In this issue of Neurosurgery News, specialists discuss minimally
invasive sacroiliac joint fusion, role of ssep monitoring, risk factors that increase the risk of
neurological deficits following thoracolumbar spinal fusion surgery, improving
the health and wellness of the neurosurgeon, and innovations in the field.
Upon completion of this activity, participants should be
- Increase resident and faculty quality of life by
implementing burnout prevention.
- Improve their self-awareness to improve a more balanced
lifestyle approach to work,family, physicality and spiritual growth.
- Improve diagnostic skills for identifying sacroiliac joint
dysfunction, so that this disease process is part of the differential diagnosis
of low back pain.
- Improve their management of patients undergoing a sacroiliac
joint fusion, which will improve patient outcomes.
- Reduce incidence of position related neuropraxia with the
correct utilization of intraoperative SSEP monitoring.
- Implement safeguards for protecting position related
neuropraxia in spine surgery.
- Closely follow recommended processes for intraoperative
patient positioning and procedures for SSEP monitoring, with interpretation of
results of the SSEP monitoring and make appropriate corrections in patient
positioning to prevent postoperative deficits.
- Improve the growth of thoracolumbar fusion surgeries and the
- Recognize the complication rate associated with these
- Recognize the risk factors for perioperative neurological
deficits associated with these surgeries
- Andrew J. Jager, MA; Michael A. Tutty, PhD; and Audiey C.
Kao, MD, PhD, Association Between Physician Burnout and Identification With
Medicine as a Calling, Mayo Clin Proc. 2016;nn(n):1-8
- Shanafelt TD, Mungo M, Schmitgen J, et al. Longitudinal
study evaluating the association between physician burnout and changes in
professional work effort. Mayo Clin Proc. 2016; 91(4):422-431.
- Shanafelt TD, Hasan 0, Dyrbye LN, et al. Changes in burnout
and satisfaction with work-life balance in physicians and the general US working
population between 2011 and 2014 [published correction appears in Mayo Clin
Proc. 2016;91(2):276]. Mayo Clin Proc. 2015;90(12): 1600-1613.
- Nuwer MR, Dawson EG, Carlson LG, Kanim LE, Sherman JE.
Somatosensory evoked potential spinal cord monitoring reduces neurologic
deficits after scoliosis surgery: results of a large multicenter survey.
Electroencephalogr Clin Neurophysiol. Jan 1995;96(1):6-11.
- Kelleher MO, Tan G, Sarjeant R, Fehlings MG. Predictive
value of intraoperative neurophysiological monitoring during cervical spine
surgery: a prospective analysis of 1055 consecutive patients. J Neurosurg
Spine. Mar 2008;8(3):215-221.
- Polly, D.
W., Cher, D. J., Wine, K. D., Whang, P. G., Frank, C. J., Harvey, C. F., . . .
Sembrano, J. N. (2015). Randomized Controlled Trial of Minimally Invasive
Sacroiliac Joint Fusion Using Triangular Titanium Implants vs Nonsurgical
Management for Sacroiliac Joint Dysfunction. Neurosurgery, 77(5), 674-691.
- Rudolf, L.
(2012). Sacroiliac Joint Arthrodesis-MIS Technique with Titanium Implants:
Report of the First 50 Patients and Outcomes. The Open Orthopaedics Journal
TOORTHJ, 6(1), 495-502. doi:10.2174/1874325001206010495
- Zaidi, H. A., Montoure, A. J., & Dickman, C.
A. (2015). Surgical and clinical efficacy of sacroiliac joint fusion: A
systematic review of the literature. Journal of Neurosurgery: Spine, 23(1),
- Rajaee SS, Bae HW, Kanim LE, Delamarter RB. Spinal
fusion in the United States: analysis of trends from 1998 to 2008. Spine (Phila
Pa 1976) 2012;37:67-76.
RA, Gray DT, Kreuter W, Mirza S, Martin BI. United States trends in lumbar
fusion surgery for degenerative conditions. Spine (Phila Pa 1976)
2005;30:1441-1445; discussion 1446-1447.
- Goz V,
Weinreb JH, McCarthy I, Schwab F, Lafage V, Errico TJ. Perioperative
complications and mortality after spinal fusions: analysis of trends and risk
factors. Spine (Phila Pa 1976) 2013;38:1970-1976.
- Cramer DE, Maher PC, Pettigrew DB,
Kuntz Ct. Major neurologic deficit immediately after adult spinal surgery:
incidence and etiology over 10 years at a single training institution. J Spinal
Disord Tech 2009;22:565-570.
Drs. Paschel, Gandhoke, Nwachuku, Maroon, and Friedlander have
reported no relevant relationships with any entities producing health care
goods or services.
Peter Gerszten, MD, is a consultant for Zimmer Biomet. L.
Dade Lunsford, MD, is a consultant for DSMB and Insightec. He is also a
stockholder in Elekta AB.
All presenters disclosure of relevant financial
relationships with any entity producing, marketing, re-selling, or
distributing health care goods or services, used on, or consumed by, patients
is listed above. No other planners, members of the planning committee,
speakers, presenters, authors, content reviewers and/or anyone else in a
position to control the content of this education activity have relevant
financial relationships to disclose.
The University of Pittsburgh School of Medicine is
accredited by the Accreditation Council for Continuing Medical Education
(ACCME) to provide continuing medical education for physicians.
The University of Pittsburgh School of Medicine designates
this enduring material for a maximum of .5 AMA PRA Category 1
Credits™. Each physician should only claim credit commensurate with
the extent of their participation in the activity. Other health care
professionals are awarded (0.05) continuing education units (CEU) which are
equivalent to .5 contact hour.
For your credit transcript, please access our website 4
weeks post-completion at http://ccehs.upmc.edu and follow the link to the
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the next page you will not be able to access a CME credit transcript. Providing
your SSN is voluntary.
Release Date: 5/31/2017 | Last Modified On:
5/31/2017 | Expires: 5/31/2018