Dear Friends,

The NASS meeting is the largest spine congress there is. I'm proud to be attending my 3rd NASS meeting and my 12th medical congress. I wasn't planning on coming, but after last week's trip to see Doctors Bitan and Buettner-Janz in NY, I realized that this contact I have with the surgeons and the industry is what makes it possible for me to help spine patients more effectively. After some hasty planning, I'm here in Seattle... I hope the hotel is not on skid row! I'll be blogging the congress as best I can. These meeting are very busy, fast moving, and non-stop. We'll see how this goes. If there is a particular technology that you are interested in, please send me a private message or post your question on the iSpine discussion forum.

PS. I apologize in advance for the funky format. I realize why I have not done this in the past. It's the end of day 2 and I'm arriving back to the hotel around 11 pm. Each day goes from 7am till 11pm, absolutely non-stop. I'm going to start the blog with tonight's event and fill in the blanks as I can. Below, I'll put a brief log of entries as I add them.


post 1: 9/28 23:45 Dynesys Dinner at the Experience Music Project

Technology Disclaimer
The devices, procedures, etc... discussed on this site are in various stages of development. While some have been proven safe and efficacious, are FDA approved and widely available; others may be in a wide range of developmental stages. Some are proven and are just waiting for FDA approval of the manufacturing process, which is expected very soon. Some are exciting ideas that may prove to be very bad ideas; possibly even harmful disasters. Some represent brilliant ideas that may ultimately become life-saving products while others will never make it to the marketplace. Even for the great products, development / testing / approval process may take years or even decades. There is no guarantee that any information presented here is correct. Items discussed here may never be available to the patient community. Medical decisions should not be made based on information found here.
iSpine Lending Library !!!
NASS 2005 and 2006 Proceedings: Symposia Handouts,
Abstracts of Podium Presentations and Poster Presentations
click here for the lending library
Day 1 - Wednesday September 27, 2006
Day 2 - Thursday September 28, 2006

Post 1:   Dynesys Dinner at the Experience Music Project

What a cool venue... a music museum at the Seattle Center... just a few yards away from the Space Needle. . This was a very interesting and productive evening. We were treated to an overview of dynesys experience and a panel discussion with some VERY heavy hitters. The meeting was chaired by Dr. Rick Delamarter. Dynesys experience is quite large now, with over 25,000 implantations worldwide. The first implantation was in 1994, by the inventor, Dr. Gilles Dubios, in France. It was released for use in Europe in 1999. It was released for use AS A FUSION DEVICE in the US in 2005. For non-fusion applications in the US, it is still in clinical trial with the study population complete and in the follow-up phase. A hydroxyapitite coated screws are now available to improve fixation and reduce the incidence of screw loosening. The format of the meeting was excellent, with ample time for open discussion and Q&A in between presentations. The panel members also presented real world cases as an exercise in patient selection for the attending surgeons. There was much interesting discussion about the appropriateness of various solutions, and much interesting discussion about various surgical techniques. One interesting exchange had Dr. Reginal Davis, chief of spine surgery at Johns Hopkins discussion adjacent level degeneration for multi-level lumbar fusions. He put the number at 25% revisions within 5 years for fusions with rigid fixation.

I was able to ask about the revisability of Dynesys. In the ADR world, we used to hear, "no problem, if it doesn't work, we can always pop it out and do a fusion." We now understand that this cavalier attitude was inappropriate and that if you need revision after ADR surgery, you have a serious problem. Apparently, revisions of Dynesys are somewhat rare, but the small handful that was done among the panel members were very easy surgeries with good results. Without the anterior approach issues, it's somewhat straightforward. Minimally invasive approach, remove old screws, insert bigger screws and fusion hardware. Not quite a freebie... but nothing like repeat anterior spine surgery.

Day 3 - Friday September 29, 2006
Day 4 - Saturday September 30, 2006