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Emerging Technologies Spine Education Summit

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Emerging Technologies Spine Education Summit Powered By Docstoc
					                    CONFIDENTIAL DRAFT

           EVIDENCE AND TECHNOLOGY SPINE SUMMIT
                        Park City, UT

                   February 2 – February 5, 2011




                               Surgical Course Directors
                                   Dr. Darrel Brodke
                                  Dr. Alan Hilibrand
                                  Dr. Carl Lauryssen
                                   Dr. Jeffrey Wang
                                    Dr. Jim Youssef

                            Non-Surgical Course Directors
                                 Dr. William Sullivan
                                 Dr. Michael Geraci




                        WEDNESDAY, FEBRUARY 2

1:00 – 4:00 pm   Afternoon Registration
6:00 – 8:00 pm   Evening Registration

6:30 pm          Faculty Meeting




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                               THURSDAY, FEBRUARY 3

                                      THURSDAY MORNING

6:30 – 7:00 am Breakfast
7:00 – 7:30 am Workshops (non-CME)

7:30 – 9:00 am SURGICAL SESSION: Evidence-Based Medicine – Biologics
     Biologics: Current Issues/Lack of Evidence/Problems
     Demineralized Bone Matrix and the Evidence
     Growth Factors and the Evidence
     Allograft Cells
     Synthetics/Ceramics/Osteoconductive products – Evidence and Differences
     Bone Marrow Aspirates
     Intradiscal Therapy using Fibrogen & Apoprotein Injected into Anular Tears
     Update on Biologics Registry
     Discussion –

9:00 – 10:15 Biologics Panel Discussion: Fusion Debates/Scenarios

      Lumbar Single Level Fusion
      Scoliosis/Deformity Fusion
      Revision Multilevel Lumbar Fusion
      Anterior Cervical Fusion
      Posterior Cervical Fusion

7:30 – 10:00 am NON-SURGICAL SESSION: Evidence-Based Medicine – What Can We Offer When
Surgeons Recommend Fusion?
     Can Exam Identify Pain Generator (disc/facet/pars defect)?
     Physical Therapy: What’s The Role of Directional Preference Based Therapy?
     Efficacy of Injections for axial lower back pain
     IntraDiscal rhGDF-5 – A Biologic Approach for Lumbar DDD
     Psychological Evaluation Prior to Surgery or Other Procedures
     Case example with Panel Discussion
     Discussion

                                     THURSDAY AFTERNOON

   3:00 – 4:00 pm POSTER SESSION and Apres Ski refreshments

   3:30 – 4:00 pm Special Session for Non-Physicians – Surgical Preparedness and
               PreOperativePlanning; Clinic Management and When to Refer


   4:00 – 5:00 pm JOINT SESSION: Modern Management of Cervical Radiculopathy

   Perspectives on Natural History and Nonoperative Treatments
    Natural history of Axial Neck Pain
    Natural history of Cervical Radiculopathy
    Discussion – 10 minutes
    Evidence for Traction and Physical Therapy
    Evidence for Cervical epidural steroids
    Discussion –

   5:00 – 6:00 pm SURGICAL: Operative Treatment of Cervical Radiculopathy

   Case Presentation – Cervical Radiculopathy – 5 minutes
    Cervical foraminotomy through less-invasive approach
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      Anterior cervical discectomy and fusion (Pi
      Anterior cervical discectomy and arthroplasty
      Rebuttals by each speaker
      Discussion –

   6:00 – 7:00 SURGICAL: Management of Cervical Spine Complications
    Management of CSF leaks in the cervical spine
    Management of Vertebral Artery Injuries
    Management of C5 Nerve Palsies
    Management of Dysphagia
    Discussion

5:00 – 6:00 pm NON SURGICAL SESSION – NON-SURGICAL TREATMENT OF CERVICAL
               RADICULOPATHY

      Evidence (or lack of evidence) for Medications
      Cervical ESI Debate: Pros and Cons
      Getting Insurance Approval for non-surgical Treatments: Role of physicians and societies in
       developing guidelines
      Discussion

6:00 – 7:00 pm NON SURGICAL HANDS ON WORKSHOP: EVALUATION AND TREATMENT OF
               THE “CONTAINER” IN PATIENTS WITH CERVICAL RADICULOPATHY


7:30 – 9:30    WELCOME RECEPTION - RED PINE CABIN




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                                FRIDAY, FEBRUARY 4
                                       FRIDAY MORNING
6:30 – 7:00 am Breakfast
7:00 - 7:30 Workshops (Non-CME)

7:30 – 8:45 am JOINT SESSION: Decision-Making in Cervical Myelopathy

      Definition and Natural History of Cervical Myelopathy
      When is surgery indicated for cervical myelopathy?

   Debate: Case of three level disease with cervical myelopathy
    Laminoplasty: Why it’s Better
    Laminectomy and Fusion: Why it’s better
    Anterior Cervical Decompression and Fusion is Best
    Discussion

8:45 – 9:00 am Break

9:00 – 9:50 am SURGICAL SESSION: Spinal Stenosis
   Cost Effectiveness in the Treatment of Spinal Stenosis
    o Are Epidurals and Physical Therapy better than Natural History?
    o Does Open Laminectomy/Laminotomy-Foraminotomy Still Make Sense?
    o MIS Decompression: More Cost Effective or Technology Over Reason?
    o Interspinous Spacers: Where Does This Fit into our Practice?
    o Discussion

9:00 – 9:45 pm NON SURGICAL SESSION: Debating Direct Access and Non-Physician
               Involvement in Spine Care
     PT Direct Access is Good
     PT Direct Access is Not Good
     Discussion

                                        FRIDAY AFTERNOON


3:00 – 4:00 pm POSTER SESSION and Apres Ski Refreshments

3:30 – 4:00 pm Special Session for Non-Physicians – Thoracolumbar Injury Classification and
               Severity Score (TLICS)

4:00 – 4:45 PM: JOINT SESSION: Management of Spondylolysis

      Debate – Case Presentation: Spondylolysis in a 20 year old gymnast
            o Natural History and Non-op Treatment of Isthmic Spondylolisthesis
            o Evidence for Pars Repair
            o Evidence for Fusion: How to Do It.
      Discussion

4:45 – 6:10 pm SURGICAL SESSION: Management of Degenerative Spondylolisthesis

      Debate – Case Presentation – Degenerative Spondylolisthesis in a 70 year old –
          o Non-Operative Treatment Works Well
          o Decompression Alone: When Is it OK?
          o Decompression with Fusion: Is This Really the Best Treatment?
          o MIS Decompression in Degenerative Spondylolisthesis: Can We Avoid the Fusion?
          o MIS Interbody and Posterior Fusion: An Advantage Over Other Options
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       Surgical failures – Have We Gone Too Far with MIS?
       Management of BMP Radiculitis After TLIF/PLIF
       Discussion


4:45 – 6:00 pm NON SURGICAL SESSION

Evidence-Based Medicine: Research Update
    Intradiscal Therapy Using Fibrogen & Apoprotein Injected into Anular Tears


Hands-On Workshop
    Evaluation of Spine Stability in a 5 to 10 Minute Re-Visit for the Busy Clinician




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                                   SATURDAY, FEBRUARY 5
                                               SATURDAY MORNING

6:30 – 7:00 am Breakfast
7:00 - 7:30 Workshops (Non CME)

7:30 – 9:35 SURGICAL SESSION: Surgical Spine Trauma

   Debate #1:
   Case: Multiple injured patient, 3 column injury L1 Burst Fxr w/conus injury
    Anterior approach only
    Posterior approach only
    Great indication for MIS “damage control”
    Discussion –

    Debate #2:
    Case: C6-7 Facet Dislocation, Complete SCI, less than 4 hrs post-injury
     Reduce with traction then MRI
     MRI, then reduce with traction
     Take immediately to OR to reduce and stabilize
     Discussion

    Debate #3:
    Case - Management of intraoperative cervical cord injury
     I would definitely give steroids
     I would definitely NOT give steroids
     Discussion


7:30 – 9:30 NON SURGICAL SESSION: SPINE TRAUMA

      Initial Evaluation of Spine Trauma Patient on Ski Slopes
      Role of Steroids: Current Evidence
      Malingered Pain Related Disorder with Emphasis on Back Injury
      Imaging: What Imaging is Best, When Should it be Performed?
      Case Panel Discussion: 45 year old male, hit a tree. Conscious, but had transient
       quadraparesis. Now arrives to slope-side clinic on spine board.
      Discussion

9:35 – 9:45    Break

9:45 – 10:30   Keynote Address          Professor Regina Herzlinger
                                        Harvard School of Business
                                        “From the Inside: Washington’s Current Health Care Agenda Now That
                                        Extensive Reform has Passed”




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                                          SATURDAY AFTERNOON


3:00 – 4:00 pm Poster Session and Apres Ski
3:30 – 4:00 0 am Special Session for Non-Physicians – Spinal Trauma and Associated Injuries: A
               Trauma Surgeon’s Perspective

4:00 – 5:25 pm JOINT SESSION: Adult Scoliosis
   
      Natural history of progression in adult idiopathic deformity
      Non-operative management of back and leg symptoms in adult deformity
      Update on cost and QALYs for adult deformity
      Discussion

      Case Presentation: Adult Degenerative Scoliosis
           o Posterior Fixation and Fusion Alone
           o Anterior/Posterior Fixation
           o Does the XLIF approach have a role?
      Discussion

5:25 - 6:05 JOINT SESSION: Sagittal Deformity Top to Bottom
    
     Non-operative management: Is there a role for pumps and stimulators
     Osteotomy Techniques
     Junctional Kyphosis and failures above a long fusion
     Discussion

6:05 – 7:40 JOINT SESSION: Update and Debate: Health Care Reform
    
     Implications of 2010 Midterm Elections for the Spine Practitioner
     Comparative Effectiveness Research
     Advocacy Issues for 2011 and Beyond
     Update on medical liability reform
     Discussion

   Debate: Could Canadian Healthcare Work in America?
    YES: “Canadian physicians and their patients are happy"
    NO: “Been there, done that…!”
    Discussion


                                        COURSE ADJOURNS




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