Monday and Tuesday, October 10-11 (8:00 a.m.–5:00 p.m.)

During this highly interactive course, physician faculty who lead NASS’ CPT and RUC efforts will address ICD-10, E&M coding and CPT4 coding of spinal surgical, medical and radiologic procedures. Attendees will leave this course with the necessary knowledge and critical tips on how to utilize new E&M codes and guidelines for 2022, navigate through the authorization and denial process, identify nuances that affect proper billing and cause rejected/delayed claims, utilize Medicare NCCI edits, and properly document to receive reimbursement.

Audience: This course is open to all.

Credits: The North American Spine Society designates this educational activity for a maximum of 14.0 AMA PRA Category 1 Credits^TM.

Agenda Register

Tuesday, October 11 (7:00 a.m.–12:00 p.m.)

The Section on Minimally Invasive Procedures Spine Surgery Lab provides attendees with exposure to some of the newest techniques and technologies in minimally invasive spine surgery. The course begins with a 1-hour didactic session to provide a brief overview of the procedures: endoscopic lumbar spine, MIS TLIF with expandable implants and enabling technologies, lateral interbody fusion techniques, and sacroiliac fusion. This is followed by 4 hours of demonstration and instruction at 10 surgical cadaver stations. Expert surgeons will demonstrate the procedures, provide tailored hands-on instruction and answer participants’ questions. This lab is high yield for those who are interested in these minimally invasive techniques or want to improve on their current knowledge base.

Audience: Physicians only.

Credits: The North American Spine Society designates this educational activity for a maximum of 4.5 AMA PRA Category 1 Credits^TM.

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Tuesday, October 11 (1:00–6:00 p.m.)

Faculty will explore the fundamental principles of computer-assisted surgery to ensure optimal accuracy during robotic and navigated spine surgery, review similarities and differences between the current robotics platforms and navigation. Attendees will practice deformity, degenerative and minimally invasive techniques to optimize efficiency while achieving consistently high accuracy in robotic and navigated surgery.

Audience: Physicians only.

Credits: The North American Spine Society designates this educational activity for a maximum of 4.5 AMA PRA Category 1 Credits^TM.

Register

7:30-9:00 a.m.

Debate: Controversies in Spine: Top 5 Debates
During this debate format symposium, you’ll hear the latest controversies for spine surgery and gain insight about best practices to address these controversies.

Symposium: Endoscopic Spine Surgery: Update and Focus on Interdisciplinary Care
Faculty will describe the pathway to learning endoscopic spine surgery, address the indications for endoscopic cervical, thoracic, and lumbar spine surgery, as well as review outcomes and complications of endoscopic spine fusion. Discussion will continue about opportunities for interdisciplinary participation in endoscopic spine surgery programs.

Symposium: Understanding Vertebrogenic Pain and Where it Fits into Your Practice
In this symposium, faculty will summarize the pathophysiology, clinical presentation and treatment of vertebrogenic pain as well as explore how this new paradigm fits into the greater context of care for people with low back pain.

9:30-10:30 a.m.

Symposium: Spine Physician as CEO
Faculty will prepare the physician CEO for the future of spine surgery; how to build a successful practice, whether small, large or academic; how to respond to healthcare reforms affecting the practice; negotiate the best possible terms to fit the practice; and medical practice acquisition.

10:35 a.m.-12:00 p.m.

Symposium: Cervical Total Disc Replacement 2.0: When Do Things Go Wrong
Faculty will describe modes of cervical total disc replacement (TDR) failure, differentiate between minimal, clinically irrelevant osteolysis following TDR vs. clinically relevant osteolysis and its potential causes, and discuss revision strategies for failed cervical TDR and formulate a treatment plan for patients presenting with this problem.

Symposium: Biologics in the Management of Low Back Pain: Current State of the Evidence and Clinical Considerations
The field of spinal biologics is rapidly evolving as patients, researchers, and clinicians are recognizing its potential to treat challenging painful conditions. In this symposium, faculty will discuss the pertinent evidence, technologies and relevant issues in biologics use for the management of low back pain.

1:00-2:30 p.m.

Symposium: Enabling Technologies in Spine Surgery: Radiation Reduction and the Role of Robotics, Navigation, Predictive Analytics and Other Safety Strategies
Faculty will describe the adverse effects of radiation exposure and review the fundamentals of radiation reduction as well as how to balance the risks and benefits of various preoperative and intraoperative imaging modalities. Additionally, attendees will gain insight to implement thoughtful surgical imaging strategies and about contemporary technologies to increase safety and reduce radiation.

Symposium: New Concepts of Age and Frailty in the Outcomes of Acute and Chronic Spinal Cord Injuries Faculty will address individualized treatment strategies to optimize care for the acute and chronic spinal cord injury in older people and to understand who may benefit from surgical stabilization, and who may do better with non-operative management. Finally, if undergoing surgery, how do the technical considerations differ and how should the approach change to maximize recovery and minimize intraoperative complications.

3:00-4:00 p.m.

Case Presentation: Low Back Pain: Epidemiology, Pathophysiology, Evaluation and Management: An Update on the NIH HEAL Initiative Back Pain Consortium Research Program
Chronic low back pain is a priority for health care systems internationally. The burden of chronic low back pain includes social and economic costs. The purpose of this symposium is to present state of the art research regarding the burden of chronic low back pain, pathophysiology of chronic low back pain, the evaluation of pain of spinal origin, and management approaches.

4:05-5:05 p.m.

Symposium: The Aging Surgeon
When is it time to make a change? Faculty will explain the changes in physical and cognitive skills that occur with aging, how surgical fitness for duty can be assessed and the signs that it’s time to make a change. Also, assist attendees in developing a plan for successful and honorable departure from practice when it becomes necessary.

7:25-8:25 a.m.

Symposium: Ambulatory Surgery Center is the Next Big Thing in Spine
During this symposium, faculty will address the pros and cons of working in ambulatory surgery center (ASC), describe the ASC vs. hospital-based practice vs. half-n-half, as well as discuss reimbursement, growth and future trends.

8:30-9:30 a.m.

Symposium: Surgical Treatment for Adult Cervical Spine Deformities: Advanced Techniques and Research Updates to Guide Safe and Effective Outcomes
Since adult patients with cervical deformities report greater disabilities and demonstrate greater postoperative complication rates than adult patients with thoracolumbar deformities, faculty will help surgeons and health care providers identify spine deformity parameters that explain the health deficits of adults with cervical deformities and identify safe treatment options.

1:00-2:30 p.m.

Symposium: Advocacy 2022
What’s happening on the frontline of health policy? Legislative leaders will discuss forecast on the upcoming mid-term elections, and how those results will affect the second half of President Biden’s first term. Further, attendees will gain a better understanding of how legislative and regulatory trends can affect this decision, as well as how NASS Advocacy is working to shape this conversation.

3:00-4:00 p.m.

Case Review: The Relationship Between Injections and Surgery
Faculty will discuss the role of injections in predicting injection and surgical outcomes as well as answer the questions: does diagnostic discography still have a role in decision making and are injections prior to surgery associated with increased rates of infections?

4:05-5:05 p.m.

Symposium: Anterior Lumbar Surgery for Degenerative Conditions
In this symposium, faculty will discuss the issues relevant to safe anterior or lateral lumbar surgery for degenerative conditions.

Panel: Women in Spine: Education, Practice and Leadership
In the symposium, attendees will have an opportunity to hear recognized women in spine discuss their experiences in education and training, challenges and opportunities encountered in practice, and development as volunteers and leaders within NASS.

7:30-9:00 a.m.

Symposium: Spinal Fusion: Back to Basics
Achieving successful fusion is often an important tenet of spine surgery. Faculty will explore fusion from beginning to end, addressing relevant concepts from basic science, patient factors, technical factors, and biologic selection. Then, faculty will critically evaluate the literature on the importance of successful fusion, as well as outcomes after failed fusion.

Symposium: Section on Comprehensive Episodes of Spine Care
No description or objectives

10:45 a.m.-12:00 p.m.

Symposium: Treatment of the Operative Chronic Pain Patient: Identification, Optimization, Management and Outcomes
Faculty will discuss how to Identify the “operative” chronic pain patient and the preoperative optimization of the “operative” chronic pain patient. Additionally, faculty will address how to manage perioperative pain medication in patients that are not narcotic naïve and how to evaluate the postoperative outcomes in patients that have chronic pain as well as methods toward building a comprehensive program for these patients.

1:00-2:30 p.m.

Symposium: Evolution of My Practice in Deformity Surgery
Several spine surgeons will discuss their practice and how they navigated difficulties, changed their techniques to push their ceiling higher. These surgeons will describe how they applied new principles and adopted or dropped new technologies in order to make progress in their practice and improve patient outcomes.

Case Presentations: Appropriate Treatment of Posterior Pelvic Pain Including the Sacroiliac Joint
Since conservative care for posterior pelvic and sacroiliac joint pain has not been defined by the evidence and differences in treatment needs for subgroups of patients with posterior pelvic and sacroiliac joint pain have not been clarified, faculty will review treatment options, clinical decision making as to when to apply which treatment based on patient characteristics and examination findings. Additionally, faculty will present clinical interprofessional treatment pearls, as well as timing and clinical considerations as to when to transition to surgical options for care.

Debate: Technology in Surgical Spine Oncology: A Current State of the Art and Future Directions
Technology in surgical spine oncology seeks to improve accuracy, efficiency and effectiveness of established treatments as well as may open the door for entirely new approaches to spine oncology problems. Faculty will examine the emerging technology in the field, multidisciplinary implications, current evidence and anticipated future directions in surgical spine oncology.

3:00-4:30 p.m.

Symposium: Surgical Planning to Improve Outcomes and Reduce Complications for Adult Spinal Deformity
Since improvement in spinal alignment following adult spinal deformity (ASD) surgery correlates strongly with improved patient outcomes and reduced postoperative complications, faculty will address preoperative surgical planning improvements to achieve surgical alignment goals.

Roundtable: Neuromonitoring: Prediction and Prevention of Neurological Deficits
Because intraoperative neuromonitoring (IONM) is used in a wide variety of spinal procedures, faculty will examine the diagnostic and therapeutic values of IONM deformity correction, tumor resections, neuromodulation procedures, and treatment of adult degenerative disorders. Additionally, faculty will present data from a large national database and will provide supporting evidence through case studies and independent research. Participants are encouraged to share their perspectives on the diagnostic and therapeutic values of IONM during the Q&A.

7:30-8:30 a.m.

Plenary Symposium: What Every Spine Physician Should Know about Thoracolumbar Trauma
During this symposium, faculty will describe the prevalence, impact and initial workup of traumatic thoracolumbar spine injuries, identify and assess the full spectrum of fracture patterns that present in the thoracolumbar spine, and address the salient features and specific considerations for each thoracolumbar injury pattern. Attendees will gain insight into the guiding principles and roles of operative vs. nonoperative treatment that will lead to optimal outcomes for a given thoracolumbar injury.

8:35-10:00 a.m.

Symposium: What Every Spine Physician Should Know about Cervical Spine Trauma
Faculty will describe the prevalence, impact and initial workup of traumatic cervical spine injuries, identify and assess the full spectrum of fracture patterns that present in the cervical spine, and recognize the salient features and specific considerations for each cervical injury pattern. Additionally, attendees will gain a better understanding of the guiding principles and roles of operative vs. nonoperative treatment that will lead to optimal outcomes for a given cervical spine injury.

10:30 a.m.-12:00 p.m.

Symposium: The Evolving Science of Optimizing Patients for Spine Surgery
During this last symposium, faculty will discuss important patient factors that affect surgical outcomes and identify opportunities to optimize patients prior to surgery.