Becker's Spine Review

20 SPINE SURGEONS Awake spinal fusion — 5 key findings By Laura Dyrda T he Journal of Neurosurgery published an article outlining "awake spinal fusion" using the endoscopic transfo- raminal lumbar interbody fusion technique without general anesthesia. e article authors reviewed the first 100 cas- es of single- or two-level awake spinal fusion performed by Michael Wang, MD, at the Uni- versity of Miami Hospital from July 2014 to August 2017. e study included 56 women and 44 men, with single-level procedures for 84 of the patients. Five things to know: 1. Patients undergoing awake endoscopic MIS TLIF typically receive light to moderate sedation and local analgesia so they remain conscious during the procedure. Patients can then provide feedback to the surgeon and an- esthesiologist during surgery. 2. Patients reported a 1.4 day hospital stay on average and surgical time lasted 84.5 minutes for one-level procedures and 128.1 minutes for a two-level procedure. 3. Blood loss during surgery was 65.4 mL for one-level procedures and 74.7 milliliters for two-level procedures among the awake endo- scopic MIS TLIF patients. 4. At the one-year follow-up, none of the pa- tients reported mechanical instability based on an X-ray and clinical examination. 5. e Oswestry Disability Index scores showed clinical improvement with strong statistical significance from the preoperative to the postoperative time period. However, the surgical plan was revised in four patients and four patients experienced postoperative complications that required revision. "As more and more people every year suf- fer from spinal disease both in America and around the world, spine surgeons have worked tirelessly to develop the safest, most effective, and least daunting therapies to offer our patients," said Dr. Wang. "We believe this study demonstrates that the awake TLIF pro- cedure is one such new technique to afford patients relief from disabling pain, without a debilitating surgery." n ISASS names Dr. Jack Zigler president for 2019-20 By Laura Dyrda T he International Society for the Advancement of Spine Surgery named Jack Zigler, MD, president for 2019-20. "My objective during my presi- dency is to re-energize ISASS and bring it back to its roots in provid- ing a forum for new technologies to be discussed and debated by international surgeons and scientists," said Dr. Zigler, co-di- rector of the Center for Disc Replacement at Plano-based Texas Back Institute. "I also want to strengthen the relation- ship with [the] industry so that we are both providing sup- port to the common goal of improving our patients' lives." The organization's forum has fostered discussion on min- imally invasive techniques, robotics and navigation, and biologic interventions. ISASS has more than 3,000 members in 78 countries. The organization publishes the International Journal of Spine Surgery and advocates for patients' rights. The organiza- tion also publishes position papers that provide guidance to payers on policy decisions related to new technologies, such as disc replacement. Dr. Zigler is a past president of the American Spinal Injury Association and has served on the ISASS board of direc- tors in the past. He was instrumental in bringing artificial disc replacement to the U.S. During his tenure as president, Dr. Zigler hopes to continue the organization's tradition of leadership and innovation. "I would like to position ISASS over the next five years so that it becomes the 'go-to' society for those working to improve the lives of patients with degenerative spine conditions by the best possible surgical treatment," he said. n

• Cover