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This online course will offer spine specialists the opportunity to assess severity and treatment options for acute spinal fractures. Recognition of the inherent danger of spinal fractures, understanding of the pitfalls of treating an osteoporotic spine, and identification and management of complications will be covered during this course. Participants will learn the importance of aggressive and thorough emergency medical evaluation and stabilization in decreasing the morbidity and mortality of the polytrauma patient. After completing this course, participants should be able to evaluate the available spinal cord injury research trends and appreciate which spinal cord regeneration techniques have and have not demonstrated high level effectiveness in the treatment of spinal cord injuries.

This course includes videotaped podium presentations in conjunction with audio and slides.  A post-course evaluation will be given to help reinforce your knowledge.

This course was originally presented to a live audience at the NASS 25th Annual Meeting in Orlando, FL, on October 5, 2010, and has been adapted for online presentation.

Course Chairmen:
John R. Dimar II, MD & Charles G. Fisher, MD

Faculty:
Paul A. Anderson, MD
Leah Y. Carreon, MD, MSc
Mladen Djurasovic, MD
Marcel Dvorak, MD, FRCSC
Brian K. Kwon, MD, PhD, FRCSC
Robert A. Morgan, MD
Y. Raja Rampersaud, MD
Alexander R. Vaccaro, MD, PhD

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

• Assess initial treatment of acute spinal fractures and the importance of trauma severity scores and outcome measures.
• Appreciate the pitfalls of the treatment of acute spinal fractures in the osteoporotic spine.
• Recognize the inherent danger of acute spinal fractures when the spine is ankylosed and understand appropriate treatment techniques.
• Identify the early and late complications that result from the loss of fixation of the unstable spinal fractures.
• Distinguish the differences and cost of various stabilization techniques and the use of various biologics in acute spinal fractures.
 

Agenda: 

• Introduction (Dimar)
• Evaluation, Initial Treatment & Stabilization of the Acute Spinal Trauma Patient (Morgan)
• The Importance of ISS, CCI, GCS Assessment in the Acute Spine Injury Patient (Carreon)
• Decision Making with TLICS (Vaccaro)
• Case Presentations (Dimar, Djurasovic, Fisher, Morgan, Vaccaro)
• Osteoporotic Fractures Treatment Options (Anderson)
• Management of Pathologic Fractures Secondary to Metastatic Disease (Fisher)
• Traumatic Fractures in the Ankylosed Spine (Dimar)
• Case Presentations (Dimar, Anderson, Djurasovic, Fisher)
• Loss of Fixation Following Open Reduction (Rampersaud)
• Non-Unions & Malunions Following Open Reduction in the Thoracolumbar Spine (Dvorak)
• New Developments in Spinal Cord Injury (Kwon)
• Cervical Spine Trauma: ER Clearance, Classification Protocols & Treatment Regimes (Anderson)
• What are the Instrumentation Options & Optimal Constructs for Fracture Reduction & Stabilization? (Djurasovic)
• Bone Graft Options & Necessity in Spine Fractures (Dimar)
• Case Presentations (Dimar, Dvorak, Rampersaud)

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 4.25 AMA PRA Category 1 Credit(s)^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Physicians should only claim 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 1/12/2011, and is available for purchase through 1/11/2014.

Appropriate Audience
Orthopedic Spine Surgeons, Neurosurgeons, Radiologists, Emergency Room Physicians, Trauma Nurse Practitioners and Physician Assistants, Trauma Nurses, and any other Health Care Professional who regularly cares for severely injured polytrauma patients.

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

Anderson, Paul A.: Royalties: Stryker (D); Stock Ownership: Pioneer (250,000 shares); Private Investments: Titan (2,000 shares), SI Bone (20,000 shares), Expanding Orthopedics (1,000 shares), Spartec (10,000 shares); Consulting: Pioneer (C), Medtronic (A); Trips/travel: Medtronic (A), Aesulap (B).

Carreon, Leah Y.: Trips/Travel: Medtronic Sofamor Danek (B); Other Office: Norton Healthcare (Employee).

Dimar, John R.: Royalties: Medtronic Sofamor Danek (H); Consulting: Medtronic Sofamor Danek (F); Trips/Travel: Medtronic Sofamor Danek (B); Research Support (Staff/Materials): Medtronic Sofamor Danek (B), Norton Healthcare (F); Fellowship Support: Norton Healthcare (F).

Djurasovic, Mladen: Consulting: Medtronic Sofamor Danek (E); Research Support (Staff/Materials): Medtronic Sofamor Danek (B), Norton Healthcare (F); Fellowship Support: Norton Healthcare (F).

Dvorak, Marcel F.S.: Royalties: Medtronic (D); Consulting: Medtronic (F); Speaking and/or teaching arrangements: Medtronic (Consulting disclosed); Trips/Travel: Medtronic (Consulting disclosed); Research Support (Staff/Materials): Medtronic (E); Grants: Medtronic (D), DePuy Spine (G), Rick Hansen Foundation (H); Fellowship Support: Medtronic (E), Synthes (E), DePuy (E).

Fisher, Charles G.: Royalties: Medtronic (D); Consulting: Medtronic (F); Speaking and/or teaching arrangements: Medtronic, DePuy, AO (Amount not disclosed); Trips/Travel: Medtronic (Amount not disclosed), AO (Amount not disclosed), DePuy (Amount not disclosed); Research Support (Staff/Materials): Medtronic (E), DePuy (E); Fellowship Support: Medtronic (F), Synthes (F).

Kwon, Brian K.: Consulting: Medtronic (D).

Morgan, Robert A.: Trips/Travel: Medtronic (B).

Rampersaud, Y. Raja: Consulting: Medtronic - Spine (D); Research Support (Staff/Materials): Medtronic (C); Relationships Outside the One Year Requirement: Medtronic Sofamor Danek (2004, Consultant).

Vaccaro, Alexander R.: Royalties: DePuy Spine (F), Biomet Spine (F), Globus (F), Medtronic (F), K2M (C), Aesculap (B); Stock Ownership: K2M (50,000 shares), Cytonics (Unknown), Disc Motion Technology (Unknown), Zygoloc (Unknown), Progressive Spinal Technology (Unknown), Computational Biodynamics (Unknown), Stout Medical (D), Bonovo Orthopaedics (100,000 shares), Electrocure (Unknown), Vertiflex (30,000 shares), Flagship Surgical (Unknown), In Vivo (Unknown), PearlDiver (Unknown), Small Bone Innovations (30,000 shares), Neucore (22,000 shares), Crosscurrent (125,000 shares), Vertilink (1,535 shares), Orthovita (10,000 shares), Syndicom (2,750 shares), Biomerix (25,000 shares), Spinemark (82,000 shares), Paradigm Spine (146,875 shares), Spinology (28,750 shares), Vertebron (184,984 shares), Replication Medica (15,250 shares), Breakaway Imaging (100,000 shares), Crosstree Medical (41,667 shares), Globus (60,000 shares); Consulting: DePuy Spine (D), Osteotech (None), Orthofix (B), Vertiflex (A), Vertebron (B), Stryker Biotech (C), Stryker Spine (F), K2M (B), Medtronic (D), AO Spine (B); Other Office: North American Spine Society Annual Meeting Program Committee (None); Research Support: Staff and/or materials: AO Spine (D), Medtronic (E).

Disclosures are current as of November 1, 2010.

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
• Adobe reader 7 or higher
• Microsoft Silverlight (if you do not have the program on your computer, you will be prompted to install it)
• 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.