Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 2nd International Conference on Spine and Spinal Disorders Rome, Italy.

Day 3 :

Keynote Forum

Majid Reza Farrokhi

Shiraz University of Medical Sciences, Iran

Keynote: A new algorithm for surgical management of cervical spondylotic myelopathy

Time : 10:00-10:40

OMICS International Spine 2017 International Conference Keynote Speaker Majid Reza Farrokhi photo
Biography:

Majid Reza Farrokhi is a Professor of Neurosurgery, Head of Shiraz Neuroscience Research Center, and Dean of Virtual School at Shiraz University of Medical Sciences. He completed his Specialty Degree in Neurosurgery in 1996 and Fellowship of Spine Surgery at Innsbruck University in 2004. He has been the Vice President of Iranian Board of Examiners in Neurosurgery since 2012. He was Chairman of Neurosurgery Department of Shiraz University of Medical Sciences from 2011-2014; Head of Fars and South of Iran AO-Spine Society from 2002-2005 and; Dean of Medical School, Bushehr University of Medical Sciences from 1996-1998. He has published more than 42 papers in reputed journals and two books.
 

Abstract:

Cervical spondylotic myelopathy (CSM) is the most common progressive degenerative disease of the spine in the geriatric population. This study aims to provide an evidence-based stepwise surgical approach, a new algorithm, to CSM according to the recent literature. We searched for evidence regarding the surgical approach to CSM in medical databases with articles dated from 1985 to 2016. In patients with effective cervical lordosis (fewer than three levels of ventral disease), anterior cervical discectomy and fusion (ACDF) or arthroplasty is preferred. Patients with more than three levels of compression are generally treated by laminoplasty, especially with preserved lordotic curvature. In patients with straightened spine who have less than three involved levels, ACDF with a plate is recommended, whereas patients with more than three involved levels with instability should undergo posterior decompression and fusion. In young patients who have a stable cervical spine, laminoplasty is recommended and in old patients with ankylosed spine, only laminectomy should be performed. Patients with mild cervical kyphosis (kyphotic angle≤10°) should be managed in the same way as patients with straightened spine. However, in severe kyphosis, cervical traction is recommended. If the kyphosis is reducible, further posterior decompression and fusion is adequate. In patients with irreducible kyphosis, if the number of involved levels is less than two, ACDF is adequate, but if it is more than two levels, anterior cervical corpectomy and fusion should be performed using cervical magnetic resonance imaging for evaluation of the patency of the subarachnoid space (SAS). With patent SAS, only posterior fusion is adequate, whereas in closed SAS, posterior decompression with posterior fusion is required. These approaches are based on the most recent evidence. This study provides a stepwise evidence-based surgical approach for the management and treatment of patients with CSM.
 

Keynote Forum

Gert Holstege

University of Groningen, Netherlands

Keynote: The problem of whiplash and possible treatments

Time : 10:40-11:20

OMICS International Spine 2017 International Conference Keynote Speaker Gert Holstege photo
Biography:

Gert Holstege is a Neuroscientist at University of Groningen in the Netherlands. He studied Medicines at Erasmus University Rotterdam from 1966 to 1971. He was Neuroscientist at Erasmus University Rotterdam from 1971 to 1987, after which he worked for four years for NASA in Mountain View, California. Since 1990, he has worked at University of Groningen, where he has been a Full Professor of Neuroanatomy since 1993 and Chairman of the Department of Anatomy and Embryology at Faculty of Medicine.
 

Abstract:

Whiplash Associated Disease (WAD) is a disease that many people suffering from. More than 75% of the cases are caused by car accidents, in which the car driver, waiting in line in traffic, because of a red traffic light or a traffic block, is hit by another car from behind. In most cases, this accident is completely unexpected for the driver of the front car, which means that the neck muscles of this driver were relaxed during the accident. During the collision the body of the driver in the front car is pushed forward with the head staying behind, resulting in a sudden and strong stretching of the relaxed anterior neck muscles. Subsequently, when the front car stops, the body of the driver is pushed backward leaving the head in an anterior position resulting in very strong stretching of the posterior neck muscles. This strong flexion-extension movement often causes large damage of the neck muscles and of the facet joints, capsules and ligaments of the upper cervical vertebrae. These neck muscles and upper cervical facet joints and ligaments send a large amount of information to the spinal cord regarding the position of the head in space. In the upper cervical spinal cord, this information is relayed to higher brain levels of which the mesencephalic periaqueductal gray (PAG) and adjoining areas are the most important. Other information regarding the position of the head originates from the vestibular nuclei and from the visual system. Based on this information the mesencephalon determines the position of the head and the eyes. In WAD-patients the damaged neck muscles and upper cervical vertebrae deliver inappropriate proprioceptive information to the PAG, resulting in a mismatch between this information and the incoming information from the undamaged vestibular and visual systems. This mismatch causes balance disturbances, dizziness, headache, and central hypersensitivity to pain, the common symptoms in WAD patients. How to correct this mismatch will be discussed.