module 3 spinal deformities 20 & 21 june 2017 · pdf file• recognise red flags,...
TRANSCRIPT
MODULE3
SPINALDEFORMITIES20&21June2017PROGRAMME
QUICKFACTSWHEN: 20-21June2017WHERE: Strasbourg,France IRCAD/EITS 1Placedel’Hôpital 67091Strasbourg,FranceMAXIMUMATTENDEES: 40delegatesREGISTRATIONFEE: EUROSPINEMember: €800 Non-member: €1000CMECREDITS: 14LANGUAGE: EnglishDRESS: CasualIMPORTANTNOTE: Attendanceateverysessionismandatory.
AwirelessInternetdevice(mobilephone/Ipad/computer)willbehelpfultoaccesson-lineresourcesduringtheprogramme.Pleasebringonewithyou.
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TARGETAUDIENCE
Seniortraineesandtrainedsurgeons,whoareplanningacareerinspinalsurgery.
LEARNINGOUTCOMES:SESSION1-PRINCIPLESOFSPINALDEFORMITY
Scoliosis:Aetiology&PrognosticFactors• Describetheaetiologyandprognosticfactorsassociatedwith
o idiopathicscoliosiso infantileidiopathicscoliosiso secondaryscoliosis
Kyphosis• Differentiatebetweentheaetiologyandprognosticfactorsassociatedwithregular
andangularkyphosis• Evaluatemanagementoptionsfor
o kyphosiso kyphus
ClinicalAssessment• Differentiatebetweenfunctionalandstructuraldeformities• Takeastructuredapproachtoclinicalevaluation• Assesskeletalmaturity• Identifyprognosticfactorsofprogression• Identifyrotationaldeformity• Performaneurologicalassessment• Explaintreatmentstrategytopatientsandtheirfamilies
ImagingofDeformities• Definetheroleofstandardcoronalandsagittalx-raytoevaluatedeformity• Definetheroleofbendingandtractionx-rays• Differentiatebetweenimaginginchildrenandadults• Minimiseradiationdosetopatients• Recogniseredflags,includingtumours,neuraltubeabnormalities,connectivetissue
andmusculardiseaseandtheirassociationwithspinaldeformity
LEARNINGOUTCOMES:SESSION2-CONSERVATIVETREATMENT
Casting,Bracing&RoleofRehabilitation• Justifytheroleofcastingtoday• Explaintheprosandconsofdifferenttypesofbracetreatment• Formulateprinciplesofrehabilitationforpatientswithspinedeformity• Definetheroleofhalotractionasdefinitiveorinterimtreatment
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LEARNINGOUTCOMES:SESSION3-PRINCIPLESOFSURGICALTREATMENT
Pre-OperativeAssessment:howtoprepareforacomplexcase• Formulateasurgicalplan• Recordacomprehensivepreoperativeassessment• Considerspecialissuesincludingpulmonary,cardiac,hematological,nutritionaland
metabolic
PositioningthePatient• Positionpatientssafely• Explaintherationaletootherteammembers• Comparethepurposeofprone,lateralandsupinepositions
BloodSaving• Anticipatethefactorsaffectingbloodloss• Recognizetriggerpointsfortransfusion• Minimisetherisksofhomologoustransfusion• Outlinetheroleoferythropoietin• Comparetheprosandconsofautologoustransfusion,haemodilution,hypotensive
anaesthesia,anti-fibrinolyticagents,intraoperativebloodsalvage
Intra-OpMonitoring• Selectappropriatetypesofmonitoring• DifferentiatebetweenSEPandMEP• Performasafeandreliablewakeuptest• Recognisewhenawakeuptestisrequired• Respondappropriatelywhenmonitoringindicatesinterventionrequired• TriggeredEMGpediclescrewstimulation.
PedicleScrewGuidanceinDeformity
• Assessappropriateplacement• Minimisetheriskofmisplacement• Balancetheprosandconsofspinalnavigation• Assesstheadvantagesanddisadvantagesoffreehandprobing
BoneFusion• Identifyfactorsinfluencingspinalfusions• Definetherolesofosteoconductionandosteoinductionfactors• Explainthephysiologyofbonegrafting• Outlinetheriskfactorsassociatedwithnon-union• Categorisebonefusionanddiagnosenonunion
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LEARNINGOUTCOMES:SESSION4-PRINCIPLESOFSURGICALTREATMENT
CongenitalSpinalCordAnomalies• Differentiatebetweentypesofcongenitalspinedeformity• Linkprognosticfactorswithappropriatetypeandtimingofintervention• Evaluatenonoperative,earlyandlateoperativetreatmentoptions
CongenitalSpinalDeformities• Relatethestagesofdevelopmenttodeformitiesofthespinalcord• Selectappropriateinvestigations• Evaluatetreatmentoptions
NeuromuscularScoliosis
• Describetheaetiologyandprognosticfactorsassociatedwithneuromuscularscoliosis
• Identifyfactorsindicatingprogressionorrisktoneurologicalstructures• Evaluatemanagementoptions• Assessassociatedpulmonaryandcardiacproblems
IdiopathicAdultDeformities• Identifycommonproblemsassociatedwithadultdeformity• Outlinetheprogressofscoliosisthroughlife• Relateappropriatemonitoringstrategies• Evaluateoperativeandnonoperativeoptionsfordifferentagegroups• Relatechangestosagittal/coronalimbalance
DegenerativeDeformities• Usespino-pelvicparameterstoassessdegenerativedeformities• Differentiatebetweenidiopathicanddegenerative(denovo)deformity• Performclinicalevaluationofsagittalbalanceandstenosis• Selectappropriateinvestigations• Evaluateoperativeandnonoperativeoptions• Considercomorbiditiesassociatedwithage• Assesspatientexpectation•
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LEARNINGOUTCOMES:SESSION5-TECHNIQUES&STRATEGY
EndLimitsofFusioninIdiopathicScoliosis • Useclassificationtodeterminetheendlimitsoffusion(Lenke)• Definethelowerandupperlimitofinstrumentation
Coronal&SagittalBalance• Planpreoperativespineassessmentofcoronalandsagittalbalance• Explainprimaryfactorsandcompensatorymechanisms• Evaluatesurgicaloptions• Formulateanappropriatepreoperativeandsurgicalplan
Technique&Strategy:posteriorapproach• Formulateprinciplesofsurgicalcorrection• Evaluatestrategicsurgicaloptions• Recogniseindicationsforaposteriororcombinedapproach
Technique&Strategy:anteriorapproach• Differentiatebetweenanteriorrelease,anteriorfusionandanteriorinstrumentation• Selectappropriateapproachforprocedure• Recogniseindicationsfor
o anteriorapproacho anteriorinstrumentation
LEARNINGOUTCOMES:SESSION6-OSTEOTOMIES
Role&TechniqueofSpinalOsteotomies
• Justifytheaimofosteotomy• Differentiatebetweenthedifferenttypesofosteotomy• Relatetoappropriatedegreeofcorrection• Selectappropriatelevel
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LEARNINGOUTCOMES:SESSION7-CADAVERLABS
CadLab1:Illio-sacralFixation:illio-sacralscrewplacement
• Identifykeystructuresofthelumbo-sacralanatomy• IdentifytheS1screwentrypoints• Relateanteriorvascularstructuresandscrewplacement• Prepareiliacscrewholes• Integratesafetymeasuresandassessrisks• Placeiliacinstrumentationandconnecttothelumbo-sacralconstruct
CadLab2:ThoracicPedicleScrewFixation&HybridSolutions
• Approachtheposteriorthoracicspine• Identifyanatomicalscrewentrypoints• Anticipatetherisksandpitfalls• Performfreehandtechniquetoprepareascrewhole• Checkintegrityofscrewholebypedicleprobe• Placepediclescrew• Preparefacetjointandplacepediclehook• Placetransverseprocessandlaminahooks
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COURSECHAIRMAN:DANIELCHOPIN FRANCECADLABCHAIRMEN:HALUKBERK TURKEYPHILIPPECHARLES FRANCECOURSEFACULTY:KARIMANABELIN-GENEVOIS FRANCEHALUKBERK TURKEYANTONIOFAUNDEZ SWITZERLANDJÖRGFRANKE GERMANYJEAN-CHARLESLEHUEC FRANCEJORGEMINEIRO PORTUGALNORBERTPASSUTI FRANCEDOMINIQUEROTHENFLUH UNITEDKINGDOMALBERTOZERBI ITALY
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SCIENTIFICPROGRAMME,MODULE3 CHAIRMAN:DANIELCHOPIN
DAY1TUESDAY,2OJUNECOURSEATTENDANCEISMANDATORY
TIME TOPIC FACULTY08:15-08:30 CourseRegistration&WelcomeCoffee 08:30-08:40 Introduction DanielChopin
SESSION1:PrinciplesofSpinalDeformity08:40-08:55 Scoliosis:aetiology&prognosticfactors JorgeMineiro08:55-09:15 Kyphosis AntonioFaundez09:15-9:35 ClinicalAssessment AntonioFaundez09:35-9:55 ImagingofDeformities AlbertoZerbi9:55-10:30 Discussion AllFaculty
CoffeeBreak20mins.SESSION2:ConservativeTreatment
10:50-11:20 Casting,Bracing&RoleofRehabilitation KarimanAbelin-GenevoisSESSION3:PrinciplesofSurgicalTreatment
11:20-11:40 Pre-OpAssessment;howtoprepareforacomplexcase
JörgFranke
11:50-12:00 PositioningthePatient HalukBerk12:00-12:10 BloodSaving DominiqueRothenfluh12:10-12:25 Intra-OpMonitoring Jean-CharlesLeHuec12:25-12:45 PedicleScrewGuidanceinDeformity HalukBerk12:45-12:55 BoneFusion NobertPasutti12:55-13:15 Discussion AllFaculty
Lunch30min14:00-14:50 CaseDiscussion DanielChopin&AllFaculty
SESSION4:PrinciplesofSurgicalTreatment14:50-15:05 CongenitalSpinalCordAnomalies KarimanAbelin-Genevois15:05-15:20 CongenitalSpinalDeformities JörgFranke15:20-15:40 NeuromuscularScoliosis KarimanAbelin-Genevois15:40-16:00 IdiopathicAdultDeformities NorbertPassuti16:00-16:20 DegenerativeDeformities JeanCharlesLeHuec16:20-16:40 Discussion AllFaculty
CoffeeBreak30minSESSION5:Technique&Strategy
17:10-17-30 EndLimitsofFusioninIdiopathicScoliosis JorgeMiniero17:30-17:50 Coronal&SagittalBalance DanielChopin17:50 EndofDay1
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SCIENTIFICPROGRAMME,MODULE3 CHAIRMAN:DANIELCHOPIN
DAY2WEDNESDAY,21JUNECOURSEATTENDANCEISMANDATORY
TIME TOPIC FACULTY08:15-08:30 Attendancesignature
SESSION5:Technique&Strategy08:30-08:50 Techniques&Strategies:PosteriorApproach DominqueRothenfluh08:50-09:10 Techniques&Strategies:AnteriorApproach NorbertPassuti09:10-10:10 Discussion:Posterior/Anterior AllFaculty
SESSION6:Osteotomies10:10-10:35 Role&TechniqueofSpinalOsteotomies DanielChopin
CoffeeBreak30min11:05-11:45 CaseDiscussion:Adult&Degenerative AllFaculty11:45-11:55 Evaluation 11:55-12:15 ClosingRemarks&Diploma DanielChopin12:15-12:45 CadLabDiscussion AllFaculty
Lunch1hourSESSION7:CadaverLabs
13:45-14:00 GototheLab 14:00-15:45 GroupA:Illio-sacralFixation AllFaculty14:00-15:45 GroupB:ThoracicPedicleScrewFixation&
HybridSolutionsAllFaculty
CoffeeBreak30min16:15-18:00 GroupB:Illio-sacralFixation AllFaculty16:15-18:00 GroupA:ThoracicPedicleScrewFixation&
HybridSolutionsAllFaculty
18:00 EndofModule
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CONTACTSEUROSPINE,theSpineSocietyofEuropeSeefeldstrasse168610UsterSwitzerlandwww.eurospine.orgwww.eurospinemeeting.comFollowuson:facebook.com/EuroSpinetwitter.com/#!/EuroSpineSocCOURSEORGANISATIONDrJulie-LynNoëlDirectorofEducationandResearchE:[email protected]:+41764179003MsSandySutterManagerofEducationandResearchE:[email protected]:+41793169278SCIENTIFICCONTENTProf.BernhardMeyerChairman,EducationCommitteeofEUROSPINE