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Cervical Spine; Surgery; Posterior Approaches; Review; Dr. Nancy Epstein; Four Part Lecture and Discussion 80 minutes total.

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SUMMARY: This is a Four Part, 70 minute,  Lecture and Interactive Discussion on Posterior approaches to Neurological Disorders involving the Cervical Spine. Part 1 (30 minutes) covers the Anatomy,  Clinical presentations, Imaging involved in these root and cord diseases. Compared with Anterior approaches there are no recurrent laryngeal palsies, dysphagia, Horner's syndromes, neural injuries affecting the diaphragm, esophageal and carotid injuries, and less chance of vertebral artery injuries and CSF leak. Pseudo-arthroses anteriorly occur  4%, 24%,and 43% for one , two and three level anterior approaches, respectively. Patient selection is Key. For posterior approaches the presence of Cervical Lordosis is important. Dr. Epstein discusses OPLL, Shingled Laminae, and adequate decompression,  cord migration. the use of the K-Line in choosing approaches posteriorly, also used in Anterior Approaches covered in previous lectures. Pros and cons of Laminoplasty are discussed. When is a Posterior Fusion necessary?  In Part 2 (16 min) she presents many case examples and surgical  tips to avoid complications. Fusion choices, lateral mass screw risks, Intra-Op imaging, CT, O-Arm and more.  Part 3  (3 minutes) has the References for the Lecture. Capture them with screen shots. Part 4 (25 min) Is an Interactive Discussion with Drs. Epstein and Ausman on each step in the surgery being done posteriorly with valuable tips to achieve a successful outcome in any environment. How to do a simple fusion posteriorly without costly instrumentation and imaging for fixation. This is a Practical Lecture and Discussion for Spine surgeons everywhere. For Residents, Young, and Experienced Spine surgeons. 'Do it right the First Time.'  'No mistakes'. 'Plan ahead.'   Excellent teaching, Excellent Interactive Discussion and Learning experience.  (JIA) 

Speaker
  • Nancy Epstein, MD

    Chief, Neurosurgical Spine and Education, Winthrop Univesrity Hospital Mineola , New York, USA