Day 1 :
Sapienza University of Rome, Italy
Pier Paolo Mura is an Orthopedic Specialist in scoliosis and an expert in spinal surgery. He also serves as a Professor at La Sapienza University of Rome, Polo\r\nPontino and Chair in Orthopedics contract. He is specialized in Orthopedics and Traumatology and diagnostic radiology. He is the Director of the Department\r\nof Orthopedics and Founder and Director of the Unit Complex Spine Surgery Center and Scoliosis Surgery Section. He is the Head of Unit of Orthopedics and\r\nRegional Delegate of the Italian Society of Spine Surgery GIS (Italian Scoliosis Group) as well as an active member of SRS (Scoliosis Research Society). He is\r\nalso Scientific Director of the research project on biomaterials in spine surgery at the Science and Technology Park in Pula.
Comparison of the results obtained using rods in titanium and cobalt chromium in surgery of scoliosis in adolescents.\r\nObjectives: The main objectives in the surgical treatment of idiopathic scoliosis are to correct the deformity on the coronal\r\nand sagittal planes and provide a stable fusion. The use of biomaterials is fundamental in order to achieve these objectives. The\r\nparameters which characterize biomaterials are: the charge of the enervation – the value of the tension at which the material\r\nbegins to plastically deform; the rigidity – the capacity of a body to oppose itself to plastic deformation; and the flexion - the\r\ncapacity of a body to oppose itself to the force of the flexion to which it is subjected.\r\nMethods: Biomechanical tests show that the properties of cobalt chromium are superior when compared to titanium. In\r\nparticular cobalt chromium is characterized by a higher charge of enervation, rigidity and flexion when compared to titanium.\r\nConclusion: Our experience highlights that, when compared to titanium, cobalt chromium is more capable of maintaining\r\nthe equilibrium of the sagittal plane both in operating fields and radiographic checks. Excellent results can be obtained with a\r\nbetter correction of the deformity and a stable fusion.
Anna Meyer Children’s Hospital, Italy
Keynote: Spinal Tumors in children
Barbara Spacca graduated in Medicine and Surgery at the University of Perugia and specialized in Neurosurgery at the University of Florence. She has worked in\r\nresearch and clinical neurosurgery at the Alder Hey Children’s Hospital in Liverpool (UK), the Hospital of Pediatrics “JP Garrahan” Buenos Aires (Argentina) and\r\nthe Great Ormond Street Hospital, London (UK) and at the Walton Centre for Neurology and Neurosurgery, Liverpool (UK). Since 2010, it is part of the structure\r\nof Neurosurgery AOU Meyer.
Spinal tumors in children are rare and heterogeneous and their treatment is very demanding. It is necessary to both manage\r\nthe disease and preserve the spinal stability so that the spine can grow normally. As a consequence, results in terms of both\r\nmortality and morbidity are often suboptimal. We analyzed our experience over a time of 17 years with a series of134 patients\r\nadmitted in a single unit of Pediatric Neurosurgery accounting for 7.7% of all the patients admitted for central nervous system\r\nmalignancies. The mean age was 8.5 years (14 days–26 years), and the mean follow-up was 28 months (3 months–13 years).\r\nThey were 75 males and 59 females. Data were reviewed retrospectively and patients were divided into four groups according\r\nto the location of the tumor and their relationship with the surrounding tissues: intramedullary (46 patients), intradural\r\nextramedullary (25 patients), extradural (53 patients), and paravertebral tumors (10 patients). Low-grade glioma was the most\r\ncommon histology (14.1%). One hundred seventeen patients were surgically treated, with a total of 138 surgical procedures.\r\nA posterior approach was chosen in 111 cases, with osteoplastic laminotomy in 80. Radiotherapy was administered to 22\r\npatients and chemotherapy to 26. At the last follow-up, 16 patients (11.9%) had died. A good control of the tumor with clinical\r\nimprovement was reported in 100 patients (74.6%). Five
Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center , USA
Lilyana Angelov is a Neurosurgeon who was trained at the University of Toronto, Canada. She completed a neurosurgery trauma fellowship in Toronto in 2001-2002,\r\nfollowed by a neurooncology\r\nand gamma knife fellowship at the Cleveland Clinic in 20022003\r\nand she is double board certified in Neurosurgery in both Canada\r\nand the United States. She joined the staff in Neurosurgery and the Gamma Knife Center at the Cleveland Clinic in Cleveland, Ohio in 2003. She has made brain\r\nand spinal neuro-oncological surgery her career focus. In 2006, she became Head of the Section of Spine Radiosurgery and Head of the Section of Spine Tumors\r\nin 2007. She developed the spine radiosurgery program at the Cleveland Clinic, the first program of its kind in Ohio and indeed one of the earliest such programs\r\nin all of the US and is recognized both nationally and internationally in this field.
Introduction: Spinal metastases are an increasing problem among cancer patients often resulting in disabling pain with or\r\nwithout neurological compromise. Minimally invasive strategies to rapidly and effectively control pain while maintaining\r\npatients’ functional status and overall quality of life is essential in these patients. We present our institutional experience in\r\nthe treatment of spine tumors with stereotactic radiosurgery, and for the first time, report on interval to pain resolution in this\r\npopulation of patients.\r\nObjectives: 1. Define the role of stereotactic radiosurgery in the treatment of spine tumors, 2. Discuss the role of pain and\r\nquality of life (QOL) instruments in cancer pain, 3. Present the impact of spine radiosurgery on pain and QOL in terms of the\r\nnature and temporal pattern of response in the treatment of patients with spine tumors.\r\nMethods: Forty eight patients presenting with 59 spine tumors associated with pain, epidural cord and/or nerve root\r\ncompression have been treated using the Novalis ® single fraction radiosurgery at the Cleveland Clinic. Patients were evaluated\r\npre-treatment using the Brief Pain Inventory (BPI) questionnaire to determine baseline pain scores. Post-treatment, BPIs were\r\nprospectively followed weekly for 1 month and every 3 months thereafter. Quality of life (QOL) was evaluated pre-treatment\r\nand at 1 month post-treatment and every 3 months thereafter using the EORTC QLQ-C30 questionnaire.\r\nResults: Fifty nine lesions (C1 to sacrum) were treated. Median patient follow-up was 6.4 months (range 0.7-12.2 months). 64%\r\n(38/59) of the target areas involved a single vertebrae level, 22% involved two vertebrae, and 14% involved ≥3 vertebrae. Mean\r\ntarget volume was 65.37 (range 2.50-197.12 cm3) treated with a mean dose of 14 Gy. BPI scores were statistically improved\r\nover baseline in 25/38 (66%) patients (p<0.0001) as early as week 1 post treatment. At 1 month, 28/35 (80%) patients had pain\r\nimprovement (p<0.0001) sustained in subsequent follow-up. QOL functional scores were also significantly improved for pain\r\n(p<0.02), insomnia (p<0.01) and constipation (p<0.02) at 1 month post treatment relative to baseline.\r\nConclusion: We demonstrate that spine radiosurgery is a non-invasive treatment that can result in rapid and durable pain\r\ncontrol in patients with spine tumors. This treatment can also significantly and positively impact on certain aspects of a cancer\r\npatients’ QOL. Thus, spine radiosurgery represents an important option for patients with spine metastases.