Today at ISASS15 - Day 2 - Thursday, April 16, 2015
The Tumor, Trauma, and Infection session provided a brief but refreshing start to the day as attendees sipped their morning coffee. Pierce Nunley and Isador Lieberman moderated the session, and the session started, fittingly, with a bit of an eye-opener: a presentation entitled Postoperative Spine Dressing Changes Are Unnecessary: Our 15-year Experience with an Institutional Dressing Change Protocol. Other presentations focused on secondary balloon kyphoplasty, and findings on how vertebral fractures affect adjacent discs (not well, as you might imagine).
The day came into full swing with the Presidential Address by ISASS President Gunnar Andersson and inspiring presentations by Presidential Guest Speakers Jiří Dvořák, MD and Robin R. Young. These remarkable speakers provided insights about the Society itself, the use of spine expertise in sports medicine, and the state of the industry, with an especial eye on the future of all of the above. To borrow a FIFA metaphor: we must run to where the ball is going, not where it is.
Jack Zigler and Robert Isaacs moderated the Cervical Degenerative session. A presentation on cervical spondylotic myelopathy found that complications from surgical treatment didn’t affect QoL scores. Another study from the same database found that previous cervical spine surgery, length of surgery, and use of corpectomy had a negative effect on outcomes, while patient characteristics and comodrbidities had no significant effect. Another paper examined the same pathology to see its effect on general health as compared to other diseases, finding its impact on QoL to be more negative than almost any other pathology apart from heart failure. Dr. Sandra Goncalves examined the recovery rates of sensory and motor function after postop — mapping the recovery curve gives you a better idea of how your patients should be coming along. Following, we look at obesity’s impact on cervical spine — it’s known to have an impact on lumbar procedure outcomes, but it appears ACDF outcomes for obese and non-obese patients are quite similar. ACDF standalone versus with anterior plating are compared for 1-level cases; plates caused more blood loss but similar outcomes across a broad spectrum of measures. Another study compares anterior plate and spacers to zero-profile implants to find lower dysphagia rates for the zero-profile group with otherwise comparable outcomes.
Old friends and new gathered to talk hot topics in spine surgery at the Point-Counterpoint Symposium. Topics like kyphosis correction, cervical TDR, intraoperative navigation, and the value of MIS get a dual treatment in more ways than one: two eminent experts in the field each pick a position on the topic and defend it, both by means of serious evidence and by jokingly playing Devil’s Advocate. The end result is a good time rife with colleagues poking fun at each other while enlightening each other too — these Symposia are some of the highlights of the meeting, and they’re part of why ISASS has a reputation for being an intimate gathering despite years’ worth of rapid growth in attendance.
The Biologics Session, as moderated by Ashish Diwan and Stephen Hochschuler, explored the latest in stem cell allograft as fusion adjunct, medical marijuana use in patients with chronic spine disorders (while patients report it is efficacious in treating pain — 81% of Colorado medical marijuana users report it works better than other narcotics to alleviate chronic back pain — they also report some negative side-effects, most notably memory problems and weight gain), BMP-2 and cancer correlations (from an enormous registry, authors found no correlation). Biologics continues to mature and the lively question-and-answer session following these presentations — especially with regard to cost-efficacy calculations.
The afternoon wound down with the Motion Session, moderated by Rolando Garcia and Theirry Marnay. Heterotopic ossification got its due discussion in the context of endplate sizing, and another round in ACDF versus TDR took place, with five-year results finding lower rates of subsequent surgery and adjacent segment disease with TDR and seven-year results finding non-inferiority of TDR versus ACDF.
Spine Talks, where a moderator presents a case study to a small group and facilitates discussion on treatment options, took place on a pair of scenarios: one in the case of deformity correction with MIS techniques, and one of which referred to the treatment of L4-5 degenerative spondy. Afterward, everyone bid each other adieu to begin an evening carousing about San Diego to enjoy cameraderie and networking. Don’t stay out too late, everyone — sessions begin at 8 tomorrow!
Award Winning Papers
ISASS is pleased to announce this year's award winning papers.
Sponsored by Dr. and Mrs. Hansen Yuan
Best overall Paper, The ISASS Leon Wiltse Award
#100: Minimally Invasive SI Joint Fusion Using Triangular Implants vs. Non-surgical Management of Chronic SI Joint Dysfunction: Results of a Prospective Multicenter Randomized Trial
Presenting Author: Peter Whang, MD
Best Clinical Paper, The Charles D. Ray Award
#498: Predictors of Revision Surgery in Adult Spinal Deformity and Impact on Patient-reported Outcomes and Satisfaction – 2-year Follow-up
Presenting Author: Cyrus Jalai
Best Basic Science Paper
#362: Intervertebral Kinematics Correlate with T2 Relaxation Times in the Lower Human Cervical Spine
Presenting Author: Thomas Cha, MD
#46: Comparison of One-level versus Two-level Anterior Cervical Discectomy and Fusion: Clinical and Radiographic Follow-up at 60 Months in Patients Serving as Control Groups in Randomized Trials
Presenting Author: Donna Ohnmeiss, PhD
Sponsored by Tom Errico, MD
Kostiuk Innovation Award
#514: Post Operative Cervical Deformity in 215 Thoracolumbar Adult Spinal Deformity Patients: Prevalence, Risk Factors, and Impact on Patient-reported Outcome and Satisfaction at 2 Year Follow up
Presenting Author: Nancy Worley
Tomorrow at ISASS15
Friday, April 17, 2015
The ISASS15 Scientific Program concludes tomorrow. The third day includes multiple general sessions, symposia, an optional supplementary course Basic and Advanced Endoscopic Spinal Surgery: Indications, Techniques, and Complication Avoidance and the closing of ISASS15.
General Session: Biomechanics
8:00 am - 9:05 am
The first session of Friday's scientific program is General Session: Biomechanics moderated by Lisa Ferrara, PhD, Boyle Cheng, PhD. Nine presentations are scheduled.
Symposium: Spine in the Out-Patient Surgery Center (ASC). The Future?
9:05 am - 10:05 am
Friday morning continues with a symposium on Spine in the Out-Patient Surgery Center (ASC). The Future? moderated by Frank Phillips, MD. Four presentations and a Q&A session are scheduled.
Break on Exhibit Floor
10:05 am - 10:30 am
General Session: Cervical
10:30 am - 11:50 pm
After the morning break, the conference will continue with a general session on Cervical moderated by Gunnar B.J. Andersson, MD, PhD, Luiz Pimenta, MD, PhD. Ten presentations are scheduled.
12:00 pm - 1:00 pm
General Session: Lightning Round
1:00 pm - 2:28 pm
The afternoon begins with a lighting round moderated by Jim Youssef, MD and Donna Ohnmeiss, PhD. Sixteen presentations are scheduled.
General Session: Clinical and Basic Science
2:28 pm - 3:38 pm
Friday afternoon continues with General Session: Clinical and Basic Science moderated by Hansen Yuan, MD, William Sears, MD. Ten presentations are scheduled.
Basic and Advanced Endoscopic Spinal Surgery: Indications, Techniques, and Complication Avoidance
3:30 pm - 6:30 pm
This optional course is free for ISASS15 attendees and is also available independent of ISASS15 registration for a fee of $100 per person, including the reception for course participants.