We are pleased to present you with the first Newsletter of the Middle East Spine Society.

Transcription

1 We are pleased to present you with the first Newsletter of the Middle East Spine Society. In this issue, The President we are proud of, Professor Salman Sharif gives us an overview and messages of recent policy issues. The interviews our Founder and First President, Prof. Mehmet Zileli on the brief history of the Middle East Spine Society. Prof. Onur Yaman and Dr. Goktug Akyoldas deliver an excellent and concise review of very exciting Second Istanbul Spine Masters and ISMISS Turkey Joint Meeting. Impressions and Messages regarding the February & December Karachi Spine 2017 in Karachi, Pakistan. Prof. Najia El Abbadi also shares her views and insights on leading 4th Meeting of MESpine in Morocco. We also provides an update information about upcoming meetings, Pain and Minimally Invasive Spine Workshop, December 15-16, 2017, and etc. Hope everyone thoroughly enjoys this issue and see you on very upcoming events! Prof. Mohamed Mohi Eldin, MD, PhD m mmohi63@yahoo.com Eko Agus Subagio, MD, PhD Eko Agus Subagio, MD, PhD easnsurg@yahoo.com easnsurg@yahoo.com Professor Salman Sharif As we move into this new year for the Middle East Spine Society, the executive committee and I would like to thank every member for being part of our society. We would especially like to thank the founding members for their never ending enthusiasm and passion for the society. Without the support of our members and affiliated societies, Continued on page 2

2 2 Continued from page 1 We would not have progressed this far. In the coming years, we hope to continue to contribute on a larger scale to the education and training in the field of spine through multiple scientific activities. Middle East Spine Society is unique for its affiliation with neurosurgical institutes from many different countries. We have already performed various workshops and courses with various international and regional societies and would like to continue to do so. We want to endeavor to collaborate and work with other organizations including WFNS, WSCS, ACNS, PSN, MNS, BSS, and Turkish MISS. This divergence will create a vast network that will enable us to exchange the knowledge and neurosurgical practices that will help young neurosurgeons be the best in their field. This year, we plan to take the society to a whole new level. While achieving new heights, the main objectives of the society set by Professor Mehmet Zileli will remain the building blocks for us. We will continue to spread the message, and research into the cause, prevention and cure of human diseases in the field of spine surgery, just the way our founding President Prof Mehmet Zileli did. I would also like to appreciate the precedent President of MESS Abd- Elhafiz Shehab-Eldien for his excellent efforts. As the President of MESS, I again welcome you all and hope to have all the spinal facilities in our region to be of high standards and at par with all the top institutions in the world. with Interviewed by Eko A. Subagio, MD, PhD Past President WSCS Past President Turkish Neurosurgical Society Chairman WFNS Spine Committee Past Chairman Ege University Neurosurgery Department, Izmir, Turkey Can you please describe briefly about yourself, your field of interest, when you started spine surgery, your education, your publications and/or books? I finished my residency in I was trained as a general neurosurgeon. In 1987 and 1988, I did research fellowship in Germany, worked on intraoperative monitoring. Till that time, I was more Continued on page 3

3 Continued from page 2 3 interested in electrophysiology. After coming back to Izmir, Turkey, I established a clinical neurophysiology laboratory and did research on that subject. My interest to spine surgery started in 1989 and continued since today. At those times, neurosurgeons had little or no knowledge on spine biomechanics, spinal implants and deformities. I visited some US centers and have got great influence by Edward C. Benzel. I pioneered founding the spine section of Turkish Neurosurgical Society in It created a big impetus to learn, train ourselves and improve our theoretic and practical knowledge on all lacking issues. I organized cadaver courses first in Turkey, than some other countries in the region. Basic courses started in 1997, this year it will be the 17th course. They are advanced spine course in Turkish. Additionally, we are organizing a yearly course called Istanbul Spine Masters in English. I am now serving as the Co- Chairman of WFNS Spine Committee. Together with Dr. Fahir Ozer, I have published a 3 volume multi-author book entitled Spine and Spinal Cord Surgery. First edition was in 1997, the last (3rd) edition was in I also contributed to many other spine related books as co-editor or chapter author. Why did you decide to found MESS? Middle East region has different dynamics than other regions of the world. Resources are not that much as it is in Europe, North America and some parts of Asia. If we should improve the spine health care in the region, we should have done it ourselves. We have region specific problems such as training problems, accreditation, lack of health care insurance, very high costs of implants etc. We wanted to unify our powers to deliver optimal spine care in the region. What was your biggest challenge before, when, and after founding the Middle East Spine Society? First of all, registration of the society was quite difficult. Even the regulations in Turkey did not allow us to register it Continued on page 4

4 Continued from page 3 4 in Turkey. We could make it in Egypt with great help of our friends in Cairo. But, still we have some problems with difficult regulations. Till today, we organized 4 general meetings in Turkey, Egypt and Morocco. We have difficulty to attract young generations to work for the society. I see the physicians in our countries, especially young generations are demotivated, do not want to be involved in voluntary and hard works. We have created a yahoo group to discuss the problems of spine care and case reports, but contributions of many members are very low. Another issue is problems created by the wars in the region. Some colleagues from Iraq, Syria, Sudan, and Yemen are in need of surgical instruments, implants and operating theater equipments. We are a very young society. We need to work harder and communicate much. I believe we have many tasks that we should progress in the near future such as; regular training meetings, developing fellowship centers, spine registry and data base, interactive discussion forums, publications etc. We need juniors who will dedicate themselves on those subjects. What do you see as significant the term challenges to spine surgery? There are many problems of spine care. First of all, practice of medicine in general is changing a lot. It is changing because we are having less contact with patients, we are ordering too many investigations, and we are facing with patients who are full with unnecessary information form internet. As spine physicians we are in trouble to understand the sources of pain and pan behavior. We become blinded with incidental findings on the images. We love to use implants and many of us see implants as toys that should be played with. Some publications about spinal implants are shadowed with company supports. The costs of spine care especially surgeries with implants are quite high and health care systems are not able to carry that. Spine surgeons must take care of cost effectiveness of every surgery. What advice would you give someone who wants to become more involved in this Society? This is very easy. They must come to our meetings, become a member, be involved in the yahoo group, ask and discuss. We are open for any suggestions and contributions. What advice would you give to a young neurosurgeon and spine surgeon? In the beginning of my carrier, brain surgery, especially aneurysm surgery was the most privileged surgery for neurosurgeons. By the time, it has partially changed. Nowadays many young neurosurgeons are choosing Continued on page 5

5 5 Continued from page 4 spine instead of brain. This is mainly to have more practicing options, or more patients in the area. Especially degenerative spine cases are rapidly increasing by aging population. Spine surgery, however, have more entrapments than cranial surgery. Especially decision making process is quite challenging, and complications are not accepted by public. Besides, mostly the reason of surgery for spinal diseases is mostly the pain only, which is a subjective feeling and can be blurred by many factors. Here, the art of medicine must be applied. So a young surgeon who has enthusiasm for spine as specialty, must not only learn very fast evolving surgical techniques, but also must have communication skills to understand the patient and choose the appropriate indications. What are your future plans to address the development of world neurosurgical education especially in the spine field? I believe, it the Middle East Spine Society becomes a success, that will be a great achievement not only for the region, but also for the world. I am currently involved with WFNS Spine Committee as one of the chairman. We have some projects in that committee such as developing regular webinars, guidelines in specific subjects and training activities. Prof. Onur Yaman & Dr. Goktug Akyoldas The Joint meeting of Istanbul Spine Masters & ISMISS Turkey 2017 held in Istanbul from October 26, 2017 to October 29, 2017 attracted participation of more than 90 members from all around the world. The Joint meetings of Istanbul Spine Masters & ISMISS Turkey are very much looked forward to as they include presentations of the latest cutting edge data as well as several educational sessions for trainees and updates for senior members too. The 1st day of the meeting began with Dr.Serdar Kahraman s interesting presentation on the use of fluorescein in spinal tumors. In the same session, presentations on approaches to thoracic disc herniations were delivered by experienced speakers. The following session started with Dr. Fahir Ozer s lecture on Kambin s triangle. Dr. Hyeun Sung Kim, Dr. Hikmet Uluğ, Dr. Robert Saftic and other speakers who were very Continued on page 6

6 Continued from page 5 6 specialized in endoscopic spinal surgery discussed the history, current aspects and future expectations of endoscopic spinal surgery. Dr. Mehmet Zileli presented his tutorial lecture on minimally invasive options in spine surgery. The 2nd day began with presenting of oral posters containing valuable scientific works. In the following, presentations were made on extraforaminal herniations and the value of dynamic stabilization in treatment of degenerative spondylolisthesis. Dr. Fahir Ozer presented details of his new technique for lumbar root decompression. In the afternoon sessions, Dr. Richard Assaker and Dr. Emre Acaroğlu gave presentations on adult spinal deformity. A panel on adolescent idiopathic scoliosis (AIS) was performed by neurosurgeons and orthopedic surgeons who were very experienced in the field. In this panel, Dr Onur Yaman, Dr. Ömer Akçalı and Dr. Emre Acaroğlu shared their wide experiences of AIS. After the panel, three controversial cases and two videos were presented. On the 3rd day morning, three panels about lumbar spinal stenosis, odontoid fractures and osteoporotic fracture were run by moderators; Dr. Richard Assaker, Dr. Fahir Özer, Dr. Athanasios Spilotopoulos. In the panels, Turkish and foreign speakers presented their experiences about related topics. In the afternoon, live surgical operations were performed real time in 3 separate operating rooms. The session was moderated by Dr. Mehmet Zileli. Dr. Fahir Özer and Dr. Onur Yaman performed decompression, interbody fusion and stabilization for lumbar degenerative spondylolisthesis, Dr. Continued on page 7

7 7 Continued from page 6 Salim Şentürk performed endoscopic lumbar discectomy and Dr.Tunç Öktenoğlu performed five segments kyphoplasty for multiple osteoporotic fractures. Operations were broadcasted interactively in the meeting hall by using advanced video cable submission system. Participants had the chance to observe each step of the surgical procedures. The questions asked by the participants were simultaneously answered by the surgeons during the operations. On the 4th day, panels about cervical spondylotic myelopathy, osteotomies in deformity surgery, and subaxial cervical trauma were moderated by Dr. Salman Sharif, Dr. Mehmet Zileli, Dr. Sait Naderi. Panels started with case presentations, then speakers discussed treatment options for related topics and finally panels ended with debates on proper management of these pathologies. In conclusion, selected topics and planning of the meeting were quite successful. There have been important and educational discussions about spinal deformity, endoscopic spinal surgery, minimal invasive approaches and dynamic stabilization of the spine. In particular, live surgery session was a unique experience for all participants.

8 8 Imad Ullah With the aim of providing the latest perk of knowledge and training to the aspiring neurosurgeons in Pakistan, the department of Neurosurgery, Liaquat National Hospital organized Karachi Spine 2017 in collaboration with the Asian Congress of Neurological Surgeons, World Federation of Neurological Societies, International Federation of Neuroendoscopy, Middle East Spine Society, World Spinal Column Society, and Pakistan Society of Neurosurgeons, a joint cadaveric workshop to provide hands on training to the young neurosurgeons in Pakistan. Douglas Orr (USA), opened the course by highlighting its objectives and aims. A quick overview of the upper and subaxial cervical anatomy was given by Sandeep Vaishya (India) & Nikolay Peev (UK) respectively, this was followed by the techniques of Anterior Cervical and Odontoid Screw fixation by Prof. Trost (USA) and Prof. Orr (USA). Approaches to Cervicothoracic Junction was discussed by Onur Yaman (Turkey). A series of approaches including transoral and anterolateral retropharyngeal and anterolateral Cranial Cervical Approach were discussed by Dr. Mehmet Zileli (Turkey) and Gregory Trost (USA) respectively. This was followed by a lecture on Cervical Dıscectomy, Anterior foraminotomy, Corpectomy delivered by Dr. Salman Sharif (Pak). Traumatic pathologies of the upper and subaxial cervical region were disscused by Mehmet Zileli (Turkey) and Sait Naderi (Turkey). In patients undergoing Cervical Spinal Arthroplasty, Dr. Kim (Korea) discussed the biomechanical changes such as Range of Motion, Disc Pressure, and Facet Strain. This was then followed by a series of case discussions and video sessions conducted by Paulo Pereira (Portugal)/ Jae Taek Hong (Seoul). The participants were then taken for a hands on cadaveric lab where they were supervised by the course directors for Continued on page 9

9 9 Continued from page 8 Odonoid Screw, Anterior Foraminotomy, Vertebral Artery Dissection, Anterior Corpectomy and Plate, Cervicothoracic Junction anterior Approach. Further cases were discussed to assess the participants. The first day of this workshop ended with an elite Gala Dinner at the Movenpick Hotel, where the guest faculty and participants had a good time by the poolside to relax and enjoy the evening. The second day of the course commenced with lectures by Salman Sharif (Pak) & Joachim Oertel (Germany) on C1-2 Transarticular Screw Techniques, Occipitocervical Fixation involving C1 Lateral Mass, C2 Pedicle Screws, C2 Laminar Screws as well as Cervical Posterior Foraminotomy. Approaches to the Thoraco-Cervical Junction and Posterolateral and lateral approaches to Craniocervical Junction were introduced by Ioannis Polythodorakis (Greece) and Prof. Trost. Lectures on Laminoplasty, Os Odontoideum and C1-2 Subluxation and Subaxial Fıxation Techniques were given by Prof. Kim & Zileli respectively. The next session of the day focused upon the spinal biomechanics and associated tumors and their surgical management. The session consisted of Surgery for Cervical Intradural/ Intramedullary Tumors Bone Tumors of Cervical Spine, Sugery for Cervical Kyphosis, Rheumatoid Cervical Disease, and the role of Minimally Invasive Spine Surgery and Electrophysiology in Spinal surgeries. The participants were again taken to the cadaveric lab for a hands-on session on Upper Cervical Fixation Techniques, Occipital Plate, C1 and C2 Screw, Lateral Mass Screw, Posterior Foraminotomy, Laminoplasty. The day ended with a trip to the city of Lahore, where the faculty enjoyed a traditional dinner and sight seeing the next day.

10 10 4 th Meeting of the Middle East Spine Society: A view and insight Prof. Najia El Abbadi Under the high patronage of His Majesty King Mohammed VI of Morocco, the Moroccan Society of Neurosurgery, in collaboration of the Moroccan Society of Spine and Spinal Cord Surgery, had organized the 4th Meeting of the Middle East Spine Society and the 26th Moroccan Congress of Neurosurgery, in Rabat, the capital of Morocco between May, The president of the congress was Professor Najia El Abbadi who also was the president of the Moroccan Society of Neurosurgery. During 4 days, 250 participants from 34 countries have shared 7 plenary session, 7 panel sessions, 8 oral presentations sessions, 4 case discussions sessions, 4 symposiums and E-posters. Also, 3 joint sessions were held with the World Spinal Column Society, the Turkish Neurosurgical Society and the Mediterranean Association of Neurological Surgeons. More than 100 invited speakers had a role on scientific sessions. Many subjects were discussed during this congress about different topics of spine and spinal cord surgery. Continued on page 11

11 11 Continued from page 10 In order to encourage young neurosurgical community, 30 scholarships were given to the participating residents and young neurosurgeons. Besides, 4 pre-congress courses were held: Intraoperative Neurophysiological Monitoring, Lumbar Minimally Invasive Spine Surgery Posterior Approaches, Sagittal Balance: How to Deal with a Deformity Case, Surgery of Pain and Spasticity. Beside scientific sessions, an opening ceremony was organized on May 10, 2017, a President s Dinner on May 11 and a Gala Dinner on May 12 at the Amphitrite Palace and resorts. All participants had the occasion to discover the Moroccan culinary culture. Pre congress and post congress programs to visit Morocco were planned for participants who wished to visit the imperial cities and touristic places in Morocco.

12 12 12 KARACHI SPINE 2017 Pain and Minimally Invasive Spine Surgery Workshop Prof. Salman Sharif The Department of Neurosurgery, Liaquat National Hospital and Medical College, in collaboration with World Federation of Neurosurgical Societies, World Spinal Column Society, Middle East Spine Society, Asian Congress of Neurological Surgeons, and Pakistan Society of Neurosurgeons, organized the three-day Pain and Minimally Invasive Spine Surgery workshop from December 15 to 17, The course was directed by Prof. Salman Sharif, Head of Department of Neurosurgery, Liaquat National Hospital Karachi; Ovidiu Palea, a renowned pain specialist from Romania, and Mehmet Zileli, a notable Neuro- Spinal Surgeon from Turkey. We were Continued on page 13

13 13 Continued from page 12 honored by the guest faculty; Onur Yaman, spine deformity specialist from Istanbul, Nikolay Peev (Belfast) and Benedikt Burkhardt, a spine fellow from the University of Saarland, Germany. Prof. Tariq Salahuddin, former president of the Pakistan Society of Neurosurgeons encouraged us by his presence throughout the conference. Beside participants from all provinces of Pakistan, we were also humbled to have participants from Kenya and Indonesia who were enthusiastic to learn from this workshop. The idea of the workshop was to train young and experienced Neurosurgeons in modern surgery. State of art technique and cadaver dissection along with discussion session and live surgery enabled our neurosurgeons to learn this new cutting-edge technique. The faculty conducted a series of live surgeries to demonstrate procedures like Awake Transforaminal Injection, Awake Endoscopic Discectomy, Minimally Invasive Surgery (MIS) Transforaminal Lumbar Interbody Fusion (TLIF), and a Lumbar Deformity Correction. The highlight of this workshop was that awake endoscopic discectomy was done first time in Liaquat National Hospital, Pakistan. Liaquat National Hospital had previously been also involved and have conducted many such educational activities. The lecture series began on December 15, during which detailed Endoscopic Surgery, the required anatomy and different surgery techniques. The interactive lectures formed a bridge between the techniques and outcomes from different parts of the world. The faculty also touched on the particulars of Minimally Invasive Spine Surgeries. The lectures were followed by a handson Cadaver Workshops where participants had hands on. The day ended with a Gala Dinner at one of the historical sites in Karachi, the Frere Hall. This event was graced by the honorable Chief Minister of Sindh, Mr. Murad Ali Shah as the Chief Guest, who appreciated the success of the academic activities and this workshop on the whole. Continued on page 14

14 14 Continued from page 13 The second day lectures focused primarily on Minimally Invasive Spine Surgeries, and how it compares to Open Spine Surgeries. The hands-on Cadaver Workshops, that followed, were on different MIS surgery approaches and Injections. Dinner was organized at the Marina Boat Club so as to enjoy the chilling weather in the open sea and cherishing the beautiful sites at the coast of Karachi. The conference concluded on 17th December with live surgeries on the correction of Cervical Spine Kypho- Scoliosis, where the participants could observe the surgeries from the theatre as they were performed. The entire workshop was televised Live Online across the globe on Neurosurgical TV, and can be viewed later on as well. The dedicated team of Karachi Spine 2017 succeeded in training its participants in an interactive and handson approach, and accomplished its goal of providing state-of-the-art knowledge and skills to the young neurosurgeons. We thank the entire faculty for their time and dedication and look forward to more training opportunities for young neurosurgeons in future.

15 15 Updates for MESS Members International Spinal Osteotomy Meeting Turkey 2018 ( February 10 th, 2018 in Koç University Hospital, Istanbul, Turkey. Joint Meeting of Istanbul Spine Masters and ISMISS Turkey 2018 ( May 10-13, Istanbul, Turkey.

16 December 2017 Newsletter of Middle East Spine Society