Today at ISASS15 - Day 1 - Wednesday, April 15, 2015
John O’Toole and Gunny Deol moderated the first portion of the MIS session to start the day. Sessions on how obese patients’ outcomes and complications differ, TLIF vs LLIF in direct comparison, a very thorough exploration of TLIF with a large consecutive prospective case series with 100% FU, and SI joint fusion were explored. Hot topics to go with your hot coffee!
Kern Singh and Sheeraz Qureshi moderated the second portion of the MIS session, which explored topics like meta-analyses of fusion rates using different graft materials in TLIF, XLIF vs TLIF for degenerative spondy, posterior lumbar interbody fusion performed in a less invasive fashion, and discussions of the learning curve associated with a circumferential MIS correction of deformity, the utility of vertebroplasty as compared to conservative treatment, MIS corpectomy results with two-year FU, and treating spine tumors in MIS and open procedures.
The Deformity session, moderated by Neel Anand and Dennis Crandall, found discussions on the topic of creating algorithms to determine means of treatment based on radiographic parameter (which found much improved sagittal alignment by creating a decision tree to help guide surgical decisions), three-column osteotomies and the effect of deformity and level of 3CO’s effect on outcomes, and causes of complications in deformity corrections (heavier patients required significantly more frequent reoperations), and examinations of patients with severe anterior malalignment but who do not compensate by way of pelvic tilt. Presentations also sought to identify predictors of postoperative cervical deformity after adult spine deformity procedures. An index is proposed to quantify possible risk in adult spine deformity procedures — topping the list of risk factors is pulmonary disease and drug use.
After a satisfying lunch at the heavily attended Industry Workshops and elsewhere, ISASS15 attendees were able to enjoy the Thoracolumbar Degenerative General Session as moderated by Dom Coric and Steve Garfin. Information was presented on disc degeneration at 5 years FU that found accelerated degeneration after discography, and a comprehensive look at anterior, posterior, and combined approaches for LIF by preoperative, operative, and postoperative measures in order to find predictors of complications, finding that ALIF has the highest rates of reoperation. New techniques are getting their time in the sun — MAS PLIF gets its due examination in a safety and efficacy study that also examined learning curves versus traditional open PLIF. Frank Phillips compares fusion in degenerative spondy versus fusion in treating degenerative disc disease to find that, yes, payors, fusion is an effective treatment in improving a range of QoL measures in DDD patients. Frederic Martens presents a confirmation of the finding that annular defect size is a significant predictor of reherniation by means of a multi-center, multi-country study. Kee Kim finds an apples-to-apples single-level LLIF and ALIF comparison to favor lateral approach in terms of intraoperative outcomes good news for those who prefer to work on their own rather than with access surgeons.
The Imaging and Applications session, moderated by Rudolph Bertagnoli and Yu-Po Lee, began with a compelling computational model of the influence of sagittal and coronal plane deformity on thoracic volume. Another presentation examines that established targets for T1 Pelvic Angle correction — are we working toward the correct goals for adult deformity correction? After all, radiographic parameters aren’t a perfect proxy for QoL. A study out of Beijing examines 3D navigation effect on treating high-grade developmental spondy, and finds that it increases the accuracy of pedicle screw placement. From Paris, we find that 3D reconstructions are able to identify rotory subluxation before 2D imaging — fascinating to see that a model can reveal more than the reality. Robotic-assisted surgery allows for more accurate placement of instrumentation with decreased radioexposure for the surgeon — they’re devices mounted to table and patient that can use two flouro images to sync and create a 3D images. The arm of the robot moves to assist in positioning instrumentation.
And all that is before you get to the Oral Posters presentations on topics like MIS, Deformity, Cervical, Basic Science, Preservation, and Spine Smorgasbord! It seems that no matter what your area of interest or expertise, you’ll find it represented here at ISASS.
General Session: Tumor, Trauma, and Infection
8:00 am - 8:30 am
The first session of Thursday's scientific program is Tumor, Trauma, and Infection moderated by Pierce Nunley, MD, Isador Lieberman, MD, MBA, FRCSC. Five presentations are scheduled.
Presidential Address and Guest Speakers
8:30 am - 10:10 am
Break on Exhibit Floor
10:10 am - 10:40 am
General Session: Cervical Degenerative
10:40 am - 11:50 pm
The second session on Thursday is General Session: Cervical Degenerative moderated by Jack Zigler, MD, Rob Isaacs, MD. Ten presentations are scheduled.
Industry Workshops (not CME)
12:00 pm - 1:30 pm
Five industry workshops will be held on Thursday.
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Symposium: Point Counterpoint
1:30 pm - 2:30 pm
The second symposium of the scientific program is Point Counterpoint moderated by Matthew Scott-Young, MBBS, FRACS, FAOrthA. Eight speakers are scheduled for four point/counterpoint debates and discussion.
General Session: Biologics
2:30 pm - 3:00 pm
Thursday afternoon continues with General Session: Biologics moderated by Stephen Hochschuler, MD and Ashish Diwan, MD, PhD. Five presentations are scheduled.
Break on Exhibit Floor
3:30 pm - 4:00 pm
General Session: Motion
4:00 pm - 5:10 pm
Next up will be General Session: Motion moderated by Thierry Marnay, MD and Rolando Garcia, MD. Ten presentations are scheduled.
Thursday afternoon concludes with Spine Talks:
Spine Talks - Room 1 - Topic: Deformity Correction with MIS Techniques
5:10 pm - 6:10 pm
Moderated by Juan Uribe, MD.
Spine Talks - Room 2 - Treatment of L4-5 Degenerative Spondylolisthesis
5:10 pm - 6:10 pm
Moderated by Vikas Patel, MD.