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Full Schedule

Full Schedule

  • 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