Day 2 :
Orthopedic department of Healthpoint Hospital in Abu Dhabi, UAE
Keynote: DEGENERATIVE DISC DISEASE: up-front considerations regarding treatment with mesenchymal adipose tissue derived stem cells
Time : 10:00-10:40
Walter Bini completed his diploma from Westminster School, Simsbury Connecticut, USA and his postgraduate degree from Universidad de Zaragoza , Facultad de Medicina, Zaragoza, Spain. In 2014 he became the Middle East Chairman of ISLASS. He was Head of Neurosurgery, Sheikh Khalifa General Hospital, UAQ-UAE from 2014-2016. Currently he is the lead neurosurgeon responsible for spinal surgery in the Waldkrankenhaus for Special Surgeries by Leipzig in Germany and also visiting consultant neurosurgeon, of the orthopaedic department of Healthpoint Hospital in Abu Dhabi, UAE.
Lumbar degenerative disc disease ( DDD ) poses an ongoing challenge as far as treatment options and alternatives, especially when considering younger patients. Over 80% of the adult population presents with one or more episodes of ongoing-progressive low-back pain ( LBP ). The primary cause is associated with degeneration of the intervertebral disc and which is triggered by a decrease of the nucleus pulposus cell population, as evidenced in histological studies. In the presence of a "black disc" without profusion and neurological compromise, microsurgery or even fusion surgery should not be contemplated. Numerous percutaneous techniques have been propagated as proper way to treat this condition throughout the literature in the past years. They have been primarily focused on the treatment of the pain generated by the involved disc and the subsequent segmental insufficiency, without addressing the degeneration of the disc and for this have had limited success and remain as pain management tools. Some significant trials in the past ( i.e. Chondrocyte transplantation trial ) and the increasing recent research and achievements with more biological strategies as far as tissue regeneration , have motivated the development of a new treatment concept initially applicable to the lumbar spine which will be presented and discussed.
Advancements have led to a significant improvement in the understanding of the cell environment and tissue transplantation at a molecular, cellular and immunobiological level. Adipose tissue has already become a central source of clinical and research work involving adipose tissue derived progenitor cells. Endothelial and mesenchymal stem cells derived from adipose tissue are being considered and used in an array of clinical conditions and seem to have clear therapeutic benefits for many disease conditions including those affecting bone, cartilage and muscle . The use of an accessible source with abundant cells which have a high potential for regeneration clearly is superior in comparison to the chondrocyte option for the lumbar disc. Mesenchymal cells have a high self renewal capacity and a potential for multi lineage differentiation. For this , adipose tissue derived MSCs ( ADMSCs) are optimal candidates for tissue regeneration and can be obtained from the patient in a one step procedure-treatment.
American Board (Nevada) & Professor of Orthopaedic Surgery, Basrah-Iraq
Keynote: Spine Patient Satisfaction
Time : 10:40-11:20
School. Chancellor of University of Basrah-Iraq. He is International Surgical Advisor, The Royal College of Surgeons (Edinburgh).
He is Iraqi Scientist Grade A. One of the outstanding people of the 20th century, Cambridge, U.K. Man of the year 2003, U.S.A. Gerhard Kuncher award winner, 2000. Distinguished Professor of the Iraqi Universities, 2003, the Ministry of Higher Education and Scientific Research. International Award winner, AAOS, USA, 2005
In Cambridge English dictionary, satisfaction is a pleasant feeling that you get when you receive something you wanted or when you have done something you wanted to do or a situation in which your complaint or problem is dealt with in a way you considered acceptable.
Many writers start differentiating between treatment offered and satisfaction achieved as the Patient satisfaction is the top priority, Perfect treatment not always leads to satisfaction because at some stations, satisfaction may be broken.
Several parameters have impact on patient satisfaction, even if the goals of surgical procedure were met perfectly, some patients will be dissatisfied therefore what patients expect from spine surgery is important and should be assessed carefully as it relates to patient satisfaction.
Some points that may help in patient satisfaction or dissatisfaction includes; Handling of previous colleagues, Previous experience with hospitals, The
background feeling of health service, His pain response, The length of the waiting list, The nature of the pathology and Previous response to treatment
The surgeon experience and capability and theatre facilities plays the most important rule in achieving patient satisfaction and choosing the right patient for spinal surgery.