A publication of

New design. New opportunities.

The only ClInICAl newspAper dedicated to spine surgery

Meeting News Coverage

CSRS Cervical Spine Research Society Annual MeetingDec. 4-6

All meeting coverage starts on page 14

EXCLUSIVES

Kern Singh, MD, said poor indications for an initial spine surgery is oftentimes associated with an outcome deemed as failed back surgery syndrome.

COVER STORY

Experts discuss poor alignment as cause of failed back surgery syndrome, which treatments workDefined as persistent back or leg pain following back surgery, failed back surgery syndrome is a broadly defined disorder that negatively affects thousands of patients each year and a problem that spine surgeons seem to address more regularly than ever before.

There is no equivalent term for a condition like failed back surgery syndrome (FBSS) in other medical specialties, Kern Singh, MD, of Midwest Orthopaedics at Rush, in Chicago, told Spine Surgery Today, and therefore the syndrome lends itself to many mischaracterizations about what FBSS is and what it is not, he said.

“The problem with using this broad classification is often the surgery is blamed, but we do not know what the indica-tions for surgery were or the fact that surgery was address-ing a particular pathology. Sometimes people undergo back surgery but actually have hip problems, sacroiliac joint prob-lems or something not related to their back,” Singh, a Spine Surgery Today Editorial Board member, said. “They have persistence of pain and blame the spine surgery itself.”

Singh said he does not use the term FBSS unless there is definable evidence that surgery was indicated and it was for the diagnosis for which the patient was operated on.

“You have to make sure the surgery is done accurately. Of-ten I see people diagnosed with FBSS who still have residual stenosis, a nonunion present, or screws or instrumentation that was incorrectly placed. So they have a reason for the

Cover story continues on page 10

SAN FRANCISCO — Data presented at the North American Spine Society Annual Meeting, here, showed the safety and eff ectiveness of cer-vical total disc replacement was maintained at 5-year follow-up regardless of whether the pros-thesis was implanted at one or two spinal levels.

Hyun W. Bae, MD, presented the results for patients in the two treatment arms — one-level cervical total disc replacement (CTDR)

with the Mobi-C prosthesis (LDR Medical; Troyes, France) vs. one-level anterior cervi-cal discectomy and fusion (ACDF) and two-level CTDR with LDR implants vs. two-level ACDF. He noted only the two-level fusion results at 5 postoperative years were not com-parable to results with the other procedures.

“Two-level fusion does seem to be a diff er-ent operation in terms of function,” Bae said,

and noted the fi ndings showed that function tended to drop off in patients who underwent two-level ACDF as the follow-up approached 5 years.

On the whole, the study showed the four procedures were good and were associated with a 90% patient satisfaction rate, according to Bae.

“I think we all believe in ACDF and it cer-tainly is a good operation, but the study really looks at what happens when you start getting into multi-level fusions and what they can cost,” he said.

Researchers fi nd similar effi cacy after 5 years for one- and two-level ACDF, CTDR

A SLACK Incorporated® publication

For more on this story, see page 6

Volume 2 • Number 1

JANUARY/FEBRUARY 2015

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Healio.com/Spine

Web WatchHelmet brand did not aff ect concussion rates There was no diff erence in concussion incidence among high school football players who had 134,437 exposures when they wore Riddell, Schutt or Xenith brand helmets. 13

NASS North American Spine Society Annual MeetingNov. 12-15

PSRS Philadelphia Spine Research SymposiumOct. 28

DEGENERATIVE DISEASES

Cost analysis done for two laminectomy treatmentsInvestigators found lumbar laminectomy with fusion for grade 1 spondylolisthesis was more cost eff ective than laminectomy alone in a study with 5 years follow-up. 9

PRACTICE MANAGEMENT

Specialty spine organizations revise lumbar disc disease defi nitionsThe new defi nitions are expected to help spine and radiology specialists avoid repeat procedures. 26

Failure of diagnosis among reasons for failed back surgery syndromeJohn C. Liu, MD, Chief Medical Editor, Neurosurgery of SPINE SURGERY TODAY discusses some of the leading causes of failed back surgery syndrome, which include failure to address proper spinal balance, failure of surgeon judgment and the continued use of new, unproven spine surgery techniques and technology. 3

SST0115pgs1,10-13.indd 1 1/9/2015 9:51:51 AM

A publication of

2016 I N t e g r at e DMedia Kit

ver.02

TM

New design.New opportunities.

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Reach Neurosurgeons and Orthopedic Spine Surgeons in a single publicationSpine Surgery Today is the only clinical BpA-audited newspaper for health care professionals who treat or conduct research related to the spine. published six times per year, Spine Surgery Today provides timely, balanced reports on clinical issues, socioeconomic topics and spine industry developments. It also delivers clinically relevant information on surgical techniques, products, therapies, procedures and technologies used in spine surgery.

Spine Surgery Today extends your marketing message to more than 8,000 U.s. physicians*, including more than 3,100 orthopedic surgeons and more than 3,500 neurosurgeons. no other publication reaches the entire spine surgery audience.

Clinical articles on spine surgery procedures innovative perspectives by guest spine surgeons technique- and technology-focused features Coverage of the latest clinical trials and studies insight into practice management New coding column for spine surgery

EXCLUSIVES

Gary Ghiselli, MD, has found minimally invasive spine surgery is cost eff ective, but urged caution with all new surgical innovations.

COVER STORY

Minimally invasive spine surgery eff ective for many indications, but diffi cult to learn Techniques and procedures for minimally invasive surgery of the spine have developed considerably in recent decades and have since become more popular among spine surgeons, in some cases even more so than the traditional open approaches, according to sources who spoke with Spine Surgery Today.

Gary Ghiselli, MD, said he finds minimally invasive sur-gery (MIS) of the spine more cost-effective than open surgery. It does more to address the quality of life for patients during the immediate recovery period, “as well as the long-term vi-ability of the muscles and tissues overlying the spine,” he said.

With experience, published studies have shown compli-cation rates can be equivalent to, but usually less than those encountered with traditional open approaches, according to Ghiselli.

“As such, if the same surgical procedure can be performed to the same technical degree with less tissue damage, then it makes logical sense that the eff ectiveness and surgical outcomes should be at least equivalent, but probably superior,” Ghiselli, of Denver, said. “Th ere are many published studies that compare the eff ec-tiveness of MIS surgery with traditional open surgery that sup-port this statement. Opponents of MIS opine that ‘traditional’ open surgery allows better exposure and access, as well as a more technically precise operation than can be performed with a MIS approach. Th e evidence simply does not support that statement,” Ghiselli told Spine Surgery Today.

Cover story continues on page 10

Th e latest SPORT study results showed that at 8 years post-treatment some groups of pa-tients with symptomatic lumbar spinal ste-nosis who opted for conservative care did as well at long-term follow-up as patients who underwent surgery.

Earlier results of the Spine Patient Out-comes Research Trial (SPORT) study for

this indication suggested surgery off ered more benefi ts for these patients. However, Jon D. Lurie, MD, MS, and colleagues up-dated those results with fi ndings from lon-ger term follow-up of the patients.

According to Lurie, surgery vs. nonoper-ative treatment varies by patient, symptoms, degree of activity and other factors. “As a

result, the value of SPORT is not in provid-ing one defi nitive answer to the question of whether surgery is better than nonoperative treatment, but in providing detailed data on the risks and outcomes of each treatment to help patients make individualized, shared decisions,” he told Spine Surgery Today.

Steven J. Atlas, MD, MPH, of Boston, and Carlo Ammendolia, DC, PhD, of To-ronto, provide perspectives.

SPORT 8-year results help physicians manage symptomatic lumbar stenosis

A SLACK Incorporated® publication

For more on this story, see page 6

Volume 2 • Number 2

MARCH/APRIL 2015

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Patients may not always see minimally invasive surgery benefi tsIn a Commentary, Scott D. Boden, MD, Chief Medical Editor, Orthopedic Surgery of SPINE SURGERY TODAY discusses why the costs associated with minimally invasive spine surgery must be controlled during the transition to a value-based economy. 3

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Web WatchMultiple epidural injections Spine surgeon referral may be appropriate for some patients who receive epidural steroid injections for neck pain and cervical radiculopathy. 13

DEFORMITY

Long-term progression of childhood AIS variesScoliosis curve progression in adulthood correlated with curve magnitude in childhood and fusion surgery typically halted later curve progression. 8

IN THE JOURNALS

Navigated, non-navigated kyphoplasty may produce similar outcomesResearch showed kyphoplasty performed with or without navigation technology showed similar overall rates of cement leakage. 26

CERVICAL

Cervical plate fi xation positively aff ects discectomy outcomesAnterior cervical plating yielded greater lordosis angle after 2-level anterior cervical discectomy at 1 postoperative year. 15

SPINE CODING SOURCE

Sampling of questions helps with coding and billingThis installment of Spine Coding Source column discusses CPT coding perspectives for implant removal, grafting. 21

SST0315pgs1,10-13.indd 1 3/2/2015 4:43:27 PM

*Source: Kantar Media, August 2015

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Delivering relevant, spine-specific coverage

Perspectives. experts share their viewpoints, provide context and suggest application to clinical practice. This brings a deeper understanding and greater participation by our readers.

In the Journals. our popular column that summarizes key literature from peer-review journals including:

Subspecialty Coverage. Includes:

• Acta Orthopaedica (Scandinavia)• American Journal of Orthopedics• Archives of Orthopaedic and

Trauma surgery• Canadian Medical Association Journal• JAMA• The Bone & Joint Journal• Journal of Bone and Joint Surgery• Journal of Neurosurgery

• Journal of Spinal Disorders and Techniques

• Journal of the American Academy of orthopaedic surgeons

• New England Journal of Medicine• Neurosurgery• Orthopedics• Spine• Spine Journal

• All Spine Surgery• Basic Science• Biologics• Cervical Coccygeal• Concussion• Deformity• Degenerative Diseases• Disc Biology• Imaging• Infection

• Lumbar • Minimally Invasive Surgery• Myelopathy• Oncology• Pain Management• Pediatrics• Practice Management• Sacral, Spinal Cord and Nerves• Thoracic• Trauma

Meeting News Coverage. Spine Surgery Today’s award-winning journalists report on site from major spine meetings, as well as provide perspectives from key opinion leaders in-print as well as with online video presentations.

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todd J. albert, MdNew York City

Gunnar B.J. andersson, Md, PhdChicago

Charles L. Branch Jr., MdWinston Salem, N.C.

evalina L. Burger, Md, BMedSc, MBCHBAurora, Colo.

ali Bydon, MdBaltimore

Norman B. Chutkan Md, FaCSPhoenix

Michael G. Fehlings, Md, Phd, FRCSC, FaCSToronto

Jeffrey a. Goldstein, MdNew York City

andrew C. Hecht, MdNew York City

James Kang, MdPittsburgh

andrew G. King, MdNew Orleans

Joseph C. Maroon, Md, FaCSPittsburgh

Panayiotis J. Papagelopoulos, MdAthens, Greece

Vikas V. Patel, MdAurora, Colo.

Raj d. Rao, MdMilwaukee

K. daniel Riew, MdSt. Louis

Kern Singh, MdChicago

Joseph Smucker, MdCarmel, Ind.

Vincent C. traynelis, MdChicago

William C. Welch, Md, FaaNS, FaCS, FiCSPhiladelphia

david a. Wong, Md, MSc, FRCS(C)Denver

John C. Liu, MDChief Medical editor, neurosurgeryLos Angeles

Scott D. Boden, MDChief Medical editor, orthopedic surgeryAtlanta

Daniel Refai, MDAssociate editor, neurosurgeryAtlanta

Editorial Leadershipa multidisciplinary board reflecting the expertise of the highly specialized spine community.

5Healio.com/SpineTM

Source: Kantar Media Spine Surgery Readership Study, August 2015.

publicatio

n A

publicatio

n B

1,756

1,555

1,247

2,000

1,800

1,600

1,400

1,200

1,000

top Spine Publications -

Ad Page Exposurein Cover-to-Cover readership

in overall readership

in Ad page exposure

#1#2#2

In only two years, Spine Surgery Today has become the #2 best read spine publication

Spine Surgery Today

Source: Kantar Media Spine Surgery Readership Study, August 2015.

6Healio.com/SpineTM

The only publication to reach orthopedic spine surgeons and neurosurgeonsSpine Surgery Today presents unique opportunities to reach the largest audience of spine and neurosurgeons in a single media buy.

Circulation

SPECIALTY CIRCULATION

Orthopedic Spine Surgeons 892

Orthopedic Surgeons 3,181

Neurosurgeons 3,533

Other Specialties performingspine procedures

568

TOTAL 8,174

2015 Audit pending Brand report

Distribution: 6x per year

Unlike other spine publications, Spine Surgery Today offers you the security of a BPA-audited circulation – so you can be sure your message is received by a verified audience.

Independent third-party verification of audiences used in buying and selling of advertising

7Healio.com/SpineTM

2016 Editorial CalendarISSUE AD CLOSING MATERIAL DUE FEATURED TOPICS BONUS DISTRIBUTION

January/

February12/1/2015 12/17/2015

Sagittal balance

LSRS

American Academy of Orthopaedics Surgeons (AAOS) Annual Meeting

March/April 2/1/2016 2/16/2016 Pediatric deformity

American Association of Neurological Surgeons (AANS) Annual Scientific Meeting; The International Society for the Advancement of Spine Surgery (ISASS) Annual Conference

May/June 4/1/2016 5/16/2016Interbody fusion

AAOS; ISASS; LSRS; CNS/AANS Spine

July/August 6/1/2016 6/17/2016Pain management

AANS

September/

October8/1/2016 8/17/2016

Sports and the spine

IMAST

North American Spine Surgery (NASS) Annual Meeting; Annual Meeting of the Congress of Neurological Surgeons (CNS)

November/

December10/3/2016 10/17/2016

Spine motion

EuroSpine; NASS; CNS

(Editorial content subject to change)

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Meeting News Coverage

CSRS Cervical Spine Research Society Annual MeetingDec. 4-6

All meeting coverage starts on page 14

EXCLUSIVES

Kern Singh, MD, said poor indications for an initial spine surgery is oftentimes associated with an outcome deemed as failed back surgery syndrome.

COVER STORY

Experts discuss poor alignment as cause of failed back surgery syndrome, which treatments workDefined as persistent back or leg pain following back surgery, failed back surgery syndrome is a broadly defined disorder that negatively affects thousands of patients each year and a problem that spine surgeons seem to address more regularly than ever before.

There is no equivalent term for a condition like failed back surgery syndrome (FBSS) in other medical specialties, Kern Singh, MD, of Midwest Orthopaedics at Rush, in Chicago, told Spine Surgery Today, and therefore the syndrome lends itself to many mischaracterizations about what FBSS is and what it is not, he said.

“The problem with using this broad classification is often the surgery is blamed, but we do not know what the indica-tions for surgery were or the fact that surgery was address-ing a particular pathology. Sometimes people undergo back surgery but actually have hip problems, sacroiliac joint prob-lems or something not related to their back,” Singh, a Spine Surgery Today Editorial Board member, said. “They have persistence of pain and blame the spine surgery itself.”

Singh said he does not use the term FBSS unless there is definable evidence that surgery was indicated and it was for the diagnosis for which the patient was operated on.

“You have to make sure the surgery is done accurately. Of-ten I see people diagnosed with FBSS who still have residual stenosis, a nonunion present, or screws or instrumentation that was incorrectly placed. So they have a reason for the

Cover story continues on page 10

SAN FRANCISCO — Data presented at the North American Spine Society Annual Meeting, here, showed the safety and eff ectiveness of cer-vical total disc replacement was maintained at 5-year follow-up regardless of whether the pros-thesis was implanted at one or two spinal levels.

Hyun W. Bae, MD, presented the results for patients in the two treatment arms — one-level cervical total disc replacement (CTDR)

with the Mobi-C prosthesis (LDR Medical; Troyes, France) vs. one-level anterior cervi-cal discectomy and fusion (ACDF) and two-level CTDR with LDR implants vs. two-level ACDF. He noted only the two-level fusion results at 5 postoperative years were not com-parable to results with the other procedures.

“Two-level fusion does seem to be a diff er-ent operation in terms of function,” Bae said,

and noted the fi ndings showed that function tended to drop off in patients who underwent two-level ACDF as the follow-up approached 5 years.

On the whole, the study showed the four procedures were good and were associated with a 90% patient satisfaction rate, according to Bae.

“I think we all believe in ACDF and it cer-tainly is a good operation, but the study really looks at what happens when you start getting into multi-level fusions and what they can cost,” he said.

Researchers fi nd similar effi cacy after 5 years for one- and two-level ACDF, CTDR

A SLACK Incorporated® publication

For more on this story, see page 6

Volume 2 • Number 1

JANUARY/FEBRUARY 2015

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Healio.com/Spine

Web WatchHelmet brand did not aff ect concussion rates There was no diff erence in concussion incidence among high school football players who had 134,437 exposures when they wore Riddell, Schutt or Xenith brand helmets. 13

NASS North American Spine Society Annual MeetingNov. 12-15

PSRS Philadelphia Spine Research SymposiumOct. 28

DEGENERATIVE DISEASES

Cost analysis done for two laminectomy treatmentsInvestigators found lumbar laminectomy with fusion for grade 1 spondylolisthesis was more cost eff ective than laminectomy alone in a study with 5 years follow-up. 9

PRACTICE MANAGEMENT

Specialty spine organizations revise lumbar disc disease defi nitionsThe new defi nitions are expected to help spine and radiology specialists avoid repeat procedures. 26

Failure of diagnosis among reasons for failed back surgery syndromeJohn C. Liu, MD, Chief Medical Editor, Neurosurgery of SPINE SURGERY TODAY discusses some of the leading causes of failed back surgery syndrome, which include failure to address proper spinal balance, failure of surgeon judgment and the continued use of new, unproven spine surgery techniques and technology. 3

SST0115pgs1,10-13.indd 1 1/9/2015 9:51:51 AM

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discount off all advertising placed in 2016 with a minimum 3 ad commitment. This discount may be combined with the Continuity Incentive. To qualify as a new product/advertiser, the advertisement must either be for a:a) company that has not advertised in a SLACK Orthopedics publication in

the past calendar yearb) new product from a company currently advertising with SLACK

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2. Orthopedics Combination Discount: Commit to all 6 issues of Spine Surgery Today and get 6 free ads of comparable size in ORTHOPEDICS (for example a King 4C in ORTHOPEDICS TODAY earns a Full Page 4C ad in ORTHOPEDICS).

3. Global Continuity Incentive: To encourage companies to advertise more consistently, the Global Continuity Incentive allows advertisements for an individual product family (Knee, Hip, etc.) to receive a discount based upon the number of issues in which they advertise across all SLACK Orthopedics Publications. Issue insertions do not need to be consecutive. This program may be combined with the New Advertiser/Product Incentive Program.a) 6 issues = 5% off d) 24 issues = 20% offb) 12 issues = 10% off e) 30 issues = 25% offc) 18 issues = 15% off

4. SLACK Corporate Discount: Take advantage of SLACK’s advertising, custom publishing, event management and other marketing services in 2016 and earn valuable discounts in 2017. Spend levels achieved in the year 2016 will determine your Corporate Discount savings in 2017 based on a total net spend.

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a) Extensions: If an extension date for material is agreed upon and material is not received by the Publisher on the agreed date, the advertiser will be charged for the space reserved.

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definitive information source for health care professionals who treat or conduct research related to spine by delivering timely, accurate, authoritative and balanced reports on the clinical issues, socioeconomic topics and spine industry developments, as well as presenting clinically relevant information on the surgical techniques, products, procedures and technologies used in spine surgery.

2. Average Issue Information:a) Average number of articles per year: 300b) Average article length: 600 words

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Specialty: Total

Orthopedic Spine Surgeons 892

Orthopedic Surgeons 3,181

Neurosurgeons 3,533

Other Specialties performing spine procedures 568

TOTAL: 8,174

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a) Additions: Noneb) Modifications: Nonec) Deletions: Noned) Estimated total circulation for 2016: 8,174

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and non-professional products or services are accepted provided they are in harmony with the policy of service to the healthcare profession and subject to Publisher’s approval. Non-professional product and service advertisers must submit ad copy two weeks prior to closing date.

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11. Indemnification of Publisher: In consideration of publication of an advertisement, the advertiser and the agency, jointly and separately, will indemnify, defend, and hold harmless the magazine, its officers, agents, and employees against expenses (including legal fees) and losses resulting from the publication of the contents of the advertisement, including without limitation, claims or suits for libel, violation of right of privacy, copyright infringements, or plagiarism.

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13. Advertorials: In order to be considered for acceptance, advertisements or inserts which contain text or copy describing a product or surgical technique, must be substantially different in text and font of the receiving publication and the word “ADVERTORIAL” or “ADVERTISEMENT” will be prominently displayed in 10 point black type in ALL CAPS at the center top of each page.

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3. Type of Binding: Saddle-stitch or Perfect bound

4. Ad Requirements: For specifications, go to: healio.com/slackadspecs

Color Proofs: One proof made from supplied files and meeting SWOP specifications must be provided with data file. Proof must be at 100% of the print size. Publisher accepts Kodak approvals, Matchprints, Chromalins, High-end Epson Quality or Iris Digital Proofs.

If only color lasers are furnished, color match on press cannot be guaranteed.

Note: Spread ads should be sent as a one-page file.

Media: CDs and DVDs. Ads will not be accepted via email. FTP site available.

5. Disposition of Ad Material: Ad material will be held one year from date of last insertion and then destroyed unless notified otherwise in writing.

iNSERT iNFORMATiON1. Availability and Acceptance:

a) Availability: Two- to eight-page inserts are available full run. Demographic and/or geographic inserts are also available.

b) Acceptance: A paper sample of the insert must be submitted to the Publisher for approval.

2. Insert Charges:a) Furnished inserts: Billed at black-and-white space rate at

frequency earned on a page-for-page basis, plus a $395 non-commisionable tip-in fee.

b) A-size inserts: Charged at the island/half page rate.c) Tabloid-size inserts: Charged at the king page rate.

3. Sizes and Specifications:

No. of Pages

Paper StockMax

MicrometerReadingMax Min

2 page (one leaf) 80# coated text 70# coated text .004"

4, 6, 8 page 70# coated text 60# coated text .004"

a) Full-size inserts: Supplied untrimmed, printed, folded (except single leaf), and ready for binding. Varnished inserts are acceptable at the Publisher’s discretion.

b) A -size inserts: Supply size 8 1/8” x 11” pre-trimmed on head and face. 1/8” foot trim.

4. Trimming: Trimming of oversized inserts will be charged at cost. Keep live matter 1/2” from trim edges and 3/16” from gutter trim. Inserts are jogged to foot. Trims 1/8” from head, face and foot.

5. BRCs: a) Pricing: Charge is $395 when accompanied by a minimum

of an island/half page advertisement. Non-Commissionable.

b) BRC Specifications: 31/2” x 5” minimum to 4 1/4” x 6” maximum; perforated with 1/2” lip (from perforation) for binding. Add 1/8” for foot trim. Cardstock minimum: 75# bulk or higher.

6. Quantity: 10,000 (estimated). Exact quantity will be given upon Publisher’s approval of insert (or call Publisher prior to closing date).

7. Shipping: Inserts must be shipped in cartons and have publication name, issue date, and insert quantity clearly marked. Inserts shipped in e-containers cannot be verified and SLACK will not be responsible for shortages on press.

cONTAcT iNFORMATiONInsertion Orders

TERMS AND cONDiTiONS

Click to view print advertising terms and conditions

Send product insertion orders and ad materials to:Denise UlrichSales Administrator

Spine Surgery Today c/o SLACK Incorporated 6900 Grove Road Thorofare, NJ 08086-9447 dulrich@slackinc.com 856-848-1000 x475 Fax: 856-848-6091

Send inserts to: Mark Henson Spine Surgery Today Publishers Press 100 Frank E. Simon Ave. Shepherdsville, KY 40165

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TM

Spine Surgery

Healio now with responsive design!

Professional Internet Usage

All PHysIcIAns

89% 1+ times daily

KOls

57% 4+ times daily

Digital Devices Used for Professional Purposes

smArtPHOne

84% All physicians

91% KOLs

tAblet

56% All physicians

66% KOLs

Reach doctors online.When accessing clinical information, physicians don't rely on one source – they use both print and online.Digital sources of information continue to increase their value to physicians.

meDIcAl PUblIcAtIOnsare among doctors’ top most important sources of information

71%PrInt

61%OnlIne

Physicians age <35 ranked medical publications accessed online as their most important source of information.

Sou

rceS

#1

Source: All data from the Kantar Media, Sources & Interactions Study, September 2014 and March 2015 Medical/Surgical Edition.

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Spine Surgery

COnsider the fACts.

Add Healio to your multichannel marketing plans.

healio.com/spine is the online home of Spine Surgery Today

Top tasks Physicians performed: Desktop/Laptop/Computer.

INte

rac

tIo

NS

84% Participate in educational activities

75% read articles from medical publications

71% read professional

news updates

71% Access meetings/convention

information

Source: All data from the Kantar Media, Sources & Interactions Study, September 2014 and March 2015 Medical/Surgical Edition.

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TM

Spine Surgery

Let us create a multichannel program for you. right now you could be engaging thousands of specialists with the right content and multichannel strategy. Healio.com extends the audience connection of sLACK’s respected and trusted publications, offering specialty-specific sponsorship and contextual advertising opportunities.

And with its responsive design, your message will be optimized for best viewability and engagement.

Healio.com 2016 online advertising opportunities

specialists delivered daily

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showcase your activities

reach 85% of your market

emAIleDUcAtIOn lAbcOnVentIOn OPPOrtUnItIesWebsIte

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cOntent mArKetIng Great content = engaged readers

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create a multichannel media strategy.

6900 grove roadThorofare, New Jersey 08086-9447800-257-8290 • 856-848-1000fax 856-848-6091

ADveRtiSiNg OffiCe:

Patrick DuffeyVice President, Sales and Marketing, Surgery and Related Sciencespduffey@slackinc.com, ext. 262

Carolyn Boerner Director of Sales Administrationcboerner@slackinc.com, ext. 355

Denise UlrichSales Administratordulrich@slackinc.com, ext. 475

PUBLiSHiNg OffiCe:

Joan-Marie Stiglich, ELSChief Content Officer

Kristine houck, MA, elsEditor in Chief

gina Brockenbrough, MAManaging Editor, OrthOpedics tOday

susan rappExecutive Editor, OrthOpaedics tOday eurOpe

John KainCirculation Manager

What can Spine Surgery Today do for you?

EXCLUSIVES

Gary Ghiselli, MD, has found minimally invasive spine surgery is cost eff ective, but urged caution with all new surgical innovations.

COVER STORY

Minimally invasive spine surgery eff ective for many indications, but diffi cult to learn Techniques and procedures for minimally invasive surgery of the spine have developed considerably in recent decades and have since become more popular among spine surgeons, in some cases even more so than the traditional open approaches, according to sources who spoke with Spine Surgery Today.

Gary Ghiselli, MD, said he finds minimally invasive sur-gery (MIS) of the spine more cost-effective than open surgery. It does more to address the quality of life for patients during the immediate recovery period, “as well as the long-term vi-ability of the muscles and tissues overlying the spine,” he said.

With experience, published studies have shown compli-cation rates can be equivalent to, but usually less than those encountered with traditional open approaches, according to Ghiselli.

“As such, if the same surgical procedure can be performed to the same technical degree with less tissue damage, then it makes logical sense that the eff ectiveness and surgical outcomes should be at least equivalent, but probably superior,” Ghiselli, of Denver, said. “Th ere are many published studies that compare the eff ec-tiveness of MIS surgery with traditional open surgery that sup-port this statement. Opponents of MIS opine that ‘traditional’ open surgery allows better exposure and access, as well as a more technically precise operation than can be performed with a MIS approach. Th e evidence simply does not support that statement,” Ghiselli told Spine Surgery Today.

Cover story continues on page 10

Th e latest SPORT study results showed that at 8 years post-treatment some groups of pa-tients with symptomatic lumbar spinal ste-nosis who opted for conservative care did as well at long-term follow-up as patients who underwent surgery.

Earlier results of the Spine Patient Out-comes Research Trial (SPORT) study for

this indication suggested surgery off ered more benefi ts for these patients. However, Jon D. Lurie, MD, MS, and colleagues up-dated those results with fi ndings from lon-ger term follow-up of the patients.

According to Lurie, surgery vs. nonop-erative treatment varies by patient, symp-toms, degree of activity and other factors.

“As a result, the value of SPORT is not in providing one definitive answer to the question of whether surgery is better than nonoperative treatment, but in providing detailed data on the risks and outcomes of each treatment to help patients make indi-vidualized, shared decisions,” he told Spine Surgery Today.

Steven J. Atlas, MD, MPH, of Boston, and Carlo Ammendolia, DC, PhD, of To-ronto, provide perspectives.

SPORT 8-year results help physicians manage symptomatic lumbar stenosis

A SLACK Incorporated® publication

For more on this story, see page 6

Volume 2 • Number 2

MARCH/APRIL 2015

Imag

e: L

aura

Kin

ser

Patients may not always see minimally invasive surgery benefi tsIn a Commentary, Scott D. Boden, MD, Chief Medical Editor, Orthopedic Surgery of SPINE SURGERY TODAY discusses why the costs associated with minimally invasive spine surgery must be controlled during the transition to a value-based economy. 3

Healio.com/Spine

Web WatchMultiple epidural injections Spine surgeon referral may be appropriate for some patients who receive epidural steroid injections for neck pain and cervical radiculopathy. 13

DEFORMITY

Long-term progression of childhood AIS variesScoliosis curve progression in adulthood correlated with curve magnitude in childhood and fusion surgery typically halted later curve progression. 8

IN THE JOURNALS

Navigated, non-navigated kyphoplasty may produce similar outcomesResearch showed kyphoplasty performed with or without navigation technology showed similar overall rates of cement leakage. 26

CERVICAL

Cervical plate fi xation positively aff ects discectomy outcomesAnterior cervical plating yielded greater lordosis angle after 2-level anterior cervical discectomy at 1 postoperative year. 15

SPINE CODING SOURCE

Sampling of questions helps with coding and billingThis installment of Spine Coding Source column discusses CPT coding perspectives for implant removal, grafting. 21

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