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The standard of care in the management of Adolescent Idiopathic Scoliosis has always included periodic spinal radiographs to measure the magnitude of the deformity and to look for progression. While effective, these methods have been shown to increase the risk of malignancy later in life due to repeated x-ray exposure. This course will discuss management strategies for reducing x-ray exposure in the treatment of adolescent scoliosis, as well as some new methods for imaging the spine and trunk to evaluate spinal deformity.

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 Co-Chairmen:
Patrick Knott, PhD, PA-C
Steven Mardjetko, MD

Faculty:
Richard Kim, MD
Xue-Cheng Liu, MD, PhD
John Thometz, MD

Learning Objectives

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

• Discuss the research evidence showing increased risk of malignancy in patients with Adolescent Idiopathic Scoliosis (AIS) who are exposed to repeated spinal radiographs over the course of their treatment.
• Evaluate overall strategies for reducing radiographic exposure of these patients while maintaining appropriate surveillance of curve progression in AIS.
• Demonstrate methods of spinal imaging that carry a lower dose of ionizing radiation than standard x-rays.
• Comprehend methods of surface topography that can be used instead of imaging to estimate curve magnitude and parameters of trunk deformity.
• Illustrate how these methods can be used together to better understand the complexity of a 3-dimentional deformity such as scoliosis.
  

Agenda:

• Introduction (Knott)
• The Epidemiology of Radiation Exposure in Patients with Spinal Deformity (Knott)
• Past Experience With Non-Radiographic Spine Imaging (Liu)
• Current Concepts in Surface Topography for Spinal Imaging Demonstration (Liu)
• A Study of Surface Topography (Knott)
• Origins of Medical Imaging (Thometz)
• The Use of MRI in the Evaluation of Spinal Deformity (Kim)
• Strategies for Reducing Radiation in Children with Spinal Deformities: Current Concepts in Patient Management (Mardjetko)
  

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 1.5 AMA PRA Category 1 Credits™.

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 8/17/2012, and is available for purchase through 8/16/2015.

Appropriate Audience
Target audience includes: Orthopedists, PA/NPs, Nurses, Physical Therapists, scoliosis specialists and other professionals with an interest in spine care.

Conflict of Interest Disclosure
All faculty members 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

Kim, Richard H.: Nothing to Disclose.
Knott, Patrick: Nothing to Disclose.
Liu, Xue-Cheng: Nothing to Disclose.
Mardjetko, Steven M.: Stock Ownership: Spinecraft Corporation (250 Shares, 10%), Mechanica (50 Shares), Axial Biotech (30 Shares, <1%); Consulting: Medtronic (Travel expenses); Board of Directors: Spinecraft (C); Scientific Advisory Board: Spinecraft (C).
Thometz, John G.: Nothing to Disclose.

Disclosures are current as of July 19, 2012.

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 or Firefox equivalent
• Adobe reader 7 or higher
• Windows Media Player
• 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.