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1 Spine Review Course: Week-at-a-Glance Wednesday, July 22, 2009 Course begins at the Renaissance Hotel Registration for nurses begins at 11 :30 AM Registration for physicians begins at 3:00 PM Welcome Reception held from 8:00...9:30 in the Ambassador Room at the hotel Thursday, July 23, 2009 A shuttle bus from the Renaissance Hotel to Lutheran will depart at 6:20 AM and 6:50 AM Those that would like to walk to Lutheran (less than 2 miles), a walking leader will depart from the Renaiss~nce at 6:15 AM Breakfast is available for course attendees starting at 6:30 AM in the hospital lobby area. The lectures begin at 7:00 AM. You may bring food and beverage into the lecture h~li. Lab sessions take place in the hospital's Wet Lab and in the Pre-Function Area of the auditorium. Each attendee will be assigned to a table in one of the labs and will remain there throughout the course. A shuttle bus from Lutheran Hospital will depart 15 and 45 minutes after the last session of the day. Thursday evening is open to explore downtown Cleveland Friday, July 24, 2009 A shuttle bus from the Renaissance Hotel to Lutheran will depart at 6:20 AM and 6:50 AM Those that would like to walk to Lutheran (less than 2 miles), a walking leader will depart from the Renaissance at 6:15 AM Breakfast is available for course attendees starting at 6:30 AM in the hospital lobby area. The lectures begin at 7:00 AM. You may bring food and beverage into the lecture hall. A shuttle bus from Lutheran Hospital will depart 15 and 45 minutes after the last session of the day. Open Evening Saturday, July 25, 2009 A shuttle bus from the Renaissance Hotel to Lutheran will depart at 6:20 AM and 6:50 AM Those that would like to walk to Lutheran (less than 2 miles), a walking leader will depart from the Renaissance at 6:15 AM Breakfast is available for course attendees starting at 6:30 AM in the hospital lobby area. The lectures begin at 7:00 AM. You may bring food and beverage into the lecture hall. No lab session today A shuttle bus from Lutheran Hpspital will depart 15 and 45 minutes after the last session of the day. Crawfish Boil and "Poker Run" Hike Bus for hikers departs Renaissance Hotel at 2:30 PM Bus for Crawfish Boil departs Renaissance Hotel at 4:00 PM Busses will return to hotel from the Benzel home at 8:00 and 9:15 PM Sunday, July 26, 2009 A shuttle bus from the Renaissance Hotel to Lutheran will depart at 7:20 AM and 7:50AM Breakfast is available for course attendees starting at 7:30 AM in the hospital lobby area. The lectures begin at 8:00 AM. You may bring food and beverage into the lecture hall. A shuttle bus from Lutheran Hospital will depart 15 and 45 minutes after the last session of the day. Open Evening Monday, July 27! 2009 A shuttle bus from the Renaissance Hotel to Lutheran will depart at 6:20 AM and 6:50 AM Breakfast is available for course attendees starting at 6:30 AM in the hospital lobby area. The lectures begin at 7:00 AM. You may bring food and beverage into the lecture hall. A shuttle bus from Lutheran Hospital will depart 15 and 45 minutes after the last session of the day. Night Out at The Corner Alley Reception from 7: :00 PM. The Corner Alley is a bowling alley and restaurant located at Euclid Avenue and East 4th Street (two blocks from the Renaissance Hotel). Attendees arrive on their own anytime after 7 PM. Tuesday, July 28, 2009 A shuttle bus from the Renaissance Hotel to Lutheran will depart at 7:20 AM and 7:50 AM Breakfast is available for course attendees starting at 7:30 AM in the hospital lobby area. The lectures begin at 8:00 AM. You may bring food and beverage into the lecture hall. Spine Review Course concludes by 11 :30 AM A shuttle bus from Lutheran Hospital will depart 15 and 45 minutes after the last session of the day.

2 2009 Cleveland Spine Review Hands-On Course July 22-28, 2009 Cleveland Spine Review: Hands-On 2009 is a comprehensive course utilizing the cadaver laboratory and didactic sessions with ample time for discussion. This intensive course emphasizes the fundamentals of spine surgery, particularly biomechanical considerations, and the surgery decision-making process. Through intensive, hands-on sessions utilizing cadavers, participants study surgical techniques and strategies for a range of procedures including: screw. lateral mass. pedicle and wire fixation. as well as occipitocervical and cervical, thoracic, lumbar, and lid sacral surgical techniques. Complex surgical exposures in all regions of the spine are emphasized. Led by experienced faculty, the course examines the multiple adjuncts to surgery, including soft tissue and bone retractors and distractors, minimally invasive surgical techniques, spinal implants (from multiple vendors), and dissection tools. Non-operative strategies are also emphasized. Significant time is dedicated to operative indication discussions. The problem-based decision-making process is introduced and emphasized during these very interactive discussions. Upon completion of this activity, the participant will be able to: Utilize problem-based decision-making to develop logical algorithms for solving complex problems. Employ physiological and surgical principles to spinal fusion and instrumentation. Apply anatomic and physiologic principles to the variety of surgical approaches available to access all regions of the spine. Recognize the fundamental skills required to perform the most appropriate operation for any given clinical pathology, and to recognize one's own limitations in these regards. Evaluate available instrumentation systems and appreciate the advantages of each, as well as the relative indications for their use. Target Audience: Neurosurgeons, Orthopaedic Surgeons, Spine Nurses, and Physician Assistants. IMPORTANT INFORMATION REGARDING CME CREDIT Evaluation The evaluation form for the Cleveland Spine Review Course is to be completed online at ~ :~~w.cievelan~linicrneded.corr~~gnle!~yloain.asp If you are a first-time user of "MyCME," you must create a log-in ID and password. Click on "New User:" located under the log-in to register. Your password must be at least 6 characters and can be any combination ofletters and numbers. CMEs: You will receive your CME attendance/credit record form when you complete the online evaluation form (see instructions above). Further instructions for logging in and keeping tract of the number of hours you attended the course are included in the syllabus. Acereditation The Cleveland Clinic Foundation Center for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Cleveland Clinic Foundation Center for Continuing Education designates this educational activity for a maximum of AMA PRA Category 1 Credits. Physicians should only claim credit commensurate with the extent of their participation in the activity. Participants claiming CME credit from this activity may submit the credit hours to the American Osteopathic Association Council on Continuing Medical Education for Category 2 credit

3 2009 Cleveland Spine Review Hands-On Course July 22-28, 2009 Disclaimer The information in this educational activity is provided for general medical education purposes only and is not meant to substitute tor the independent medical judgment ot a physician relative to diagnostic and treatment options ot a specific patient's medical condition. The viewpoints expressed in this CME activity are those ot the authors/faculty. They do not represent an endorsement by The Cleveland Clinic Foundation. In no event will The Cleveland Clinic Foundation be liable tor any decision made or action taken in reliance upon the information provided through this CME activity. Faculty Disclosure In accordance with the Standards for Commercial Support issued by the Accreditation Council for Continuing Medical Education (ACCME), The Cleveland Clinic Foundation Center for Continuing Education requires resolution of all faculty conflicts of interest to ensure CME activities are free of commercial bias. The following faculty have indicated that they may have a relationship, which in the context of their presentation(s), could be perceived as a potential conflict of interest: ConSUlting - AxioMed Consulting - A/tiva ConSUlting - Ca/citech Consulting, Teaching & Speaking, Grant/Research - DePuy Spine Stock Shareholder - Disc Dynamics Teaching and Speaking - Integra UfeSciences Consulting - Nanovis Teaching and Speaking - NuVasive Consulting, Board Membership, Grant/Research, Stock Shareholder, Membership on Advisory Committee or Review Panel - OrthoMems Grant/Research, Stock Shareholder - Spine Wave Consulting - SpineMark ConSUlting, Membership on Advisory Committee or Review Panel - Turning Point Lars Gilbertson Research - OrthoMems Research - Stryker Spine Michael Steinmetz Teaching and Speaking - Stryker Spine Eric Woodard. Management Position and Board Membership - In Vivo Therapeutics The following faculty have indicated they have no relationship which, in the context oftheir presentationes), could be perceived as a potential conflict ofinterest: Gordon Bell lain Kaltas Ajit Krishnaney Eric Mayer Daniel Mazanec Thomas Mroz Abdeltattah Saoud Judith Scheman Richard Schlenk Greg Trost Adrian Zachary CI{:.,iel~jndCjini,- Over 7~, Years of [xceilf?f1ce CONTINUING MEDJCAlE.OUCATION Copyright 2009 The Cleveland Clinic Foundation. All Rights Reserved.

4 Edward C. Benzel, MD Cleveland Clinic, Cleveland, OH Marc E. Eichler, MD Newton Centre, MA Lars Gilbertson, PhD Cleveland Clinic, Cleveland, OH, MD Cleveland Clinic, Cleveland, OH Gregory R. Trost, MD University of Wisconsin, Madison, WI Honored Guest Eric Woodard, MD New England Baptist Hospital Boston, MA Nursing Directors Ann Henwood, MSN, RN, ens Cleveland Clinic, Cleveland, OH Andrea Strayer, MS, AlG NP, CNRN University of Wisconsin, Madison, WI Guest Faculty Denise Niklasch, MSN, CS, RN, ANP, CNRN Medical College of Wisconsin Milwaukee, WI Abdelfattah Saoud, MD, PhD Ain Shams University Cairo, Egypt Cleveland Clinic Faculty Betty Balmat, RN Division of Nursing Gordon Bell, MD Katie Evanchick, PA-C Fran A. Feldkamp, MS, MPAS, PA-C lain Kalfas, MD Ajit Krishnaney, MD Eric Mayer, MD Daniel Mazenec, MD Robert Mclain, MD Alfred Melillo, PA-C Thomas Mroz, MD Paul Ruggieri, MD Neuroradiology Judith Scheman, PhD Chronic Pain Rehabilitation Richard Schlenk, MD Michael Steinmetz, MD Adrian Zachary, MD

5 l Wednesday, July 22,2009 July 22-28, 2009 RN Early-Start Lectures 11 :30-12:00 Registration 12:00-12:'10 Opening Renlarks 12:10-12:40 Functional Anatomy and Physiology Of the Spine, Spinal Cord, and Peripheral Nerves 12:40-1:30 1:30-1:55 1:55-2:40 2:40-3:20 3:20-3:30 4:00-4:30 4:30-4:45 4:45-5:00 5:00-5:30 5:30-6:00 6:30-6:50 6:50-7:30 7:30-8:00 Cervical Spine Pathology and Correlative Neuro Assessrnent Radiology Fundamentals Fundamentals of Biome<;hanics Spinal Column Pathology and Medical Decision Making: The Surgeon's Perspective Discussion Welcome, Opening Remarks, Introduction to Course Introduction to Problem Based Decision Making Biomechanics of the Cervical Spine Surgery of the Craniocervical Jundion: Indications and Techniques Sub-axial Cervical Spine: Pathologies and Treatments Laminoplasty Indications, Techniques and Evidence Ventral Surgery of the Cervical Spine Indications and Techniques Cervical Cases Andrea Strayer Andrea Strayer Ann Henwood Paul Ruggieri Greg Trost Andrea Strayer Lars Gilbertson lain Kalfas Ajit Krishnany Gordon Bell Tom Mroz

6 JUly 22-28, 2009 Thursday, July 23, :20 & 6:50 Shuttle from Renaissance Hotel to Lutheran Hospital 6:30-7:00 Continental Breakfast and Exhibits 7:00-7:15 Recap 7:15-7:45 Dorsal Surgery of the Cervical Spine Indications and Techniques 7:45-8:00 Orthotics 8:00-8:45 Surgical Approaches to the Craniocervical Junction 8:45-9:15 Cervical Defonnity Evaluation and Treatment 9:15-9:45 Cervical Disc Arthroplasty Indications and Techniques 9:45-10:15 Break Mike Steinmetz Greg Trost Greg Trost 10:15-12:00 Lab I: Craniocervical Approaches (Include Whitesides?) 12:00-13:00 Lunch and Cases & Nurse/PA lecture: Cervical Case StUdies AI Melillo 13:00-13:45 Ventral Approaches to the Cervical Spine and Cervico Thoracic Junction Greg Trost 13:45-15:45 Lab II: Anterior Cervical Approaches and Instrumentation, Arthroplasty 14:45-15:45 Nurse/PA Lecture: Intensive Care Management after Spinal Cord Injury 15:45-16:15 16:15-17:00 Break Cases 17: 15 & 17:45 Return Shuttle to Renaissance Hotel Open Evening Denise Niklasch

7 Friday, July 24,2009 JUly 22-28, :20 & 6:50 Shuttle from Renaissance Hotel to Lutheran Hospital 6:30-7:00 Continental Breakfast and Exhibits 7:00-7:15 Recap 7:15-8:45 Lab III: Ventral Approaches to the Cervicothoracic Junction 8:45-9:30 Guest Lecturer: Cervical Trauma 9:30-10:00 Break 10:00-11 :30 Lab IV: Dorsal Cervical Approach, Instrumentation, Laminoplasty 11 :30-12:00 Cases Nurse/PA Lecture: Billing for the Midlevel Provider Nurse/PA Lecture: Care of the Geriatric Spine Patient 12:00-12:45 Lunch Eric Woodard Gail Pfeiffer Andrea Strayer (Combined Course begins Friday PM) 13:00-13:15 13:15-13:45 13:45-14:15 14:15-14:45 14:45-15:15 15:15-15:30 15:30-16:00 16:00-17:00 16:00-17:00 Intro to Combined Sessions Introductory Biomechanics Biomechanics of Implants and Implant Failure Selection of Patients for Surgery Interventional Diagnostics Can they Improve Outcomes? Break Masqueraders of Spinal Pathology Cases Nurse/PA Lecture: Implementing Evidence-based Practice for the Spine Patient on Your Unit 17:15 & 17:45 Return Shuttle to Renaissance Hotel Lars Gilbertson Eric Mayer Daniel Mazanec Denise Niklasch Opan Evaning.3

8 Saturday, July 25,2009 JUly 22-28, :15 6:30-7:00 7:00-7:15 7:15-7:45 7:45-8:30 8:30-9:00 9: :45-10:15 10:15-10:45 10:45-11 :15 11 :15-11 :45 11 :45-12:30 '11 :45-12:30 12:30-14:00 Shuttle from Renaissance Hotel to Lutheran Hospita' Continental Breakfast and Exhibits Recap Surgery of the Geriatric Spine Overview of Spinal Biomaterials Understanding Evidence and Outcomes Honored Guest Lecture Spinal Technologies: Where Are We Going? Break Psychology of Spinal Disorders Outcomes Instruments What to Use and Why Pain Management Cases f\jurselpa Lecture: Lunlbar Anatorny and Correlative Exarnination Lunch and Spine Bowl I Lars Gilbertson Greg Trost Eric Woodard Judith Scheman Judith Scheman Adrian Zachary Fran Feldkanlp and Greg Trost 14:15 & 17:45 Return Shuttle to Renaissance Hotel 14:30 Depart Hotel for Hike I Poker Run 15:00 Hike I Poker Run 16:30 Depart Hotel for Crawfish Boil 17:00 Crawfish Boil at Dr. Benzel's Home

9 July 22-28, 2009 Sunday, July 26, :20 & 7:50 Shuttle from Renaissance Hotel to lutheran Hospital 7:30-8:00 Continental Breakfast and Exhibits 8:00-8:15 Hike Recap 8: 15-8:45 Thoracolumbar Stabilization Strategies 8:45-9:00 Ventral Lumbar Stabilization Techniques 9:00-9:30 Dorsal Thoracolumbar Fixation Techniques 9:30-9:45 Thoracolumbar Trauma 9:45-10:30 Ventral and Ventral Lateral exposures of the TIL spine 10:30-11:00 Break 11 :00-12:30 Lab V: Ventral and Lateral Thoracic and Lumbar Exposures 12:30-13:00 Lunch 12;30-13:00 Nurse/PA Lecture: Practice Issues 13:00-13:30 Biomechanics of Deformity Correction 13:30-14:00 Lumbosacral Pelvic Fixation Techniques 14:00-14:45 MIS Results Tricks and Pearls 14:45-15:15 Break 15:15-16:30 Lab VI: Dorsal Thoracic and Exposure and Fixation 16:00-16:30 Nurse/PA Lecture: Surgical Issues fro01 an Allied Health Perspective 16:30-17:30 Spine Bowl II Mike Steinmetz Eric Woodard Ann Henwood Rich Schlenk A. Saoud Michael Steinmetz Betty Balmat Eichler &Trost 17:30 & 18:00 Return Shuttle to Renaissance Hotel Open Evening

10 JUly 22-28, 2009 Monday, July 27,2009 6:20 & 6:50 Shuttle from Renaissance Hotel to Lutheran Hospital 6:30-7:00 Continental Breakfast and Exhibits 7:00-7:15 Recap 7: 15-8:00 Deformity Prevention and Correction 8:00-8:15 Spine Surgery Pearls and Tricks of the Trade 8:15-8:45 AUF, PUF, TLIF Indications and Techniques 8:45-9:15 Spinal Tumor Management Strategies 9: 15-9:45 Break 9:45-11 :15 Lab VII: Everything Dorsal Lumbar 11 :15-12:00 Cases 11:15-12:30 Nurse/PA Lecture: Pre and Post Op Care Considerations for the Spine Patient l\jurselpa Lecture: Alternative Pain Manage,.nent 12-12:30 Lunch 12:30-13:00 13:00-13:30 13:30-15:00 '14: 30-15:00 15:00-15:30 15:30-17:00 Vertebroplasty and Kyphoplasty Bone Physiology Grafting and Substitutes Lab VII: Everything Ventral Lumbar Spine NurselPA Lecture: Lurnbar Cases Break Spine Bowl Finale 17:30 & 18:00 Return Shuttle to Renaissance Hotel Gordon Bell Rich Schlenk AI 1\1elillo Andrea Straye,' Rich Schlenk Ajit Krishnaney Katie Evanch'ck Trost & Eichler Tuesday, JUly 28, :15 Shuttle from Renaissance Hotel to Lutheran Hospital 7:30-8:00 Continental Breakfast and Exhibits 8:00-8:30 MIS Surgery Indications and Techniques 8:30-9:00 Biomechanics of Motion Preservation 9:00-9:30 Implants Cost Control 9:30-10:00 Spinal Infection Management Strategies 10:00-10:30 Break 10:30-11 :00 Cases 11 :00-11 :30 Wrap-up 11 :30 & 12:00 Return Shuttle to Renaissance Hotel Mike Steinmetz Ajit Krishnaney

2018 Midwest Spine Symposium

Friday & Saturday, September 21-22, 2018 Description The 2018 Midwest Spine Symposium is an opportunity for regional spine surgeons to interact with each other, share skills and newly discovered techniques