Moderators: Yi Lu, MD, PhD; Konstantinos Margetis, MD, PhD

Spinal cord injury (SCI) remains a highly challenging pathology associated with significant morbidity and mortality. Obtaining high level evidence on the treatment of SCI is difficult. The reasons include the heterogeneity of the different sub-types of SCI injuries, the different sub-populations of SCI patients, the practical limitations of performing research in an acute setting and the differences in local practices. Therefore, the expert opinion based on the individual experience and the interpretation/application of the current literature remains crucial, especially in the management of several SCI clinical scenarios, where high level evidence is missing.

Some of these scenarios have been particularly controversial. The presence of such debate might suggest that more than one option is viable, and the choice depends on the specific circumstances. Discussing these options in a forum offers immediacy in the communication and can be helpful in delineating the best practices in these challenging situations.

In this symposium, the Section on Spinal Cord Injury have identified challenging, controversial cases and we aim to present them in a way that would stir discussion and exchange of ideas, but also provide a view of the current trends by offering a polling session. We included clinical examination, pharmacological treatment, surgical decision-making topics, both for acute and chronic SCI to provide a comprehensive overview that would be helpful for the practicing spine specialist

Upon completion of this session, participants should gain strategies to:

• Describe viable options on controversial SCI cases;
• Understand the strengths and weaknesses of each option;
• Familiarize with the current trends on treating controversial SCI cases.

Agenda

Introduction
Konstantinos Margetis MD, PhD; Yi Lu, MD, PhD

Initial Neurological Examination: INSCI Score or a Simpler Scale?
Rajiv Saigal MD, PhD

Timing of SCI Surgery: Should We Aim for Ultra-Early Decompression or Just Early?
Brian K. Kwon MD, PhD, FRCSC

AIS A: Should We Perform Decompression or Not?
Christoph P. Hofstetter MD, PhD

Spinal Cord Injury, Methylprednisolone or Dexamethasone or Nothing?
Michael G. Fehlings, MD, PhD, FRCSC

Dens Fracture in Elderly: Surgery or Bracing?
John P. Birkedal, MD

Jumped Cervical Facets: Anterior, Posterior or Combined Approach?
James C. Miller, MD

Thoracolumbar Burst Fractures and the Role of Corpectomy
Muhammad Abd-El-Barr, MD, PhD

GSW: Bullet Removal, Yes or No? If Yes, When?
Konstantinos Margetis MD, PhD

Spinal Cord Stimulation in SCI
Rajiv Saigal MD, PhD

Post-SCI Syringomyelia: Detethering, Syringo-Subarachnoid Shunt or Syringo-Pleural Shunt?
Jamie R. Wilson, MD, FRCS

Closing Remarks
Konstantinos Margetis MD, PhD; Yi Lu, MD, PhD

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