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Full Schedule

Full Schedule

  • Thursday, March 16, 2023
  • 11:00 AM – 7:30 PM EST
    Registration
  • 12:30 PM – 1:15 PM EST
    (INT-1) Industry Lunch Symposia: Cross-Fire Debate: Strategies for Post-op Pain Management Following Spine Surgery Sponsored by Pacira

    Industry Speaker: Mohamad Bydon, MD – Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55902, USA

    Industry Speaker: Michael Y. Wang, MD – University of Miami

    This interactive discussion will discuss the role of ERAS in spine surgery novel approaches in the management of post-surgical pain following spine surgery. Faculty will present their individualized protocols along with techniques in administering EXPAREL via surgical infiltration versus a surgeon-administered, ultrasound guided, ESP/TLIP block.

    Sponsored Session

  • 1:00 PM – 5:30 PM EST
    (SPEAK) Speaker Ready Room
  • 1:30 PM – 3:00 PM EST
    (INT-20) Industry Supported Hands-On Cadaver Session: Decreasing Blood Loss & Improving Efficiencies in MIS & Complex Spine Cases with BoneScalpel and Bone Graft Substitutes Sponsored by Bioventus
    Join our esteemed faculty to hear how they were able to see more and achieve more with The TELIGEN System, an integrated technology platform that delivers an advanced visualization experience in conjunction with the TELIGEN Vue procedural solution.

    Sponsored Session

  • 1:30 PM – 5:30 PM EST
    (S-APP) Tips & Pearls for Advanced Practice Providers

    Course Director: Kenneth M. Crandall, MD – University of Maryland Medical Center

    Course Director: Gina Duel, MSPAS, PA-C – Hoag Specialty Clinic/ HOAG Hospital

    Course Director: Sara McEvoy, MPAS, PA-C – University of Utah

    This course will cover pre-operative and post-operative education and management of patients with degenerative spine conditions. A special emphasis will be made on teamwork and communication to create a better patient and provider experience.

    Ticketed Event

    Advanced Practice Provider

  • 1:30 PM – 5:30 PM EST
    (SPEC1) Special Course 1: Persistent Symptoms After Surgery: Case Based Salvage Options

    Course Director: John Caridi, MD (he/him/his) – Northwell Health

    Course Director: Sanjay S. Dhall, MD – Harbor UCLA Medical Center

    Patients who have persistent pain and or weakness after seemingly successful surgical intervention can be very challenging. This course offers a panel of experts who will discuss their experiences with this problem. The discussion will center around diagnosis and treatment for this population.

    Ticketed Event

  • 1:30 PM – 5:30 PM EST
    (SPEC2) Special Course 2: (Joint DSPN and AOSNA) Applying Modern Deformity Concepts Into Practice: A Case-Based Approach

    Course Director: Dean Chou, MD – Columbia University

    Course Director: Kai-Ming Fu, MD, PhD – Weill Cornell Medical Center

    This course focuses on spinal deformity principles and case-based discussions to apply to real-world clinical practice. Such concepts as when bigger surgeries are needed and when smaller surgeries suffice are discussed. In addition, principles of approaches to deformity and considerations of types of surgeries will be discussed.

    Ticketed Event

  • 1:30 PM – 5:30 PM EST
    (SPEC3) Special Course 3: Outpatient Spine Surgery: How to Do It and Do It Well

    Course Director: Kurt M. Eichholz, MD, FACS, FAANS – St. Louis Minimally Invasive Spine Center

    Course Director: Karthik HS Madhavan, MD – Sanford Health/ University of North Dakota

    The Ambulatory Surgical Center is a potentially sustainable financial model in the setting of spine surgery. Several spine surgeons have been moving part of their practice to an ASC. This course provides an overview of the development and operations of an ASC, from early simple cases to more complex procedures. Spine surgery in the ASC setting continues to evolve, as more minimally invasive procedures are being developed. As more spine surgeons move towards ASC’s they need to have a better understanding of the ASC reimbursement system, recent trends in ASC surgeries and enabling technologies.

    Ticketed Event

  • 1:30 PM – 5:30 PM EST
    (SPEC4) Special Course 4: Innovations in Spine

    Course Director: Paul Park, MD – Semmes Murphey Clinic

    Course Director: Juan S. Uribe, MD – Barrow Neurological Insitute

    This course will cover technological, as well as operative and non-operative advances in the treatment of spinal disease. Topics will include novel non-fusion options for the treatment of back pain, regenerative technologies, artificial intelligence, surface technology, expandable cage technology, advanced application of navigation and robotics. Many of these innovations have the potential to improve surgical efficiency, safety and outcomes. Attendees will gain a better understanding of the basis for these technologies and techniques, its applications clinically, evidence for the technologies, outcomes and costs.

    Ticketed Event

  • 3:30 PM – 5:00 PM EST
    (INT-21) Industry Supported Hands-On Cadaver Session: Decreasing Blood Loss & Improving Efficiencies in MIS & Complex Spine Cases with BoneScalpel and Bone Graft Substitutes Sponsored by Bioventus
    Join our esteemed faculty to hear how they were able to see more and achieve more with The TELIGEN System, an integrated technology platform that delivers an advanced visualization experience in conjunction with the TELIGEN Vue procedural solution.

    Sponsored Session

  • 6:00 PM – 9:00 PM EST
    (OPENREC) Opening Reception

    Social Event

  • Friday, March 17, 2023
  • 6:30 AM – 6:30 PM EST
    Registration
  • 7:00 AM – 7:45 AM EST
    Continental Breakfast
  • 7:00 AM – 7:45 AM EST
    (INT-10) Industry Sponsored Breakfast: Explore the Unseen with Spineology: The Future of Endoscopic Fusion Sponsored by Spineology

    Industry Speaker: Michael Y. Wang, MD – University of Miami

    Industry Speaker: Saqib Hasan

    This in-depth discussion will remove the stigma of intraoperative ultrasound and introduce an innovative, essential technology that provides active imaging during a variety of spinal procedures.
    It will review the only soft tissue visualization platform that can be easily incorporated into the surgical workflow, where the surgeon can monitor spinal cord health, identify key anatomy, and verify the extent of decompression.

    Sponsored Session

  • 7:00 AM – 6:00 PM EST
    (SPEAK) Speaker Ready Room
  • 8:00 AM – 10:05 AM EST
    (SS-1) Scientific Session 1: Sports & Spine

    Moderator: Praveen V. Mummaneni, MD, MBA – Department of Neurological Surgery, University of California, San Francisco

    Moderator: David O. Okonkwo, MD, PhD – Department of Neurological Surgery, University of Pittsburgh Medical Center

    Trauma

    Spine

  • 9:00 AM – 4:30 PM EST
    Exhibit Hall
  • 10:00 AM – 10:10 AM EST
    (INT-14) What's New Presentation: P-15 Peptide: A Game Changer in Spinal Fusion Surgery Sponsored by Cerapedics

    Industry Speaker: Michael P. Steinmetz, MD – Cleveland Clinic Lerner College of Medicine

    Session will review the complex landscape of bone graft products available for use in spinal fusions while highlighting the clinical decision matrix surgeons are faced with when selecting their graft. Participate in this session to expand your awareness of i-FACTOR's 72-month data, its potential role in spinal fusion, and what's on the horizon for P-15.

    Sponsored Session

  • 10:05 AM – 10:30 AM EST
    Beverage Break Sponsored by NuVasive and What's New Session in the Exhibit Hall
  • 10:15 AM – 10:25 AM EST
    (INT-15) What's New Presentation: HEDRON™: Benefits of 3D Printed Technology in Spine Surgery Sponsored by Globus Medical

    Industry Speaker: Michael P. Steinmetz, MD – Cleveland Clinic Lerner College of Medicine

    HEDRON™ implant technology offers a wide variety of interbody spacers across different applications. During the ten-minute technology review of Globus Medical’s HEDRON™ 3D Printed technology, the surgeon speaker will discuss the clinical impact of titanium 3D printed interbody spacers.

    Sponsored Session

  • 10:30 AM – 12:15 PM EST
    (SS-2) Scientific Session 2: Excellence Requires Change

    Moderator: Adam S. Kanter, MD – Hoag Specialty Clinic

    Moderator: Charles Sansur, MD, MHSc – University of Maryland Medical Center

    Peripheral Nerve

    Spine

  • 12:30 PM – 12:40 PM EST
    (INT-12) What's New Presentation: Is There a Better Alternative to the Surgical Microscope for Minimally Invasive Lumbar Spine Surgery? New Data on the Ergonomic Impact, Safety and Operating Room Efficiency of Viseon MaxView Sponsored by Viseon

    Sponsored Session

  • 12:30 PM – 1:15 PM EST
    Lunch in the Exhibit Hall
  • 12:30 PM – 1:15 PM EST
    (INT-2) Industry Lunch Symposia: The Future VUE of MIS Surgery Featuring the TELIGEN™ System Sponsored by DePuy Synthes

    Industry Speaker: Richard G. Fessler, MD, PhD – Rush University Medical Center

    Industry Speaker: Michael Y. Wang, MD – University of Miami

    Join our esteemed faculty to hear how they were able to see more and achieve more with The TELIGEN System, an integrated technology platform that delivers an advanced visualization experience in conjunction with the TELIGEN Vue procedural solution.

    Sponsored Session

  • 12:30 PM – 1:15 PM EST
    (INT-3) A Comprehensive Review of the Prone Lateral Technique with Robotic Navigation Sponsored by Globus Medical
    This discussion will focus on Globus Medical's comprehensive Prone Lateral surgical solution, including ExcelsiusGPS® for robotic navigation, Excelsius3D™ for intraoperative imaging, Expandable interbody spacer technology, and the NEW prone lateral patient positioner. The audience will gain a full understanding of this technique including setup, workflow and the patient selection process. The speaker will present benefits of the technology for this surgical application and share case reviews as well as workflow recommendations.

    Sponsored Session

  • 12:30 PM – 1:15 PM EST
    (INT-4) Industry Lunch Symposia: Intelligence-Based Medicine: How AI and Enabling Technologies Are Changing The Way We Practice Spine Surgery Sponsored by Medtronic

    Industry Speaker: Andrew Grossbach, MD

    Industry Speaker: Martin H. Pham, MD – University of California, San Diego

    Sponsored Session

  • 12:30 PM – 1:15 PM EST
    (INT-5) Industry Lunch Symposia: Carbon Fiber: Shifting the Tumor Care Paradigm Sponsored by icotec

    Industry Speaker: John H. Shin, MD – Massachusetts General Hospital, Harvard Medical School

    Industry Speaker: Bernhard Meyer, n/a – Department of Neurosurgery, Technical Universtiy Munich

    Industry Speaker: Joshua Palmer, MD – The Ohio State University

    Join us for an interactive discussion on the impact Carbon/PEEK implants are having on multidisciplinary care for spine tumor patients worldwide. Hear first-hand experiences from leading experts in the field and learn how they are improving patient outcomes by expanding treatment options and enabling safer care.

    Sponsored Session

  • 12:45 PM – 12:55 PM EST
    (INT-13) What's New Presentation: When Fusion Is All You Want to See Sponsored by Spinal Elements

    Sponsored Session

  • 1:15 PM – 2:30 PM EST
    (SS-3) Scientific Session 3: Spine Confessions: Confronting the Elephant in the Room

    Moderator: Srinivas Prasad, MD – Thomas Jefferson University

    Moderator: Charles Sansur, MD, MHSc – University of Maryland Medical Center

    Complication Management

    Spine

  • 2:30 PM – 3:10 PM EST
    Beverage Break and What's New Session in the Exhibit Hall
  • 2:35 PM – 2:45 PM EST
    (INT-16) What's New Presentation: Delivering Precision Medicine to the Interbody Space with aprevo® Patient Specific Devices Sponsored by Carlsmed

    Industry Speaker: Christopher P. Ames, MD – University of California, San Francisco

    Sponsored Session

  • 2:50 PM – 3:00 PM EST
    (INT-17) What's New Presentation: iFuse Bedrock Granite - The Latest Evolution in Spinopelvic Fixation Sponsored by SI-BONE

    Industry Speaker: Juan S. Uribe, MD – Barrow Neurological Insitute

    Join Dr. Juan Uribe, Chief of Spinal Disorders at Barrow Neurological Institute for a review of spinopelvic fixation complications, solutions, and the latest evolution in fixation, iFuse Bedrock Granite. Topics covered include Iliac vs S2AI fixation, stacked configurations, and iFuse Bedrock Granite features & Benefits.

    Sponsored Session

  • 3:10 PM – 4:40 PM EST
    (SS-4) Scientific Session 4: The Art of Spine Surgery

    Moderator: Burak M. Ozgur, MD – Hoag Spine Center, Hoag Hospital

    Moderator: Zoher Ghogawala, MD (he/him/his) – Lahey Hospital and Medical Center

    Technology

    Spine

  • 4:40 PM – 6:15 PM EST
    (DEBATE) Debates: Millennial Mayhem

    Moderator: Mohamad Bydon, MD – Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55902, USA

    Moderator: Steven Ludwig, MD – University of Maryland Medical Center

    Socioeconomic

    Spine

  • 6:15 PM – 7:30 PM EST
    (BOOTH) Booth Crawl in the Exhibit Hall

    Social Event

  • Saturday, March 18, 2023
  • 6:30 AM – 5:00 PM EST
    Registration
  • 7:00 AM – 7:45 AM EST
    Continental Breakfast
  • 7:00 AM – 7:45 AM EST
    (INT-11) Industry Sponsored Breakfast: Redefining Soft Tissue Visualization for Spinal Procedures with Intraoperative Ultrasound Sponsored by BK Medical

    Industry Speaker: Timothy Chryssikos, MD, PhD – University of California, San Francisco

    Industry Speaker: Praveen V. Mummaneni, MD, MBA – Department of Neurological Surgery, University of California, San Francisco

    Industry Speaker: Saman Shabani, MD – University of Wisconsin

    This in-depth discussion will remove the stigma of intraoperative ultrasound and introduce an innovative, essential technology that provides active imaging during a variety of spinal procedures.
    It will review the only soft tissue visualization platform that can be easily incorporated into the surgical workflow, where the surgeon can monitor spinal cord health, identify key anatomy, and verify the extent of decompression.

    Sponsored Session

  • 7:00 AM – 4:00 PM EST
    (SPEAK) Speaker Ready Room
  • 7:45 AM – 9:15 AM EST
    (AB-1) Award Winning Abstract Presentations: Session 1

    Moderator: Yakov Gologorsky, MD, FAANS – Metropolitan Neurosurgery Associates

    Moderator: Nathan Pratt, MD (he/him/his) – University of Texas Medical Branch

    Introduction: Robotic spine surgery is increasing in utilization. Previous studies described improved screw accuracy and fewer complications with robot assisted surgery. Other studies have reported outcomes associated with fellow involvement in spine surgeries. This study focuses on the effect of new fellow involvement in robotic spine surgery. We hypothesize there will be an increase in robot time/screw associated with new fellow involvement.

    Methods: Prospectively collected data of patients undergoing robotic spine surgery by a single attending surgeon with assistance of a fellow were reviewed. All fellows completed neurosurgery or orthopedic residency and were undergoing an additional year of training. New fellow and experienced fellow cases were compared through review of operative reports and rotation schedules. An experienced fellow was one who had previous training with the attending surgeon earlier in the training year. Homogeneity of cases between fellows was assessed. Times reported are inclusive of registration.

    Results: 82 patients (56%F, mean age 57±18) were included. There were no differences in age, primary diagnosis, levels fused, and revision status between cases by new and experienced fellows. Mean instrumented levels were 8±5. Mean total robotic time for new and experienced fellows was 32.5 and 22.0 minutes (p < 0.05), respectively. Total number of robotic screws was higher for new fellows (18.5 vs 13.1 screws,p < 0.05). There was no difference in mean robot time/screw time (1.9 vs 2.1 minutes,p=0.41). There were no robot related intra-operative complications. All executed robotic screws were accurate and there was no robot abandonment. There was no difference in mean fluoroscopic time (37.0ms and 37.7ms,p=0.9) or radiation doses (15.5mGy and 12.5mGy,p=0.5).

    Conclusion : No differences in mean robot time/screw, fluoroscopic time or dose between new and experienced fellows were found. Total robot time was increased for new fellows, however, there was a significant increase in number of screws placed by new fellows which would explain the difference in total robot time. Equivalent time/screw in both groups with no inaccurate screws and no robot related intra-operative complications suggests fellow involvement is safe and doesn't increase time for robot related set-up and utilization.

    How to Improve Patient Care:

  • 7:45 AM – 9:15 AM EST
    (AB-2) Award Winning Abstract Presentations: Session 2

    Moderator: Benjamin Elder, MD, PhD – Mayo Clinic

    Moderator: Mark E. Oppenlander, MD – Barrow Brain and Spine

    Introduction: Intraoperative RBC salvage (aka Cell Saver) is widely employed in spinal deformity surgery. Unlike other surgical subspecialities wherein blood is immediately salvaged (with low potential RBC injury), modern approaches to spine surgery inherently result in collection of blood exposed to high-heat electrocautery, prolonged stasis, and abrasive pharmaceuticals, potentially resulting in RBC injury. However, this has not been studied in a scientific manner. We present preliminary results of a prospective study defining the quality of RBC salvage in spinal deformity surgery.

    Methods: Patients undergoing spinal deformity surgery with Cell Saver were prospectively enrolled (N = 35). Comparison blood samples include baseline (arterial-line), allogenic (blood bank), and salvage (Cell Saver transfusate). Qualitative laboratory measures of RBC health and hemolysis were collected. Morphological assessment utilized Stimulated Raman Histology (SRH) and artificial intelligence based machine-learning algorithm.

    Results: Salvage blood differed significantly from baseline and allogenic blood, including an unpredictable range of RBC density (2.11-9.52 x1000/uL), and significantly lower MCV (smaller RBCs) vs. baseline and allogenic samples (p = 0.015 and 4.05E-8, respectively). SRH revealed a high proportion (30.7%) of often irreversibly injured acanthocytes (shrunken and irregularly spiculated RBCs). Salvage blood samples had significantly higher intracellular components indicating active lysis: potassium (p = 0.019 and 8.2E-16), LDH (p = 3.3E-11 and 1.66E-6), and free-hemoglobin (p = 4.87E-7 and 0.001). The salvage blood mean hemolysis index (HI) was significantly higher than baseline (155x, p = 1.1E-10) and allogenic blood (7.23x, p = 2.29E-5).

    Conclusion : Intraoperative salvaged blood is composed of high proportions of irreversibly injured RBCs with HI even exceeding levels suitable for transfusion by US FDA and Council of Europe standards, properties that may decrease the suitability of salvaged RBCs as a blood replacement. Collection of postoperative laboratory data, perioperative outcomes, and ex-vivo mechanical fragility and rheological profiles are currently underway.

    How to Improve Patient Care: RBCs salvaged during spinal deformity surgery exhibit signs of irreversible injury and hemolysis, and are potentially poor blood substitutes.

  • 7:45 AM – 9:15 AM EST
    (AB-3) MVP- Top Abstracts: Session 3

    Moderator: Sanjay S. Dhall, MD – Harbor UCLA Medical Center

    Introduction: Anterior plating on some traditional models has been associated with problems such as dysphagia and mechanical injuries. This study compares clinical outcomes over 8-years between the use of zero-profile stand-alone cages with integrated screw fixation vs. published data of traditional ACDFs.

    Methods: Clinical and radiological data were aggregated for patients who underwent single- or multi-level ACDF surgeries between January 2014 and December 2021 with zero-profile stand-alone cage system with integrated instrumentation and screw fixation (n=190). After excluding the cases with missing data, 169 cases (1-level: n=28; 2-levels: n=52; 3-levels: n=65; 4-levels: n=24) were reviewed. Relevant outcome measures included, but not limited to, demographics, and were compared to published literature.

    Results: None of the patients experienced any infections, and zero showcased any signs of postoperative complications such as functional pseudarthrosis or chronic dysphagia, and no readmissions were directed. Patients reported no complaints about chronic radicular pain, neck pain or disability. The length of hospital stay shows that the majority of patients (n = 136, 82.42%) discharged the day following surgery, 10 (6.06%) discharged on the same day, and the remainder (n = 19, 11.52%) discharged 2 or more days after surgery, maximum 6 days, showing significantly shorter stay for the present study. While smoking history was a significant predictor, with patients who currently or previously smoked predicted to have a length of hospital stay 0.33 (95%CI: 0.04, 0.62) days longer than those with no history of smoking (p = .042), the full model was not statistically significant (F[6, 150] = 1.89, p = .086, R2 = .07).

    Conclusion : The zero-profile stand-alone cages with integrated screw fixation have shown equivalent or greater clinical outcomes including shorter length of hospital stay compared to traditional cage profiles. Further clinical data collection will add to the literature and functional utility.

    How to Improve Patient Care:

  • 7:45 AM – 9:15 AM EST
    (AB-4) Specialty Breakout 1: Minimally Invasive/Motion Preservation/General Spine Abstracts

    Moderator: Khoi D. Than, MD (he/him/his) – Department of Neurosurgery, Duke University Hospital

    Introduction: Patient surveys are administered to patients in the hospital or clinic to gauge patient satisfaction. However, intrinsic bias may exist when patients are given surveys by physicians or healthcare providers. Social media is an avenue through which patients can freely discuss their perceptions about their condition. We sought to investigate social media aiming to perform patient-centered analysis utilizing posts regarding anterior cervical discectomy and fusion surgeries on Twitter and Instagram.

    Methods: A cross-sectional analysis of Twitter and Instagram posts was conducted to identify pertinent themes written by patients who have undergone ACDF surgery. Posts tagged with #acdf, #acdfsurgery, and @acdf were searched. Instagram query resulted in 445 posts about the patients experience, and Twitter search yielded no relevant posts. A single investigator coded all posts as relating to none, one, or multiple themes. A second investigator independently coded all posts. Both results were compared to determine any disagreement. Both investigators discussed all discrepancies until a unanimous decision was made.

    Results: Most posts were made post-operatively (93.5%) by women (83.9%). The most common themes were spreading positivity (78.7%), presence of screws/implants (60.9%), awareness of cervical spine pain (57.3%), and quality of life (52.6%). Fisher’s exact test revealed that females are more likely than males to discuss the most difficult part of the experience (p = 0.04) and mental health (p < 0.0001). Most posts (86.1%) had comments underneath. Posts involving resiliency, the most difficult part of the experience, reaching out or offering online support, and the appearance of mobility and stability support were more likely to have comments under the post (p < 0.01). Posts made in 2021 were 7.3 times more likely to discuss fear of the procedure and 2.83 times more likely to discuss general fear than those made in 2020, which may be attributed to the COVID-19 pandemic.

    Conclusion : ACDF patients utilize social media to share personal experiences regarding their surgery and recovery. Gender influenced ACDF patient focus. Patient perception of a condition is essential, so pre-procedural expectations should be emphasized during pre-operative discussions.

    How to Improve Patient Care: Spine surgeons can utilize this research to more effectively determine their patient's primary focus both pre- and post-operatively.

  • 9:00 AM – 2:00 PM EST
    Exhibit Hall
  • 9:15 AM – 10:30 AM EST
    (SS-5) Scientific Session 5: Beyond the Foramen: Peripheral Nerve Perplexities

    Moderator: Line G. Jacques, MD, MSc – University of California, San Francisco

    Moderator: Mark A. Mahan, MD – University of Utah

    This course will cover management of various peripheral nerve disorders and how they relate to spine conditions. Using a case-based format, faculty will review indications, timing of intervention, and surgical approaches. Relevant anatomy, clinical presentation, and outcomes will be discussed. This course is an excellent review for oral board and maintenance of certification.

    Peripheral Nerve

    Spine

  • 10:30 AM – 10:40 AM EST
    (INT-19) What's New Presentation: The Science Behind MagnetOs and Early Experience at a Major Trauma Center Sponsored by Kuros Biosciences

    Sponsored Session

  • 10:30 AM – 11:00 AM EST
    Beverage Break and What's New Session in the Exhibit Hall
  • 10:45 AM – 10:55 AM EST
    (INT-18) What's New Presentation: Introducing the New Versatile Prone Lateral Patient Positioning System Sponsored by Globus Medical

    Industry Speaker: Christopher M. Holland, MD, PhD (he/him/his) – Carolina Neurosurgery and Spine Associates

    This is a ten-minute review of the NEW Prone Lateral Patient Positioner and an introduction to the Excelsius™ Prone Lateral surgical procedural solution, inclusive of ExcelsiusGPS®, Excelsius3D™ and Expandable Spacer technology. The speaker will highlight the features of the new patient positioning system and discuss how combining these technologies for a Prone Lateral procedural approach may provide a better user-experience than competitive solutions.

    Sponsored Session

  • 11:00 AM – 12:20 PM EST
    (CAHILL) Cahill Controversies: To Operate or Not to Operate??!!

    Moderator: Kristen E. Jones, MD, FAANS – University of Minnesota

    Moderator: Wilson Z. Ray, MD (he/him/his) – Washington University in St. Louis School of Medicine

    Socioeconomic

    Spine

  • 12:30 PM – 1:15 PM EST
    Lunch in the Exhibit Hall
  • 12:30 PM – 1:15 PM EST
    (INT-6) Long-term Evidence and Clinical Management of Cervical Disc Arthroplasty Sponsored by Orthofix
    A panel of experts on both large joint and cervical spine arthroplasty will review available long-term outcomes and clinical management strategies following cervical spine arthroplasty.

    Sponsored Session

  • 12:30 PM – 1:15 PM EST
    (INT-7) Industry Lunch Symposia: To Flip or Not to Flip? How UNLEASH™ Lateral, Prone Lateral & ATP Solutions Leverage Enabling Technologies & Innovations to Empower Your Decision Sponsored by DePuy Synthes

    Industry Speaker: Jang W. Yoon, MD – University of Pennsylvania Perelman School of Medicine

    Industry Speaker: Yi Lu, MD PhD – Brigham and Women's Hospital

    Industry Speaker: Elias Dakwar

    Join our esteemed faculty for a moderated debate and discussion on which lateral approach they believe is the best way to access the spine. This session will showcase the UNLEASH™ Lateral and ATP Procedural Solutions, which leverage advanced techniques and enabling technologies to deliver patient-specific care while improving OR workflow and efficiency.

    Sponsored Session

  • 12:30 PM – 1:15 PM EST
    (INT-8) Industry Lunch Symposia: Robotic Navigation: Benefits of Adding Automated Trajectory Alignment to your Navigation Workflow Sponsored by Globus Medical

    Industry Speaker: Nicholas Theodore, MD, MS (he/him/his) – Johns Hopkins University School of Medicine

    This panel discussion will focus on integrating Excelsius™ technology into a surgical workflow and specifically discuss the benefits this technology offers over freehand navigation techniques. The speaker will review the impact of adding automated alignment of surgeon-selected trajectories and the introduction of Excelsius3D™ to further facilitate workflow through a comprehensive ecosystem.

    Sponsored Session

  • 12:30 PM – 1:15 PM EST
    (INT-9) Industry Lunch Symposia: PTP - The Evolution of the Lateral Approach Sponsored by ATEC

    Industry Speaker: John Pollina, MD – University at Buffalo Neurosurgery

    Industry Speaker: Gurvinder Deol, MD – Wake Orthopedics

    PTP utilizes a maximally efficient prone position while providing a consistently reproducible approach, enabling the surgeon to achieve powerful alignment. PTP is the next step for lateral interbody fusion (LIF) bringing together the benefits of an MIS transpsoas approach with the advantages of an ergonomic prone position, facilitating an intuitively superior single-position surgery used to treat a wide range of patient pathologies.

    Sponsored Session

  • 1:15 PM – 2:30 PM EST
    (SS-6) Scientific Session 6: Leaders in Spine: Tales from the Crypt

    Moderator: Irene Say, MD – UCSF

    Moderator: Juan S. Uribe, MD – Barrow Neurological Insitute

    Socioeconomic

    Spine

  • 2:30 PM – 5:00 PM EST
    (SPEC5) Special Course 5: Spine Summit Grand Rounds: Difficult Cases - The Decision-Making Dilemma

    Course Director: Eve Tsai, MD, PhD – University of Ottawa

    Course Director: Christopher Maulucci, MD (he/him/his) – Tulane university

    This course with a focus on Spine Section member participation. Spine Section members are encourage to submit their cases through the Spine Section portal. Intended for audience members to bring difficult cases they have managed or are currently managing.

    Ticketed Event

    Spine

  • 2:30 PM – 5:00 PM EST
    (SPEC6) Special Course 6: Starting Your Career: Practical Tips for Success

    Course Director: Owoicho Adogwa, MD, MPH – Department of Neurosurgery, University of Cincinnati School of Medicine

    Course Director: Laura Snyder, MD – Barrow Neurological Institute

    This course addresses neurosurgery and neuroscience research across the continuum of scientific inquiry: clinical research, translational research, comparative effectiveness research and bench/basic science research. In this comprehensive course, you will hear from scientific leaders in neurosurgery/neuroscience research, about surgeon- and institutional-level factors that enhance your success as an early career investigator. The course will be beneficial to neurosurgery residents and junior faculty interested in pursuing careers as surgeon-scientists/researcher.

    Ticketed Event

    Early Career Development

  • 2:30 PM – 5:00 PM EST
    (SPEC7) Special Course 7: Practical Matters: Hands-On Operating Room Preparation for the APP

    Course Director: Corinna Zygourakis, MD – Stanford Health Care

    This course will teach the must-have knowledge and skills to ensure success in the operating room for every Advanced Practice Provider.

    Ticketed Event

    Advanced Practice Provider

  • 2:30 PM – 5:00 PM EST
    (SPEC8) Special Course 8: Treatment and Complication Avoidance in the Management of Spinal Tumors

    Course Director: Ilya Laufer, MD – NYU Langone Department of Neurosurgery

    Course Director: John H. Shin, MD – Massachusetts General Hospital, Harvard Medical School

    This course will review and highlight the multi-disciplinary management of spinal tumors for the practicing surgeon. Practical tips for managing common tumors and clinical scenarios with an emphasis on complications avoidance and surgical planning will be emphasized. Participants are encouraged to prepare and present cases for discussion.

    Ticketed Event

    Tumor

    Spine

  • 5:00 PM – 6:00 PM EST
    (WINS) WINS Reception

    Social Event

  • 6:30 PM – 9:00 PM EST
    (SOC) Young Spine Surgeon Reception & Dinner (pre-registration required, spots are limited)

    Social Event

    Ticketed Event

  • Sunday, March 19, 2023
  • 6:30 AM – 11:30 AM EST
    Registration
  • 6:30 AM – 12:15 PM EST
    (SPEAK) Speaker Ready Room
  • 7:00 AM – 7:30 AM EST
    Breakfast Case Discussions: Challenging Peripheral Nerve Cases Submitted by You

    Moderator: Zarina S. Ali, MD (she/her/hers) – University of Pennsylvania

    Moderator: Elias B. Rizk, MD, PhD, MSc – Department of Neurosurgery, Penn State Milton S. Hershey Medical Center

  • 7:00 AM – 7:45 AM EST
    Continental Breakfast
  • 7:30 AM – 9:30 AM EST
    (AB-5) Specialty Breakout 2: Trauma/General Spine Abstracts

    Moderator: Eve Tsai, MD, PhD – University of Ottawa

    Moderator: Erik Hayman, MD – University of South Florida

    Introduction: The Manufacturer and User Facility Database (MAUDE) provided by the Food and Drug Administration (FDA) organization is a regulatory tool for post market surveillance providing vital information regarding defects and adverse events pertaining to commercially available devices. Corpectomies devices have evolved over the years to the current expandable titanium cage commonly used. We present an overview of the adverse events of corpectomies reported in the MAUDE database.

    Methods: Retrospective data was collected on the MAUDE database between January 1, 2010 to October 18, 2022. Corpectomy cages included those manufactured by Medtronic, Globus, Depuy Synthes. Reports that were duplicates, contained insufficient information and involved non-corpectomy devices were excluded.

    Results: Overall, 348 adverse events met the inclusion criteria. Corpectomy devices (348) included Medtronic 158 (T2 Stratosphere), Globus Medical - 42 (Fortify - 28, XPAND – 14), Stryker – 83(VLIFT), Depuy Synthes – 60(XRL) and Ulrich Medical –5 (Solidity). Corpectomy related adverse events were grouped into 23 categories .Corpectomy breakage (18%) was the most widely reported adverse event followed by migration/expulsion of device (16%). Fracture (10%) altered mechanics (10%), activation failure (7%) and collapse (7%) were the other prominent device related complications. Of the reported events, patients commonly did not have any clinical signs/symptoms (72%) while 12% reports had inadequate patient related information. Other patient related complications included bone fracture, implant failure, hemorrhage, peripheral nerve injury, pain, post-operative wound infection, tissue damage etc. Corpectomy collapse was the most common device complication reported from Fortify (15/28) and Xpand (4/14) while the most common complication for VLIFT was corpectomy break (35/83). T2 Stratosphere reported migration or expulsion of device (45/158) and XRL reported mechanical complications (13/60) as the most common complication.

    Conclusion : MAUDE database serves as a valuable post market surveillance tool. Valuable information regarding device related complications can aid surgeons in clinical decision making.

    How to Improve Patient Care: Few corpectomy devices are commercially available. While the MAUDE database is not mandated, it provides a unique insight into the possible effectiveness of these devices

  • 7:30 AM – 9:30 AM EST
    (AB-6) Specialty Breakout 3: Tumor/General Spine Abstracts

    Moderator: Oren Gottfried, MD (he/him/his) – Duke University

    Moderator: Patricia Sullivan, MD – Department of Neurosurgery, The Warren Alpert Medical School of Brown University and Lifespan Health System/Rhode Island Hospital, Providence, Rhode Island

    Introduction: Spinal surgery has historically relied on patient-reported outcome measures as the gold standard to assess post-operative outcomes. To supplement these subjective questionnaires, patient mobility data harvested from built-in accelerometry within smartphones was analyzed to provide granular information about a patient’s pre-operative and post-operative functional status. In this study, we utilized first-order derivatives of activity data to phenotype the pre-operative and post-operative courses of patients who underwent either lumbar decompression (LD) or fusion (LF) surgery.

    Methods: LD and LF patients were retrospectively consented and enrolled. Activity data (steps-per-day) recorded in Apple Health (Apple Inc., Cupertino, CA) over 2 years peri-operatively was classified into temporal epochs representing distinct functional states including pre-operative baseline, pre-operative decline, and post-operative recovery. The first-order derivatives of patient activity magnitude across time were then calculated for all epochs.

    Results: A total of 21 LD and 31 LF patients were included, encompassing over 70,000 datapoints. 66.7% (14/21) of LD and 67.7% (21/31) of LF patients experienced at least one period of activity decline pre-operatively, defined as diminished physical activity compared to baseline. During these declines, the mean first-order derivative for LD patient activity, representing the rate of activity decline during disease progression, was significantly more positive than that for LF (0.043 vs. -0.123, p = 0.045), indicating a greater rate of decline for LF compared to LD. During post-operative recovery, the LD first-order derivative was significantly higher than LF’s (0.003 vs. -0.060, p = 0.041), suggesting a more gradual functional recovery in LF compared to LD.

    Conclusion : First-order derivative analysis of patient activity data is a promising technique for phenotyping patient activity profiles and differentiating between different pathologies and the morbidity of surgical treatments. Comparing patient activity data undergoing different surgical procedures can help establish common presenting patterns of pre-operative patient activity as well as the unique contributions of specific surgical interventions to overall patient outcomes.

    How to Improve Patient Care:

  • 7:30 AM – 9:30 AM EST
    (AB-7) Specialty Breakout 4: Peripheral Nerve/Basic Science/General Spine Abstracts

    Moderator: Alexander E. Ropper, MD – Baylor College of Medicine Neurosurgery

    Moderator: Suzanne Tharin, MD, PhD, FAANS (she/her/hers) – Stanford University School of Medicine

    Introduction: A plethora of literature exists comparing outcomes between robot-assisted minimally invasive techniques and conventional open approaches; however, the comparison between robot-assisted percutaneous and robot-assisted open surgeries remains largely unknown. Determining differences between these cohorts can inform surgeons and patients during their preoperative planning. This is the first prospective, multicenter study of four geographically diverse institutions on robot-assisted spine surgery to compare the outcomes/complications between two robot-assisted techniques.

    Methods: Adult patients undergoing spine surgery with a bone-mounted robotic-assist with navigation confirmation were prospectively enrolled from 2020-2022 at 4 independent institutions, among 6 spine surgeons. A propensity score matching (PSM) algorithm was employed to control for potential selection bias between percutaneous and open surgery. The minimum follow-up was 90 days.

    Results: After PSM, 336 patients with 2,524 robot-assisted screws remained without significant differences in demographics/comorbidities, diagnoses, and operative factors. Overall, mean ASA 2.3±0.6, BMI 29.8±5.5kg/m², and length of stay (LOS) 3.1±1.8 days, with 9.0% nicotine users. Most common diagnoses: spondylolisthesis (40%), lumbar stenosis (21%), and deformity (15%); mean number of levels fused 4.0±3.1. Although no difference was found for operative time (195±88min open, 197±120min percutaneous, p=0.839), robot time/screw was significantly lower for open (4.3±2.5min open, 8.3±3.8min percutaneous, p< 0.001). There was no difference in robot abandonment (2.1% open, 0% percutaneous, p=0.081) and screw accuracy (99.1% open, 98.6% percutaneous, p=0.307); however, open was associated with screws not executed due to registration/unreachability issues (1% open, 0% percutaneous, p=0.001). Intraoperative blood loss was greater for open (301mL open, 108mL percutaneous, p< 0.001). No difference was observed for intraoperative complications, LOS, 90 day surgical/medical complications, and revision surgery.

    Conclusion : In the first prospective, multicenter robot-assisted surgery study, open approach was associated with shorter robot time/screw, higher robot-related registration/unreachability issues, and greater intraoperative blood loss compared to percutaneous approach. Both had high screw accuracy (99%) with no difference in robot abandonment, screw accuracy, LOS, revision surgery, and intraoperative/90 day postoperative complications between groups.

    How to Improve Patient Care:

  • 7:30 AM – 9:30 AM EST
    (AB-8) Specialty Breakout 5: Spinal Deformity/General Spine Abstracts

    Moderator: Darryl Lau, MD – NYU Langone

    Moderator: Harry Mushlin, MD – Department of Neurological Surgery, Renaissance School of Medicine at Stony Brook University

    Introduction: There is a high prevalence of cervical myelopathy that requires surgery; as such it is important to identify how different groups benefit from surgery. The AANS launched the Quality Outcomes Database prospective longitudinal registry that includes demographic, clinical, and patient-reported outcome data to measure the safety and quality of neurosurgical procedures. In this study we assess the impact of gender on patient reported outcomes in patients undergoing surgery for cervical myelopathy.

    Methods: We analyzed 1152 patients undergoing surgery for cervical myelopathy in the Quality Outcomes Database (QOD) cervical module. A univariate comparison of baseline patient characteristics between males and females undergoing surgery for CSM was performed, with statistical significance determined by a two-sided Wilcoxon rank sum test. Baseline characteristics that significantly differed between males and females were included in a multivariable generalized linear model comparing baseline and 1-year postoperative Neck Disability Index (NDI) scores.

    Results: This study included 546 females and 604 males. Females demonstrated a significantly greater improvement in NDI 1 year after surgery (p = 0.036). In addition to gender, the presence of axial neck pain and insurance status were also significantly predictive of improvement in NDI after surgery (p = 0.0013, and p = 0.0058 respectively). There was no significant difference in baseline NDI or NDI 1 year after surgery between the laminoplasty versus laminectomy/fusion group.

    Conclusion : Females are more likely to benefit from surgery for cervical myelopathy compared to males. Interestingly, presence of preoperative axial neck pain and insurance status are also associated with improvements in NDI post operatively. It is important to both identify gender differences in pre-operative baseline characteristics and postoperative outcomes after surgery in order to deliver more personalized and patient-centric care.

    How to Improve Patient Care:

  • 9:30 AM – 11:15 AM EST
    (SS-7) Scientific Session 7: Our Greater Purpose

    Moderator: Scott Meyer, MD (he/him/his) – Atlantic Neurosurgical Specialists

    Moderator: Charles Sansur, MD, MHSc – University of Maryland Medical Center

    This session will review and highlight the multi-disciplinary spine surgery success stories. We often focus on our complications and learn from them, but in a similar fashion we can also learn from our greatest success stories. This course will go through such cases and focus will be placed on critical components that led to the success of the case. Participants are encouraged to prepare and present cases for discussion.

    Socioeconomic

    Spine

  • 11:15 AM – 12:10 PM EST
    (SPECBUS) Special Session: Business Tips, Pearls, & Tactics (co-brand with CSNS/CSNS faculty)

    Moderator: Kurt M. Eichholz, MD, FACS, FAANS – St. Louis Minimally Invasive Spine Center

    Moderator: Yi Lu, MD PhD – Brigham and Women's Hospital

  • 12:10 PM – 12:35 PM EST
    (BUSMTG) DSPN Business Meeting

    Speaker: Adam S. Kanter, MD – Hoag Specialty Clinic

    Speaker: Juan S. Uribe, MD – Barrow Neurological Insitute

    Speaker: Luis M. Tumialan, MD – Barrow Brain and Spine

    Speaker: Domagoj Coric, MD – Carolina Neurosurgery & Spine Associates

    Speaker: Elad I. Levy, MD, MBA (he/him/his) – University at Buffalo Neurosurgery

    Speaker: John Knightly, MD, FAANS (he/him/his) – AANS

    Speaker: Joseph Cheng, MD, MS – University of Cincinnati College of Medicine