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Although the ability to evaluate MRI studies is critical to the delivery of effective spine care, most spine specialists learn this skill in an informal fashion during training and in clinical practice. As a result, we may not have an understanding of the science and physics behind MR imaging and the various pulse sequences that are available for obtaining the scans. Many of us prefer to read our patients’ MR imaging studies ourselves rather than rely solely on the “official” radiologist’s report. We learn to make preoperative, intraoperative, and postoperative decisions based on those readings. However, unlike radiologists who are trained to evaluate MRI studies in a systematic fashion, we may be more likely to evaluate the images in a less organized manner and to rely on our anatomic expertise and experience, which may not be the most effective method.

This online course will help teach spine specialists how to systematically evaluate and interpret MR imaging studies of the spine. Although there are many courses that focus on MR imaging of the spine, this one is distinctive in that it is given by spine surgeons and radiologists specifically for spine specialists. As such, it is more clinically oriented than other courses. It also provides an excellent reference for radiologists and others such as physical medicine and rehabilitation clinicians, rheumatology physicians, and nonoperative musculoskeletal care specialists who evaluate MR images of the spine and who would like to gain a better appreciation of the associated clinical aspects.

This course includes videotaped podium presentations in conjunction with audio and slides.  A post-course evaluation will be given to help reinforce your knowledge.

Course Chairman:
A. Jay Khanna, MD

Faculty:
John A. Carrino, MD, MPH
Daniel M. Sciubba, MD


Agenda:

• Introduction (Khanna)
• Essentials of MRI Physics, Pulse Sequences and MRI Safety (Carrino)
• Systematic Review of MR Imaging Studies (Khanna)
• MRI Anatomy of the Spine and Normal Variants (Carrino)
• MRI of the Cervical Spine (Khanna)
• Occipitocervical Imaging and Pathology (Sciubba)
• Magnetic Resonance Imaging of the Lumbar Spine (Khanna)
• Tumors of the Spine (Sciubba)
• Magnetic Resonance Imaging of the Pediatric Spine (Khanna)
• Correlation of MRI with Other Imaging Modalities (Carrino)
• Advanced Techniques in Spine MRI (Carrino)
  

Continuing Medical Education (CME) Information
This activity has been planned and implemented in accordance with the Essential Areas and Standards of the Accreditation Council for Continuing Medical Education (ACCME). The North American Spine Society is accredited by the ACCME to provide continuing medical education for physicians and takes responsibility for the content, quality and scientific integrity of this CME activity.

The North American Spine Society designates this enduring material for a maximum of 9.0 AMA PRA Category 1 Credit(s)^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The American Medical Association has determined that physicians not licensed in the US to participate in this CME activity are eligible for AMA PRA Category 1 Credits™.

This course was released on 8/25/2010, and is available for purchase through 8/24/2013.

Appropriate Audience
Spine specialists who want to learn how to evaluate and interpret MR imaging studies of the spine. Radiologists, physical medicine and rehabilitation clinicians, rheumatology physicians, and nonoperative musculoskeletal care specialists who evaluate MR images of the spine and who would like to gain a better appreciation of the associated clinical aspect are also welcome. Target audience includes: spine surgeons, nonoperative spine care specialists, radiologists with an interest in spine pathology, residents and fellows, Physician Assistants and Nurse Practitioners.

Learning Objectives
Upon completion of this course, participants should be able to:

• Define and recognize the normal MRI anatomy of the cervical, thoracic and lumbar spine.
• Cite and apply the rationale for use of the most common MRI pulse sequences used in the spine.
• Describe the most commonly seen pathologic findings in the cervical, thoracic and lumbar spine.
• Utilize a systematic approach to evaluate MR imaging studies.
• Correlate the imaging findings on spine MRI with those on other imaging modalities.

Conflict of Interest Disclosure
All faculty provided estimated dollar amounts per the NASS Disclosure Policy through the NASS online disclosure module. NASS staff then translated that information into dollar ranges for purposes of this index, as well as for presentation at the live course.

These ranges are as follows:

• None: Existing relationship but no remuneration in prior calendar year
• Level A: $100 to $1000
• Level B: $1,001 to $10,000
• Level C: $10,001 to $25,000
• Level D: $25,001 to $50,000
• Level E: $50,001 to $100,000
• Level F: $100,001 to $500,000
• Level G: $500,001 to $1M
• Level H: $1,000,001 to $2.5M
• Level I: Greater than $2.5M

Carrino, John A.: Research Support (Staff/Materials): Siemens Medical Systems (E); Grants: Siemens Medical Systems (E).

Khanna, A. Jay: Private Investments: New Era Orthopaedics, LLC (20%); Consulting: Orthofix (D); Speaking and/or teaching arrangements: AO Spine North America (B), DePuy Spine (B); Trips/Travel: AO Spine North America (A); Scientific Advisory Board: Johns Hopkins Center for Bioengineering, Innovation and Design (None); Other Office: Johns Hopkins Center for Bioengineering, Innovation and Design (None).

Sciubba, Daniel M.: Speaking and/or teaching arrangements: DePuy Spine (B); Trips/Travel: DePuy Spine (B); Grants: NREF (D).

Disclosures are current as of May 21, 2010.

Technical Requirements
The following hardware/software specifications must be met or exceeded to complete this course:

• Web browser and internet connection
• Computer equipped with audio output (speakers or headphones)
• Printer (to print PDF handout)
• Internet Explorer 7 or higher
• Adobe reader 7 or higher
• Microsoft Silverlight (if you do not have the program on your computer, you will be prompted to install it)
• Disable pop-ups

Disclaimer
The material presented is made available by the North American Spine Society for educational purposes only. The material is not intended to represent the only, nor necessarily the best, method or procedure appropriate for the medical situations discussed; rather, it is intended to present an approach, view, statement or opinion of the faculty, which may be helpful to others who face similar situations. NASS disclaims any and all liability for injury or other damages to any individual attending the meeting and for all claims which may arise out of the use of the techniques demonstrated therein by such individuals, whether these claims shall be asserted by physicians or any other person.