The Cervical Spine: Tumor, Trauma, Degenerative

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The Cervical Spine: Tumor, Trauma, Degenerative March 4, 2017 Hisham Jaroudi Auditorium American University of Organized by The Divisions of Neurosurgery and Orthopedics at the Department of Surgery at the Medical Center. The event is held in joint providership with the Cleveland Clinic and in collaboration with the Lebanese Orthopeadic Society, the North American Spine Society (NASS) and the Lebanese Society of Neurological Surgeons (LSNS).

Copyright 2017. All rights reserved.

General Information Program Overview Care of the patient with cervical spine pathology requires familiarity with ever evolving modern diagnostic and therapeutic strategies for patients suffering from spinal disorders that may not be reported clearly or concisely in the literature. Current research shows an increasing interest in cervical degeneration disease, trauma and tumor as well as techniques to manage and treat these conditions. However, many surgeons who evaluate and treat cervical spine disorders are not exposed to the latest modalities. The Beirut Annual Spine Symposium will allow course participants to address these topics through didactic lectures, panel discussions, case presentations, and Q&A sessions. Learning Objectives By the end of the symposium, participants will be able to: 1. Describe evidence-based parameters for management of tumors (primary and metastatic) of the cervical spine 2. Determine how to avoid the complications of cervical spine surgery 3. Efficiently manage patients with cervical spine trauma 4. Evaluate and treat spinal pain arising from cervical spine degeneration in a cost effective and reliable manner based on evidence-base medicine 5. Identify when to appropriately refer patients to complex spine specialists Target Audience This activity is designed for neurosurgeons, orthopaedics, radiologists and family medicine doctors, in addition to nurses, nurse practitioners, physiatrists, chiropractors and pain specialist therapist. Venue Hisham Jaroudi Auditorium,,

Accreditation Statement This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of The Cleveland Clinic Foundation Center for Continuing Education and the Medical Center. The Cleveland Clinic Foundation Center for Continuing Education is accredited by the ACCME to provide continuing medical education for physicians. The Cleveland Clinic Foundation Center for Continuing Education designates this live activity for a maximum of 7 AMA PRA Category 1 Credits. Physicians should claim only the 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 for Category 2 credit. Lebanese Order of Physicians Statement The 1 st Beirut Annual Spine Symposium also complies with the Lebanese Order of Physicians Continuing Medical Education guidelines. Evaluation Form and CME Certificate The evaluation and CME certificates are available online. In order to receive AMA PRA Category 1 Credits, please go to www.ccfcme.org/mycme to complete the course evaluation and to print your CME certificate. Once you enter the site, please enter 02010824. The above code is active for 30 days following the symposium. User Instructions: If you are a first-time user of MyCME, you will need to create a six-digit password comprised of any combination of letters and/or numbers. This will become your permanent log in for future Cleveland Clinic MyCME programs. 1. Log in to www.ccfcme.org/mycme 2. Click on New Member Account? located under the login box 3. Complete all the fields in the form and click on Save 4. Click on Login 5. Login using your e-mail address and password 6. In the Event Code box, enter the code 02010824 and click Submit 7. Complete all the fields in the evaluation and click next step 8. Enter the number of CME you are claiming and click Save and View Certificate. Your official CME certificate will appear. Please print and keep with your permanent files. Please note: Be sure to print your CME certificate and keep for your files. This is your permanent record; no other certificate will be generated.

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 they may have a relationship, which, in the context of their presentation(s), could be perceived as a potential conflict of interest: Patrick Hsieh Consulting Medtronic, DePuy Spine The following faculty have indicated they have no relationship which, in the context of their presentation(s), could be perceived as a potential conflict of interest: Abdel Majid Sheikh Taha Christine El Yahchouchi George Abi Saad Ghassan Skaf Ghassan Kanazi Hani Mhaidli Ibrahim Omeis John Abdel Nour John Finkenberg Joseph Maarawi Joseph Salame Marwan Rizk Mohammad Badra Nabil Khoury Nabil Okais Nadim Afeiche Toufic Eid Rachid Haidar Disclaimer The information in this educational activity is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient s medical condition. The viewpoints expressed in this CME activity are those of the authors/faculty. They do not represent an endorsement by The Cleveland Clinic Foundation. In no event will The Cleveland Clinic Foundation be liable for any decision made or action taken in reliance upon the information provided through this CME activity. Copyright 2017 The Cleveland Clinic Foundation. All Rights Reserved.

Activity Directors Ibrahim Omeis, MD, F.A.A.N.S Neurosurgery & Spinal Surgery George Abi Saad, M.D., F.A.S.N. Director, Continuing Medical Education Office Ghassan Skaf, MD Neurosurgery & Spinal Surgery Rachid Haidar, MD Orthopedic & Spinal Surgery Organizing Committee Abdel Majid Sheikh Taha, MD Hani Mhaidli, MD, PhD John Abdel Nour, MD

Faculty Listing Abdel Majid Sheikh Taha, MD Instructor Orthopedic & Spinal Surgery Christine El Yahchouchi, MD Instructor Anesthesiology Ghassan Kanazi, MD Anesthesiology Ghassan Skaf, MD Neurosurgery & Spinal Surgery Hani Mhaidli, MD, PhD Past President of the Spanish Spine Society Board member of SRS (scoliosis research society) President-elect of SILACO (Sociedad Ibero-latinoamericana de Columna vertebral) Chiar of SRS NGO site mission in morocco Head of Spine Service University Hospital Las Palmas de Gran Canaria Las Palmas, Spain Ibrahim Omeis, MD Visiting Assistant Neurosurgery & Spinal Surgery

6 John Abdel Nour, MD Clinical Associate (Orthopedic) Department of Surgery John Finkenberg, MD Orthopedic Surgery Alvarado Hospital Medical Center San Diego, California, USA Joseph Maarawi, MD, PhD Neurosurgery & Spinal Surgery Saint Joseph University Joseph Salame, MD Instructor Neurosurgery & Spinal Surgery Marwan Rizk, MD Assistant Anesthesiology Mohammad Badra, MD Orthopedic & Spinal Surgery Clemenceau Medical Center

7 Nabil Khoury, MD Diagnostic Radiology Nabil Okais, MD Neurosurgery Saint Joseph University Nadim Afeiche, MD Clinical Instructor Neurosurgery and Spinal Surgery Patrick Hsieh, MD Associate Neurological Surgery University of Southern California Los Angeles, California, USA Rachid Haidar, MD Orthopedic & Spinal Surgery Toufic Eid, MD Assistant Radiation Oncology

Program Day 1: Saturday, March 04, 2017 08:00-08:45 REGISTRATION/COFFEE 08:45-09:00 Welcome Note Drs. Ghassan Skaf, Ibrahim Omeis and Rachid Haidar Session 1: Tumor I Moderators: Dr. Ibrahim Omeis and Dr. Rachid Haidar 09:00-09:10 Imaging Value in Spine Tumors Dr. Nabil Khoury 09:10-09:20 Evidence Base Medicine in Management of Spine Metastasis Dr. Abdel Majid Sheikh Taha 09:20-09:30 Prognostic Factors, Surgical Outcomes, and Guidelines for Managing Metastatic Spine Cancer Dr. Rachid Haidar 09:30-09:40 Decision Making in Metastatic Tumors Dr. Ibrahim Omeis 09:40-09:50 Update on Ablative Stereotactic Radiotherapy for Spinal Metastasis Dr. Toufic Eid 09:50-10:00 Q&A Session 2: Tumor II Moderators: Dr. Ibrahim Omeis and Dr. Rachid Haidar 10:00-10:10 General Overview of the Surgical Options in Primary Spine Tumors Dr. John Abdel Nour 10:10-10:20 Primary Cervical Spine Tumors Is EN BLOC Resection Worth it? Dr. Patrick Hsieh

10:20-10:30 Extramedullary Tumors: Surgical Nuances Dr. Ibrahim Omeis 10:30-10:40 Intramedullary Tumors Surgical Nuances and Avoidance of Complications Dr. Joseph Maarrawi 10:40-10:50 Spinal AV-fistulas Evaluation and Management Dr. Joseph Salame 10:50-11:00 Avoidance of Complications in Cervical Spine Tumor Surgery Dr. Hani Mhaidli 11:00-11:10 Q&A 11:10-11:30 COFFEE BREAK Session 3: Trauma I Moderators: Dr. Ghassan Skaf and Dr. John Abdel Noor 11:30-11:40 Update in Spine Trauma: Screening the Patient with Neck Pain Dr. John Finkenberg 11:40-11:50 Upper Cervical Spine Trauma: Classifications and Types Dr. Mohammad Badra 11:50-12:00 Craniocervical Stabilization: When and How Dr. John Abdel Nour 12:00-12:10 Management of Type 2 Dens Fracture: Odontoid vs C1-2 Fusion Dr. Ghassan Skaf 12:10-12:20 Q & A

Session 4: Trauma II Moderators: Dr. Ghassan Skaf and Dr. John Abdel Noor 12:20-12:30 The Evolution of C1-C2 Fusions: Current Best Practice Techniques Dr. Patrick Hsieh 12:30-12:40 Treatment Approach to Subaxial Spine Trauma: Classification and Decision Making Dr. Nadim Afeiche 12:40-12:50 Operative Treatment of Fracture-Dislocation of Subaxial Cervical Spine Dr. Hani Mhaidli 12:50-13:00 Management of Cervico-Thoracic Junction Injuries Dr. Ibrahim Omeis 13:00-13:10 Central Cord Syndrome: Guidelines to Management Dr. Abdel Majid Sheikh Taha 13:10-13:20 Q & A 13:20-14:20 LUNCH Session 5: Degenrative I Moderators: Dr. Abdel Majid Sheikh Taha and Dr. Nadim Afeiche 14:20-14:30 Cervical Degenerative Disease: Clinical Burden, Non-operative Management Dr. Marwan Rizk 14:30-14:40 Referred Pain from Facet Joint Disease: Evaluation and Management Dr. Christine El Yahchouchi 14:40-14:50 Cervicogenic Pain, Etiology, Diagnosis and Treatment Dr. Ghassan Kanazi

14:50-15:00 Cervical Radiculopathy: Indication for Surgical Treatment Dr. John Finkenberg 15:00-15:10 Cervical Myelopathy: Treatment and Challenges Dr. Ghassan Skaf 15:10-15:20 Cervical Ossification of Posterior Longitudinal Ligament: Approach to Management Dr. Rachid Haidar 15:20-15:30 Q & A 15:30-15:50 COFFEE BREAK Session 6: Degenrative II Moderators: Dr. Hani Mhaidli and Dr. Abdel Majid Sheikh Taha 15:50-16:00 Posterior Cervical Approach. How to Decide: Laminoplasty, Laminectomy, Laminectomy with Fusion? Dr. Patrick Hsieh 16:00-16:10 When to Supplement Anterior Surgery with Posterior Fusion: 360 Fusion Dr. Hani Mhaidli 16:10-16:20 Management of Cervical Adjacent Segment Disease Dr. John Finkenberg 16:20-16:30 Update: Cervical Disc Arthroplasty Dr. Ibrahim Omeis 16:30-16:40 Complications of the Anterior Cervical Approach Dr. Abdel Majid Sheikh Taha 16:40-16:50 Conservative Posterior Cervical Approach in DDD Dr. Nabil Okais 16:50-17:00 Q & A 17:00-17:20 Case Presentations 17:20 ADJOURN

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Organized by: Continuing Medical Education (CME) Office Medical Center P.O. Box 11-236 vriad El Solh Beirut 1107 2020 Lebanon Tel: +961-1-350 000 ext. 4717-4752 Fax: +961-1-744 467 Email: cme@aub.edu.lb Web: http://cme.aub.edu.lb