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The purpose of this course is to present the state-of-the-art spine trauma treatment techniques predicated on the best possible evidence and presented by an experienced staff of spine trauma specialists. Although the type of injuries that occur in the spine remain essentially the same, advances in understanding the pathophysiology of spinal cord injuries, improvements in stabilization techniques, the development of MRI compatible pedicle instrumentation, and the development of biologic agents to augment fusion are a few of the significant technological advances that have occurred over the past decade. These advances have profoundly changed the success and outcomes of the treatment of acute spinal trauma as shown by ongoing prospective outcome studies.
This course includes videotaped podium presentations in conjunction with audio slide lectures. A post-course Evaluation and assessment questions will be given to help reinforce your knowledge.
John R. Dimar II, MD
Bizhan Aarabi, MD, FACS, Neel Anand, MD, Paul Anderson, MD, Rick Bransford, MD, Mladen Djurasovic, MD, Marcel Dvorak, MD, FRCSC, Michael Fehlings, MD, PhD, FRCSC, Charles Fisher, MD, John Hurlbert, MD, PhD, Brian Kwon, MD, Robert Morgan, MD, Y. Raja Rampersaud, MD
The course is divided into three teaching modules; cervical trauma, spinal cord injury (SCI), and thoracic/lumbar trauma. Each module has faculty lectures covering significant advances in the specific topic followed by case presentations to an expert panel and the audience to determine a consensus opinion as to the best course of treatment. The Cervical Module will focus on recent advances in stabilization of the occipital – C1/C2 and the cervical/thoracic junctions following severe trauma that results in instability. The Spinal Cord Injury Module focuses on current recommendations concerning the timing of spinal cord decompression and stabilization following an acute spinal cord contusion and the results of a current ongoing prospective study. Additionally, a thorough review of current advances in the physiologic/pharmacological treatment of spinal cord injuries and a neurologically based spinal injury classification system will be discussed. The Thoracolumbar Injury module presents a wide variety of trauma topics including pediatric trauma, acute lumbosacral fractures, minimally invasive stabilization of thoracolumbar trauma, and the application of outcome/adverse event measures to trauma.
Session 1: Cervical Spine (1.5 CME)
- Stabilization of Acute Fractures – J. Hurlbert
- Subaxial Spine Fracture Classification & Treatment Algorithms – P. Anderson
- Bridging the Unstable Cervical/Thoracic Junction Following Acute Injury – C. Fisher
- Case Presentations – P. Anderson, M. Djurasovic, M. Dvorak
Session 2: Fractures with Spinal Cord Injury (1.25 CME)
- Evidence-Based Decision-Making on the Timing of Decompression and Fusion in Spinal Cord Injury: STASCIS Study – M. Fehlings
- Application of the TLICS Classification to Acute Neurological Injury in the TL
Spine – M. Dvorak
- Advances in the Treatment of Acute Spinal Cord Injury – B. Kwon
- Case Presentations – M. Fehlings, B. Kwon, R. Morgan
Session 3: Thoracolumbar Treatment & Outcomes (1.5 CME)
- Pediatric Fractures – J. Dimar
- Application of Outcome Measures and Adverse Events to Measure Spinal Trauma Outcomes – Y. Rampersaud
- Minimally Invasive Strategies for Thoracic and Toracolumbar Spine
Injuries – N. Anand
- Complex Lumbo-Sacral Fractures – R. Bransford
- Case Presentations – A. Agarwala, M. Djurasovic, Y. Rampersaud
This course was originally presented to a live audience at the NASS 24th Annual Meeting in San Francisco, CA, on November 9, 2009, and has been adapted for online presentation.
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 4.25 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 5/13/2010, and is available for purchase through 5/12/2013.
Orthopedic surgeons, neurosurgeons, physiatrists, pain specialists, neurologists, radiologists, physical therapists, rheumatologists, osteopathic physicians, nurse practitioners, chiropractors, and other physicians and allied health professional involved in spine care.
Upon completion of this course, participants should be able to:
- Apply current concepts for the treatment of acute cervical spinal injury.
- Consider recent advances in the pathophysiology of acute spinal cord injury and how it affects the choice of treatment.
- Evaluate new thoracolumbar injury classification systems application to acute trauma.
- Apply course paradigms to create effective algorithms to treat acute spinal trauma.
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
Aarabi, Bizhan: Nothing to Disclose.
Anand, Neel: Royalties: Medtronic (E), Nuvasive (E); Stock Ownership: Trans1 (Unknown), Globus (Unknown); Private Investments: Paradigm Spine (Unknown), Bonovo Orthopaedics (Unknown), Pearl Diver (Unknown); Consulting: Nuvasive (D); Speaking and/or teaching arrangements: Medtronic (D), Gobus Medical, Inc (C), Applied Spine Technologies, Inc (B), Pioneer Surgical Technology, Inc (B), Trans1 (B), Zimmer (B); Trips/Travel: Medtronic (Consulting disclosed); Scientific Advisory Board: Applied Spine (10,000 stock options), Atlas Spine (10,000 stock options), Globus Medical (150,000 stock options); Grants: Zimmer (E, paid to institution).
Anderson, Paul A.: Royalties: Stryker (B); Stock Ownership: Pioneer (250,000/<1%); Private Investments: Titan (2,000/<1%), Expanding Orthopedics (1,000/<1%); Consulting: Pioneer (B), Medtronic (F); Trips/Travel: Medtronic (B), Aesulap (B); Grants: CSRS (C).
Bransford, Richard J.: Speaking and/or teaching arrangements: Synthes (B), AO Spine North America (B); Fellowship Support: DePuy (E), AO (E).
Dimar, John R.: Royalties: Medtronic Sofamor Danek (H); Consulting: Medtronic Sofamor
Danek (F); Trips/Travel: Medtronic Sofamor Danek (B); Research Support (Staff/Materials): Medtronic Sofamor Danek (B), Norton Healthcare (F); Fellowship Support: Norton Healthcare (F).
Djurasovic, Mladen: Consulting: Medtronic Sofamor Danek (E); Trips/Travel: Degenerative Spine Study Group (unknown); Research Support (Staff/Materials): Medtronic Sofamor Danek (B), Norton Healthcare (F); Fellowship Support: Norton Healthcare (F).
Dvorak, Marcel F.: Royalties: Medtronic (D); Consulting: Medtronic (F); Speaking and/or teaching arrangements: Medtronic (Consulting disclosed); Trips/Travel: Medtronic (Consulting disclosed); Research Support (Staff/Materials): Medtronic (E); Grants: Medtronic (D), DePuy Spine (G), Rick Hansen Foundation (H); Fellowship Support: Medtronic (E), Synthes (E), DePuy (E).
Fehlings, Michael G.: Royalties: DePuy Spine (F); Consulting: DePuy Spine (B); Fellowship Support: DePuy Spine (E).
Fisher, Charles G.: Royalties: Medtronic (D); Consulting: Medtronic (F); Speaking and/or teaching arrangements: Medtronic, DePuy, AO (Amount not disclosed); Trips/Travel: Medtronic, AO, DePuy (Travel expenses); Research Support (Staff/Materials): Medtronic, DePuy (E); Fellowship Support: Medtronic, Synthes (F).
Hurlbert, R. John: Nothing to Disclose.
Kwon, Brian K.: Consulting: Medtronic (D).
Morgan, Robert A.: Trips/Travel: Medtronic (B).
Rampersaud, Y. Raja: Consulting: Medtronic - Spine (D); Research Support (Staff/Materials): Medtronic (C); Relationships Outside the One Year Requirement: Medtronic -Sofamor Danek (NASS Annual Meeting, 2004, Consultant).
Disclosures are current as of April 22, 2010.
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
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.