezovic N, Mekhail N. Intradiscal Thermal Annuloplasty (IDTA) for the Treatment of Discogenic Pain in Patients with Multilevel Degenerative Disc Disease. ASRA Regional Anesthesia and Pain Medicine, A16; 2003.

6. Hayek SM, Paige B, Kapural L, Stanton-Hicks M, Mekhail, NA. Complications of Tunneled Epidural Catheters in Non-Cancer Patients with Regional Pain. Anesthesiology 99:A1111, 2003.

7. Kapural L, Mekhail N, Elezovic N. Pain Reduction and Improvement in Functional Capacity after Kyphoplasty. 13 World Anesthesiology Congress, Paris, France 2004.

8. Kapural L, Mekhail N, Hayek SM, Arrigan S. A Prospective Outcome Study of the Intradiscal Thermal Annuloplasty (IDTA) Versus Intradiscal Radiofrequency Ablation for Discogenic Pain. 13 World Anesthesiology Congress, Paris, France 2004.

9. Kapural L, Hayek SM, Stanton-Hicks M, Malak O, Mekhail N. Occipital Nerve Electrical Stimulation via Midline Approach and Subcutaneous Surgical Leads for Treatment of Severe Occipital Neuralgia: the Case Series. Anesthesiology 101: A961, 2004.

10. Kapural L. Mekhail N. Spinal Cord Stimulation is an Effective Treatment for the Severe Pelvic Visceral Pain. AAPM Annual Meeting Palms Springs, CA, 2005 (2005 Scientific Poster Award).

11. Hayek SM, Henderson J, Kapural L, Stanton-Hicks M, Boulis N, Mekhail N. Peripheral Nerve Stimulation for Postsurgical Facial Neuralgias. AAPM Annual Meeting, 2005.

12. Kapural L, Mekhail N, Polk S and Tetzlaff J. Epidural Steroid Injections for the Treatment of Painful Lumbosacral Stenosis: a Large Retrospective Outcome Study. Journal of Pain 2005;6(3)S49.

13. Kapural L, Mekhail N, Kapural M. Value of the Magnetic Resonance Imaging in Predicting Success of Lumbar Epidural Steroid Injections in Patients with Lumbosacral Stenosis, IASP Meeting 2005, Sidney, Australia.

14. Kapural L. Spinal Cord Stimulation for Chronic Visceral Pain Secondary to Chronic Non-alcoholic Pancreatitis: a Case Report, ASA 2006.

15. Kapural L, Mekhail N, Kapural M, Hicks D. Histological And Temperature Distribution Studies of the Novel Transdiscal Heating System In Degenerated and Non-Degenerated Human Cadaver Lumbar Discs. Anesthesiology 2006;105:A705.

16. Kapural L, Cata J, Stanton-Hicks M. An Effective Treatment of Severe CRPS Type 1 in Child Using High Doses of Intrathecal Ziconotide. NANS 2006.

17. Kapural L, Stillman M, Kapural M, Mekhail N. Botulinum Toxin Occipital Nerve Block for the Treatment of Severe Occipital Neuralgia: a Pilot Study, AAPM 2007 A154.

18. Hayek S, Stanton-Hicks M, Kapural L. Four Extremity Spinal Cord Stimulation Using Dual Lower-Cervical Epidural Octapolar Percutaneous Neuroelectrodes. ASA 2006.

19. Kapural L, Ng A, Mekhail N. A Novel Radiofrequency Annuloplasty (Transdiscal Biacuplasty) for the Treatment of Lumbar Discogenic Pain: 6-months Results of the Pilot Study. AAPM 2007 A155.

20. Kapural L, Cata JP. Intrathecal Ziconotide Infusion for the Treatment of CRPS: A Retrospective Overview. 10th International Conference on Neuropathic Pain. Salt Lake City, Utah , Nov 1-3, 2007.

21. Kapural L, Lokey C, Leong M, Fiekowski S. Intrathecal Ziconotide for Complex Regional Pain Syndrome: Seven Case Reports. Joint 8th International Neuromodulation Society (INS) and 11th North American Neuromodulation Society (NANS) Meeting Posters, Acapulco, Mexico Dec 9-12, 2007.

22. Cata JP, Vydyananthan A, Kapural L. Intrathecal Ziconotide in Patients with Postlaminectomy Syndrome (PLS): a Retrospective Overview. IASP World Meeting, Scotland.

23. Kapural L, Nageeb F, Kapural M, Cata JP, Narouze S, Mekhail N. Cooled Radiofrequency (RF) System for the Treatment of Chronic Pain from Sacroiliitis: the First Case-series, IASP World Meeting, Scotland.

Articles Written by Leonardo Kapural, MD, PhD

Transforaminal Epidural Injections Treat Leg and Back Pain

Epidural glucocortoid, or steroid, spinal injections are commonly given to patient with leg and/or back pain to relieve pain and improve mobility.

Case Studies Presented by Leonardo Kapural, MD, PhD

Intractable Chronic Pain in Patient with Post-laminectomy Syndrome (Failed Back Surgery)

Presented by: L. Kapural MD, PhD, J. Ferreira PA-C

The patient is a 51-year-old male who presents with lumbar and leg pain secondary to lumbosacral neuritis and post-laminectomy (failed back surgery) syndrome.

Articles Reviewed by Leonardo Kapural, MD, PhD

Epidural Injection for Low Back and Leg Pain

Spinal epidural injections place powerful anti-inflammatory medication near or at the pain-provoking nerve area of the spine.

Lumbar Epidural Injection

Spinal epidural injections may help relieve low back and leg pain often caused by lumbar spinal stenosis or disc herniation.

Caudal Epidural Injection Information

Read how this treatment may help to decrease nerve root inflammation and hopefully reduce back or leg pain.

Thoracic Epidural Injection

An epidural injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots, hopefully reducing the pain in the mid back or around the rib cage.

Diagnostic and Therapeutic Selective (Transforaminal) Epidural Spinal Injection

By stopping or limiting nerve inflammation, the epidural injection may promote healing.

Cervical Epidural Injection

Learn what to expect from cervical epidural injections here. An epidural injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots, hopefully reducing the pain in the neck, shoulders, and arms.

IDET Explanation: Basic Information from a Pain Management Specialist

IDET is a relatively new pain management treatment option for discogenic pain -- pain that's specifically related to your intervertebral discs. An interventional pain management specialist explains how IDET works.

IDET Controversy: Answers from a Pain Management Specialist

If you have discogenic pain, IDET is a treatment option for you. However, it's relatively new, so some medical professionals consider it experimental. A pain management specialist responds to those challenges.

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