The 14 th Annual Cabo Meeting: State of Spine Surgery Think Tank June 15 17, 2017 Hyatt Ziva Los Cabos, Mexico Final Program

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1 THURSDAY, JUNE 15, 2017 The 14 th Annual Cabo Meeting: State of Spine Surgery Think Tank 7:00 am Registration, coffee, & exhibits 7:30 Welcome F. Phillips, MD Session 1: The Future of Spine Surgery Mod: W. Eisner Panel: J. Dunkel, F. Phillips, MD, D. Terry 7:35 A whole new world. What are the implications of the new Presidential administration for spine surgeons, device companies, technology and innovation, and the millions with health insurance? Session 2: Safety in Spine Surgery Mod: T. Albert, MD 8:35 Why safety really matters to all stakeholders S. Berven, MD 8:41 Predicting complications, risk stratification and frailty: When to say no G. Mundis, MD 8:47 Pre-operative optimization of the patient T. Allen, MD 8:53 Discussion 9:08 How to reduce risks of SSI A. Araghi, MD 9:16 Intra-operative neurologic injuries: Avoidance and prompt response J. Harrop, MD 9:24 Lumbar Discectomy & Reoperations: Prognostic risk factors from a randomized clinical trial (control group only) A. Araghi, MD 9:32 How to adopt new technology in a safe manner S. Hochshuler, MD 9:40 Strategies to reduce blood loss in spinal surgery A. Kanter, MD 9:48 Discussion 10:05 Refreshment break Session 3: Part I: Debates Debate: L4/5 Spondylolisthesis with Stenosis Mod: G. Mundis, MD 10:25 Introductory case G. Mundis, MD 10:29 Lami and postero-lateral fusion R. Sasso, MD 10:35 Inter-laminar approaches K. Radcliff, MD 10:41 MIS TLIF I. Moss, MD 10:47 LLIF with indirect decompression L. Pimenta, MD 10:53 Discussion Debate: Cervical Spondylosis: Two-level Disease Mod: W. Taylor, MD 11:03 Introductory case W. Taylor, MD 11:07 ACDF remains the most predictable option M. Colman, MD 11:13 Two-level TDR R. Sasso, MD 11:19 Role for hybrid constructs J. Zigler, MD 11:25 Economics of anterior cervical reconstruction J. Goldstein, MD 11:31 Discussion

2 THURSDAY, JUNE 15, CONTINUED Session 3: Part II: Degenerative/Deformity: Blurring the lines Mod: J. Uribe, MD 11:41 When is degenerative disease really deformity? G. Deol, MD 11:45 What are the indications for a small surgery in the setting of a spinal deformity? S. Qureshi, MD 11:51 Is ALIF surgery for deformity making a comeback? F. Phillips, MD 11:57 Fusion selection in degenerative scoliosis S. Khan, MD 12:03 pm Discussion 12:10 Acknowledgment of supporters F. Phillips, MD 12:15 Lunch Session 4: Part I: Reversing the tide of payer power: Will doctors be in charge of patients again? Mod: F. Phillips, MD Panel: J. Dunkel, J. Dunn, D. Terry, J. Zigler, MD Supported by SI Bone 1:05-1:50 Session 4: Continued Trauma and Tumor Mod: G. Deol, MD 1:50 How and why we are treating spinal tumors different to 10 years ago M. Colman, MD 1:56 Trends for trauma in the next 10 years J. Harrop, MD 2:02 Discussion Proximal Junctional Kyphosis Mod: G. Deol, MD 2:08 Where are we with PJK classification? S. Khan, MD 2:14 Mechanisms of proximal junctional failure T. Cha, MD 2:20 Prevention strategies of PJK G. Mundis, MD 2:26 Discussion 2:35 Refreshment break Debate: Degenerative Scoliosis 2:47 The degenerative surgeon thinks it s just some DDD because they don t want to do all the academic measurements 2:53 The deformity surgeon thinks it s a spinal deformity so all they have to say is T10-Pelvis instead of actually having to diagnose the patient 2:59 Discussion Mod: A. Vaccaro, MD, PhD G. Mundis, MD T. Albert, MD Navigation, Robotics and Radiation Reduction Mod: A. Vaccaro, MD, PhD 3:05 Intra-operative navigation and robotics: Accuracy, efficiency and radiation K. Siemienow, MD 3:11 Is robotic spinal surgery a marketing ploy? S. Qureshi MD 3:17 Radiation in surgery; How LessRay Technology can significantly enhance safety and functionality J. Uribe, MD 3.23 Discussion 3:30 Adjourn

3 THURSDAY, JUNE 15, CONTINUED 5:15 Breakout Session with Refreshments Optimizing fusion results with Cellular Titanium Implants: size and shape does matter Supported by EIT N. Lamerigts, MD, PhD 6:30 Beach Reception FRIDAY, JUNE 16, :00 am Registration, coffee, & exhibits 7:30 Welcome A. Vaccaro, MD, PhD Session 5: Delivering Value in Healthcare - Care Coordination Mod: A. Vaccaro, MD, PhD 7:35 What is value? How is it defined by the government, payers, physician and patient? Where is American healthcare heading ACOs, bundle payments, population healthcare. What s next? A. Vaccaro, MD, PhD 7:45 How can physicians provide value in spinal care: Pre-op optimization; evidence based; patient risk assessment; patient navigation; demand match; clinical, functional and quality of life outcomes Predictive modeling; hospital partnerships C. Vannello, MD 7:55 What tools / technologies are necessary to deliver value based healthcare: Navigation system, EMR, and web-based rehab Data collection: metrics to collect, sources, transparency, and Healthgrades B. Spira, PT 8:05 Panel Discussion: So what does it all mean for spine surgeons now and in the next 5 years? Panel: G. Mundis, MD; B. Spira, PT; C. Vannello, MD; J. Zigler, MD Session 6: Minimally Invasive Spine Surgery Mod: J. Goldstein, MD 8:20 Do outcomes suggest MIS is the standard for most degenerative spinal pathologies? R. Fessler, MD When Do I Use Them: Why, and What s the Evidence? 8:30 Lateral trans-psoas L. Pimenta, MD 8:38 Lateral pre-psoas R. Fessler, MD 8:46 Mini-ALIF R. Guyer, MD 8:54 Discussion Complicated MIS: Surgical Tips 9:02 MIS TLIF for Grade 2 spondylolisthesis W. Taylor, MD 9:10 MIS anterior column release J. Uribe, MD 9:18 Discussion

4 FRIDAY, JUNE 16, 2017, CONTINUED Debate: Neuromonitoring Mod: J. Goldstein, MD 9:26 Intraoperative neuromonitoring is absolutely essential in lateral surgery W. Taylor, MD 9:34 Neuromonitoring laterally is overrated, costly and gives a false sense of protection J.J. Abitbol, MD 9:42 Discussion 9:50 Refreshment break Session 7: Adaptive Spine Intelligence and its Influence on Spinal Treatment Options Mod: A. Vaccaro, MD, PhD Supported by Medicrea 10:10 Is the past the future as it relates to product development and commercial delivery? R. Kienzle 10:18 Adaptive spine intelligence: Big data and machine learning in spinal care T. Mosnier, PhD 10:28 In my practice: case examples C.J. Kleck, MD 10:40 Discussion Technology Updates Mod: J. Zigler, MD 10:55 Minimally invasive midline lumbar fusion techniques with a novel system of implants J. Malloy, DO (Link Spine) 11:01 Improving fusion and alignment outcomes with a 3D expandable TLIF device M. Bawa, MD (Spine Innovation) 11:07 Sagittal alignment advances and pre-operative planning (Ortho Kinematics) C. Wade, PhD 11:13 MIS screw placement time and radiation exposure (Premia Spine) S. DeLuca, DO 11:19 Results from a 554-patient randomized lumbar discectomy clinical trial: 2yrs and beyond (Intrinsic) T. Allen, MD 11:25 Discussion 11:35 M6 Cervical Disc: Design rationale and clinical performance (Spinal Kinetics) R. Sasso, MD 11:41 Posterior cervical fusion cages (Providence Medical) W. Smith, MD 11:47 Defending the SA ALIF in the new reimbursement environment (Innovasis) R. Dryer, MD 11:53 The next generation of interbody devices: HA Infused PEEK. (Innovasis) T. Bassett, MD 11:59 Preliminary results of quantitative functional X-Ray analysis of stand-alone 3-D printed porous titanium cervical implants. (EIT) M. Arts, MD, PhD; J. Wolfs, MD; & 12:05 pm Discussion N. Lamerigts, MD, PhD Stem Cells in Spine Surgery Mod: T. Allen, MD 12:10 Stem cells: A basic science primer for the clinician H. Bae, MD 12:17 Role in treatment of DDD: Evidence or marketing? H. Smith, MD 12:24 Role in fusion: Evidence or marketing? H. Sandhu, MD 12:29 Discussion 12:35 Walking break to move to lunch and break-out sessions

5 FRIDAY JUNE 16, 2017, CONTINUED 12:45-1:45pm Breakout Session with Lunch: Navigating the changes in healthcare from pay for procedure to pay for performance Supported by: Titan Spine A. Bruggeman, MD; P. Slosar, MD; & J. Dunkel 1:45pm 2:15pm Tech Focus Session Supported by: Amendia Spine Adjourn SATURDAY, JUNE 17, :00 am Registration, coffee, & exhibits 7:30 Welcome F. Phillips, MD Session 8: Spine Practice in the Future Mod. F. Phillips, MD 7:35 Value model in the new healthcare paradigm: Obtaining value at a single specialty center C. MacLean, MD, PhD 7:53 The changing landscape of ASCs: Cash cow or troubled venture for surgeons? R. Guyer, MD 8:01 What ancillaries make sense? A. Vaccaro, MD, PhD 8:09 Are out of network contracting and policies coming to an end? T. Albert, MD 8:17 Discussion Session 9: Bio-materials Mod: JJ Abitbol, MD 8:27 Nanosurface technology: A primer for spine surgeons P. Slosar, MD 8:35 Metal coated PEEK: Does it work? K. Siemienow, MD 8:43 Novel porous PEEK: Getting bone to grow to PEEK (Vertera Spine) F. Phillips, MD 8:51 Synthetic bioactive bone grafts (Prosidyan) A. Bruggeman, MD 8:57 Discussion Technology Updates Mod: S. Hochshuler, MD 9:09 Spine stabilization after decompression. Does it have to be a fusion procedure? (Paradigm) R. Guyer, MD 9:15 Improving 3D printed implant performance with a novel bone-like structure D. Kondrashov, MD (Spineart) 9:21 Safe and Effective MIS Decompression and Fusion (Spinal Simplicity) L. Jacobs, MD 9:27 Discussion The Value of Spinal Deformity Surgery Mod: T. Albert, MD 9:34 Deformity surgery is too costly to be cost effective K. Radcliff, MD 9:40 Deformity surgery is cost efficient with demonstrated health benefits S. Berven, MD 9:46 Discussion 9:50 Refreshment break

6 SATURDAY, JUNE 17, CONTINUED Session 10: Research Highlights Mods: M. Colman, MD & S. Khan, MD 10:05 Variability in assessing spinopelvic parameters (SPP) with lumbosacral transition vertebrae (LTV): Inter- and intra-observer reliability among spine surgeons 10:09 Cervical mismatch: the normative value of T1S-CL and its ability to predict ideal CL 10:13 Visualization of the cervicothoracic junction with EOS imaging is superior to conventional lateral cervical radiographs 10:17 A comparative analysis between ALIF and TLIF for the indication of L5-S1 isthmic spondylolisthesis 10:21 Discussion A. Khalsa, MD B. Staub, MD B. Hirsch, MD K. Walsh, MD 10:25 How does routine microscope use affect short term surgical outcomes in single level lumbar discectomy: A review of 43,948 patients from the National Surgical Quality Improvement Program P. Morrissey, MD 10:29 Intraoperative pedicle screw navigation does not significantly decrease complications after spinal fusion S. Wagner, MD 10:33 High C2-T3 sagittal imbalance is an independent predictor of recurrent proximal junctional kyphosis O. Aguwa, MD 10:37 Principles of deformity correction J. Orina, MD 10:41 Discussion 10:45 Expandable cages, is the evidence there? P. Kim, MD 10:49 Spinal arthrodesis procedures S. Presciutti, MD 10:53 Use of FIBERGRAFT BG morsels mixed with BMA in anterior cervical discectomy and fusion at 1, 2, 3 and 4 levels: A retrospective analysis of fusion results H. Bedi, MD 10:57 Analysis of hospital length of stay following lumbar anterior/posterior combined fusion: Is there a disadvantage associated with shorter stays? R. Johnson, MD 11:01 Use of ALIF for adult spinal sagittal malalignment Y. Javidan, MD 11:05 What happens to patients who are lost to follow up in primary spinal deformity surgery? G. Arutyanyan, MD 11:09 Comparison of complications associated with cervical spine surgery for traumatic injury vs. degenerative disease in the U.S. V. Lo, MD 11:13 Discussion 11:17 Walking break 11:25 Breakout Session with Lunch: Innovation and efficiency for modern spine surgery Supported by: Spineart D. G. Kondrashov, MD, FAAOS

7 SATURDAY, JUNE 17, CONTINUED Young Surgeon Forum Part I: Industry Relationships Mod: H. Bae, MD 12:30 pm Surgeon perspective M. Bawa, MD 12:36 Industry perspective T. Recupero CCO, SI Bone 12:42 Best Practices The rules and risks of engagement E. Graubart VP Prof. Dev., Titan Spine 12:48 IP perspective C. Bagga CEO, Prosidyan 12:54 Discussion Part II: Clinical Challenges - Real Questions My First Year Out Mod: G. Mundis, MD Panel: Drs. K. Radcliff, J. Uribe, A. Kanter 1:15 Trauma- do I need to general ortho/neuro call? How about general? 1:30 Technology- should I avoid Infuse? LLIF? TDR? 1:45 How do I safely adopt new technology? 2:00 I know PI= LL +/-10, but what about: BALANCE= Work/Life Part III: Academic / Practice Challenges Mod: K. Radcliff, MD 2:10 ABOS pearls & pitfalls S. Khan, MD 2:20 Can I still be academic in private practice? How do I get/stay academically involved G. Mundis, MD 2:27 What is a mentor and how do I get one? B. Woods, MD 2:33 Finding a job: Salary, location, and safety H. Smith, MD 2:40 Finances 101 A. Araghi, MD 2:47 Discussion 3:00 Meeting adjourns

Spine: Base to Summit 2018 Beaver Creek, CO ǀ January 18-21, 2018 Program

Spine: Base to Summit 2018 Beaver Creek, CO ǀ January 18-21, 2018 Program THURSDAY, JANUARY 18 6:30 Registration, Breakfast and Exhibits Heritage Hall Foyer/Brown Dempsey Room 4:00 Welcome C. Shaffrey, MD SESSION 1: The Best Technique Is Grouse Mountain Room Mod: R. Haid, MD