Current and past leaders of NASS were heavily involved in the recent 28th Edition of the Brussels International Spine Symposium (BISS) held November 19-20, 2021 in Brussels, Belgium. More than 450 people were registered for the event. The subject matter was “The Failed Spine” and the program chairs, as always, were Robert Gunzburg, MD and Marek Szpalski. The faculty included many NASS members and international experts such as: Chris Colloca (Phoenix), Scott Blumenthal (Dallas), Jean-Charles Le Huec (Bordeaux), Ciaran Bolger (Dublin), Jean-Jacques Abitbol (San Diego), Dave Wong (Denver) Brad Weiner (Houston) Christoph Hofstetter (Seattle), Isador Lieberman (Dallas) Rick Guyer (Dallas), Pierce Nunley (Schreveport). Many of these faculty gave more than 1 talk with Dave Wong leading the way in giving at least three. NASS also had a membership booth there to recruit new members, follow up with current members and promote NASS programs.
The program chairs graciously include the NASS president each year, so recent NASS president Eeric Truumees, MD (Austin) gave an excellent presentation on Where Spine Surgery Fails: Problems with “Failed Spine Surgery Syndrome”. Read Dr. Truumees’ full abstract
Eric Muehlbauer, NASS Executive Director, spoke on the Epidemiology and cost of failed spine: he reported that there is no consensus on definition of FBSS and said that coders are taught is a synonym for post laminectomy syndrome and therefore the correct code to assign is M96.1. Failed back surgery syndrome is reported to affect between 10 to 40% of patients but it’s difficult to be accurate due to the wide scope of its definition and its heterogeneous etiology. Failed Back Surgery Syndrome has estimated health care costs of up to $20 billion dollars annually. Direct costs can be characterized in a variety of ways including: Cost of implanting Spinal Cord Stimulators (SCS); Cost of revision surgeries; Cost of conventional medical management and the cost of other treatments, including morphine pumps. He reminded the group that at a fairly recent NASS symposium, Jerome Schofferman and colleagues including Paul Slosar taught us that the best way to address patients with a supposed FBSS relies on a precise and accurate diagnosis. They said that with a careful history, examination, imaging studies, psychological evaluation and diagnostic injections, a diagnosis can be reached in over 90% of patients. They reported that in their research the most common diagnoses were: Foraminal stenosis (25% to 29%), Painful disc (20% to 22%), Pseudarthrosis (14%), Neuropathic pain (10%), Recurrent disc herniation (7% to 12%), Facet joint pain (3%) and Sacroiliac joint (SIJ) pain (2%).
Before the event, NASS was invited to Bruges, Belgium for a hard hat tour of the nearly completed Bruges Meeting and Convention Center. (BMCC) The building will open its doors in January 2022 and will be located in the historical city centre, within easy walking distance from most hotels and sights. Interesting to note is that the entire city centre of Bruges is considered a UNESCO world heritage site so it is really a unique setting. The conference section has a capacity of meetings and conferences from 10 up to 514 attendants. The ‘three chairs’-principle will be applied, which means that every attendant will have a chair in the plenary hall, one in the catering area and one in the break-out rooms. All facilities will be available: a plenary hall with – among other things – 514 retractable seats, a large foyer, poster areas, twelve modular break-out rooms and a catering area on the top floor offering magnificent views of the city.
Luckily, during the tour staff were able to stop at one of the many chocolate shops to gather a few souvenirs before proceeding on to Brussels.