| A PUBLICATION FOR IASA MEMBERS • ISSUE 10 • WINTER 2018 |

Bringing Smiles toChildren’s Faces

ALSO IN THIS ISSUENEW BOARD MEMBERS PAGE 3A FELLOWSHIP EXPERIENCE IN COLORADO PAGE 8IASA WORKSHOP AT AIIMS PAGE 10IASA RECEPTION AT ASSICON PAGE 11

OUR SUCCESSFUL HUMITARIAN MISSION IN AHMEDABAD PAGE 4

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Dear Members,

I am excited and honored to become the latest Chairman of IASA. My career in the medical device industry began twenty-eight years ago with a significant number of them dedicated to Spine. I look forward to my involvement and continued growth with such a great organization. I have known our outgoing Chairman, Kevin Carouge, for most of my career, so it is certainly a privilege to follow what he has fostered within the IASA organization.

I would like to thank Kevin for his dedication to IASA since its inception, specifically for Mission support, Fellowship opportunities, as well as Educational events. IASA has certainly grown in all three of these areas during Kevin’s six years as Chairman. I would like to take this opportunity on behalf of the IASA board and its members to wish him all the best moving forward. We could not have done this without him!

Also, two IASA board members finished their terms in 2018. We would like to extend our sincere gratitude to Dr. Arvind Jayaswal as well as Dr. Alok Sharan. Dr. Jawaswal, a founding board member of IASA, has been instrumental in every aspect of IASA’s development, specifically the educational programs. Dr. Sharan has been a board member for the last three years including the development of educational efforts established at King George’s Medical Center. Both plan on being active members of IASA, but will surely be missed by the board.

As two of our board members depart, I would like to announce and recognize our two new additions. IASA is pleased to welcome Mr. Sashin Ahuja, an Orthopaedic Spine surgeon who currently practices at the Spire Cardiff Hospital in Cardiff, UK. I would also like to welcome Dr. Saumyajit Basu, also an Orthopaedic Spine surgeon, who currently practices at the Park Clinic in Kolkata, India. Both of these gentlemen are well respected in their fields. Please feel free to learn more about each of them on the following page.

I would like to highlight the IASA involvement for 2017 as it pertains to Fellowships, Education, and Humanitarian Missions as well as our Visiting Surgeons Program:

Fellowships We received twenty-five applications in 2017, from

which nine fellows were selected, and completed their rotations in the US or the UK.

Education In November, we held our first two-day workshop in

Delhi. Twenty-nine surgeons attended, along with an eight member expert faculty from the US and India.

Humanitarian Missions The first coordinated mission by IASA was held

in November at the Health & Care Foundation in Ahmedabad. A team of five surgeons made complex scoliosis corrections on seven patients, between the ages of 5 to 17.

Visiting Surgeons Program Three Board members, Dr. Sharan, Dr. Sengupta, and

Dr. Jayaswal visited King George’s Medical Center in Lucknow for presentations and discussions with faculty. Live surgeries took place on separate trips to Lucknow to encourage the establishment of a spine center within the orthopaedic department of the hospital.

In closing, as we commence our seventh year, it’s with great hope that all of our members continue to be involved and find opportunities to grow our organization beyond its current structure. We need all of you to make that happen!

Kindest Regards,

Dennis Booth Chairman, IASA

Vision and Guidance: Thoughts from the Chairman

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BOARD MEMBERSMEET OUR NEW

Dr. Saumyajit Basu is the head of the Department of Spine Surgery at Park Clinic and Kothari Medical Center in Kolkata, India. His main areas of interest are cervical spine and spine deformities. He is the secretary/treasurer of the Association of Spine Surgeons

of India (ASSI), an active member of the Scoliosis Research Society (SRS), Vice President of the Spine Society of West Bengal, and Program Director of AO Spine Fellowship at Park Clinic.

Dr. Basu sits on the editorial boards specific to the spine for the Indian Journal of Orthopaedics (IJO), Asian Spine Journal (ASJ), and the Indian Spine Journal (ISJ). Dr. Basu has published more than 20 articles in national and international publications, and has written 10 book chapters. He has given over than 200 presentations at meetings and conferences.

Dr. Sashin Ahuja is a consultant orthopedic spine surgeon at several hospitals in Cardiff, Wales: University Hospital of Wales, University Hospital Llandough, Noah’s Ark Children Hospital for Wales, and Spire Cardiff Hospital.

His practice involves treating all aspects of spinal pathology and has pioneered an MIS approach to sacroiliac joint stabilization in the UK.

He is a member of the AO Spine as a UK Council Chair and the Program Director of their International Reference Center; a member of the British Association of Spinal Surgeons, British Scoliosis Society, and a member of the Royal College of Physicians and Surgeons in Glasgow, Scotland.

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BRINGING SMILES TO CHILDREN’S FACES

ANOTHER SUCCESSFUL HUMANITARIAN MISSION IN AHMEDABAD

T E A M M E M B E R S ( F R O M L E F T T O R I G H T )

MR. SHAISHAV BHAGAT IPSWICH HOSPITAL, IPSWICH, UK

DR. ASHVIN PATEL KENNEDY-WHITE ORTHOPAEDIC CENTER, SARASOTA, FL

MR. MUSHTAQ SHAIKH BESPOKE HEALTHCARE, PRESTON, UK

MR. SASHIN AHUJA UNIVERSITY HOSPITAL OF WALES, CARDIFF, UK

DR. RAKESH PATEL UNIVERSITY OF MICHIGAN, ANN ARBOR, MI

MR. ROB ZOLL STP SPINE - ANN HARBOR, MI

IASA has an ongoing partnership with the Health & Care Foundation, a charitable non-profit organization in Ahmedabad. For the past three years, we have supported a group of UK surgeons and neuro-monitoring specialists who have organized the details of each mission. IASA decided to open this opportunity to other members interested in volunteering for a mission and in 2017 we did just that.

A group of five spine surgeons – two from the UK, two from the US, and one with a local practice in Ahmedabad – came together to do seven complex and successful surgeries on children with scoliosis, ranging from five to 17 years of age. Dr. Sashin Ahuja, Dr. Shaishav Bhagat, neuromonitoring specialist Dr. Mushtaq Shaikh, all from the UK, had been to the Health & Care Foundation on other IASA missions in the past. IASA recruited US surgeons Dr. Ashvin Patel and Dr. Rakesh Patel to join the other surgeons for the November 2017 mission trip.

Dr. Amit Jhala of Ahmedabad has an ongoing relationship with the Health & Care Foundation and without him as the local anchor, none of the missions would have been possible. Dr. Jhala screened the patients ahead of time and continued post-op check-ups on the children as needed. Dr. Nisarg Parikh, Dr. Jhala’s Fellow, also joined to learn new techniques with anesthesiologist Dr. Bharat Oza present for all seven surgeries.

The report that follows gives you a glimpse of the mission achievements.

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NITESH - MALE, 17 FATIMA - FEMALE, 12

DHARVI - FEMALE, 5

B E F O R E B E F O R E

B E F O R E

A F T E R A F T E R

A F T E R

Nitesh had idiopathic scoliosis. He previously had been operated on for tracheo-bronchial anomaly at a very young age. Posterior correction was done on the convex side to improve his coronal and sagittal balance.

Fatima has severe congenital scoliosis. She had had a previous operation at age 9. She received an extension of her growing rods. This must be repeated every 6 months until she can have final deformity correction and fusion. For the time being she can continue to grow until she reaches puberty.

Dharvi has an extremely rigid, congenital scoliosis. After a long discussion on whether to consider full deformity correction or use growing rods, the team decided to proceed with posterior deformity correction with rib resection and asymmetric pedicle subtraction osteotomy through the fused segments. Overall scoliosis has improved significantly. She suffered intraoperative pneumothorax during osteotomy and removal of ribs.

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MATAYA - FEMALE, 9

B E F O R E A F T E R

Mantaya had infantile scoliosis and underwent rod surgery in the past. With the loosening of previous implants, she needed revision of the metalwork. She will continue to have growing extensions until puberty or age 12, at which point deformity correction with be considered.

SANGEETA - FEMALE, 12

B E F O R E

A F T E R

Sangeeta had severe rigid scoliosis with tethered cord, a condition where the spinal cord fails to ascend in the vertebral column. She underwent neurosurgical intervention followed by scoliosis correction. This operation lasted for just over 10 hours; an amazing example of teamwork including five surgeons, two anesthesiologists and various assistants rotated throughout the procedure. The correction achieved was very satisfactory to the surgeons and the patient.

H U M I N I TA R I A N M I S S I O N T O A H M E D A B A D [ C O N T I N U E D ]

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NETRA - FEMALE, 6

B E F O R E A F T E R

Netra had congenital scoliosis. The team undertook extension of the growing rods, which will be repeated every six months to allow for the growth of the spine while maintaining the corrected position.

DIYA - FEMALE, 10

B E F O R E A F T E R

Diya had severe thoracolumbar congenital scoliosis. She underwent posterior correction with rib resection and osteotomy. The pedicles on the concave side were too small to insert screws. The team was able to achieve approximately 50% correction as she had considerable intraoperative bleeding which precluded us from performing any further correction. At follow up, it appeared her overall balance had considerably improved. She may be considered for a further correction when she has achieved further growth.

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TRAVELINGFELLOWSHIP

A U R O R A , C O L O R A D O

A FELLOWSHIP EXPERIENCE IN TWO PARTS Dr. Shakti Goel - Zydus Hospital, Ahmedabad

In June, I received an email from IASA that I had been selected for the fall 2017 fellowship. Program Director Nazie Dana worked day and night to get things finalized for me and make arrangements for the scheduled month. I was informed that I would be rotating with Prof. Vikas Patel and Prof. Sumeet Garg at the University of Colorado Hospital and Children’s Hospital Colorado, respectively.

The arrangements at Aurora were all taken care of by IASA. Ms. Dana ensured I would have no issues with travel, stay, health insurance, meals or local transportation and hence was continuously in touch via phone and emails.

The rotations at University of Colorado Hospital started on an amazing note. The first day I observed lumbar disc replacement, which I experienced for the very first time. Dr. Patel also took me out to lunch to discuss surgeries and our research projects in India. Subsequently, I was involved in varying surgeries ranging from Coflex insertion, C1 screw insertion, SI joint fusion, OLIF, ALIF, etc. which I had never seen before. Witnessing navigation while inserting screw was a unique experience for me. Moreover, the use of 3D microscopes in surgical procedures was something that I had little knowledge about.

A typical day at University of Colorado started at 7 am with meetings, pre-operative discussion, and research in

Dr. Goel with Dr. Vikas Patel

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progress or journal clubs followed by surgeries/OPD. In the spine clinic, I learned the unique ways to counsel patients. I was shown an EOS machine, which is a weight bearing CT scan and helps to calculate the various angles and parameters without the pain of ‘stitching’ X-rays together. I was introduced to various spine faculty and fellows who made my rotations an enjoyable experience. Each of the faculty took special care and answered my doubts with utmost precision. I visited the biomechanics laboratory and discussed the ways the researchers calculated the torque forces on spine implants. A tour to the cadaver laboratory was yet again a unique experience. UCH arranged a cadaveric workshop for me where I was trained to put lateral mass screws in cervical spine and the art of micro-discectomy. The faculty was kind enough to guide me in a step-wise manner so that I learn meticulously. I received as a gift a few books authored by Dr. Vikas Patel and his team. The books helped simplify the understanding of spine pathologies and surgical techniques.

Before my rotation with Dr. Sumeet Garg began at the Children’s Hospital of Colorado, I was invited for dinner at his home. I had a wonderful time with him and his family. We talked a lot about India and spine. The following day I participated in a pre-operative conference followed by an out-patient clinic. That day was the first time that I witnessed a magnetic rod expansion surgery in a scoliosis

patient. This was something that I had read about but never seen. The following days, I was made a part of an ‘infection’ meet, pre and post-operative discussions and attended surgical correction of Adolescent Idiopathic Scoliosis. Free hand screw insertion in scoliosis using a power drill was very fascinating. I learned the art of 3D model planning for accurate screw placements in scoliosis surgery and casting techniques for infantile idiopathic scoliosis.

During the last few days at the Children’s Hospital Colorado, I observed the VCR (Vertebral Column Resection) surgery for kyphosis correction. I even visited the ortho-prosthesis laboratory where I learned about the advantages of placing a thermal sensor in a scoliosis brace to determine brace compliance by the pediatric patient.

The IASA fellowship was an amazing journey where I not only learned some newer techniques in spine but also the art of teaching, self-discipline, and how to remain calm during surgeries. I was engaged for hours by the friendly environment of the operation theatre. The way the faculty supported each other, the bond between fellows and the faculty, and the mentor-mentee relationship is something I have taken with me to my country. The IASA fellowship went much beyond spine learning; it was an experience of different cultures, teaching methodologies and surgical ethics. It’s an experience that I will never forget and hope to spread in my own country. y

Dr. Goel with Dr. Sumeet Garg

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IASA SPINE WORKSHOP AT AIIMS IN DELHIFor the first five years all our “Essentials in Spine” workshops were held in Bangalore; we had considered moving the workshop to other parts of the country to attract other surgeons. This past November, we held “MIS Approaches to Lumbar and Cervical Spine” at the All India Institute of Medical Science (AIIMS) in Delhi. Though the cadaver facility was smaller, we still had 29 surgeons join and hone their surgical skills. The program, a combination of didactic presentations, demonstrations, and hands-on bioskills training was expertly put together by co-chairs, Dr. Arvind Jayaswal of Primus Super Specialty Hospital in Delhi and Dr. Srinivas Prasad of Jefferson University Hospitals in Philadelphia, PA. A prominent body of international faculty from the US and India was invited to not only educate the attending surgeons but to maximize interaction with them.

We addressed the lumbar spine on the first day, focusing on MIS approaches to degenerative lumbar disease, percutaneous screw fixation techniques, MIS TLIF, midline approaches to pedicle screws, and lateral approaches to the lumbar spine. Emphasis on the second day included presentations on cervical stenosis and degenerative disease, ACDF techniques, arthroplasty, laminoplasty, and lateral mass fixation. Afternoon sessions consisted of hands-on cadaver lab time.

Our 2018 workshop will be held on November 16 and 17 in Bangalore. Save the date and stay tuned for more information.

INTERNATIONAL FACULTY

Dr. Deepak Agrawal - Professor of Neurosurgery and Gamma Knife, AIIMS, Delhi

Dr. Bhavuk Garg - Associate Professor at the Department of Orthopaedics, AIIMS, Delhi

Dr. Alok Ranjan - Chief of Neurosurgery, Apollo Health City, Hyderabad*

Prof. Sumit Sinha - Director of Neurosurgery & Spine Services, Paras Hospital, Gurgaon

Dr. Praveen Mummaneni - Vice Chair of the Department of Neurosurgery, UCSF, San Francisco, CA*

Dr. Alok Sharan - Co-Director, WESTMED Spine Center, Yonkers, NY*

*IASA BOARD MEMBERS

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IASA RECEPTION AT 2018ASSICONThe 31st Annual Conference of the Association of Spine Surgeons of India (ASSICON) was held in Chennai from January 19–21. At our information desk, members and Fellows stopped by while many others filled out membership application forms.

We also had a gathering of our members on the evening of the 18th, where over 80 members and new recruits joined to learn more about IASA and what we have done in the past year. Program Director Nazie Dana made a presentation and answered various questions regarding our program. y

Did you receive an award recently? Have you switched hospitals? Did your article get published in a peer-reviewed periodical? Were you invited to speak at a conference? Did you complete a Fellowship?

Let us know and we will publish it in the next issue of our newsletter! Email your news to Nazie Dana, Program Director at IASA: ndana@indo-americanspine.org

Ì Dr. Praveen Mummaneni has been elected Treasurer of the Congress of Neurological Surgeons.

Ì Following a fellowship in Minimally Invasive Spine Surgery at Boston University Medical Center in Boston, MA, Dr. Abhijeet Kadam is currently a Spine Surgery Fellow at Medstar Union Memorial Hospital in Baltimore, MD. He will also present a paper titled “The Role of Minimally Invasive Long Segment Percutaneous Pedicle Screw Fixation for Spinal Metastatic Disease” at the 2018 AAOS in New Orleans.

Ì Dr. Shakti Goel, a past IASA Fellow, has joined the Indian Spinal Injury Center in Delhi as a junior consultant. Recently Dr. Goel presented a paper on “Clinical Correlation of Intraoperative Neuro-monitoring in 188 Individuals Undergoing Decompression & Instrumentation of the Spine” at ASSICON 2018, Chennai. The paper was awarded first prize at Spine Association of Gujarat in 2017.

Ì Dr. Jagodish Gosh’s book, A Short Book of Spinal Tuberculosis, has been published by Lap Lambert Academic Publishing.

Ì Dr. Shardul Soman, a past IASA Fellow, has been awarded the APSS DePuy Synthes Clinical Fellowship at the National University Hospital Singapore (NUHS) in 2018 under the tutelage of Prof. Gabriel Liu.

Ì Dr. Aju Bosco has been awarded a travel grant by the Global Spine Congress to attend their 2018 Convention in Singapore.

M E M B E R N E W S

IASA Newsletter is printed twice a year. Editor: Nazie Dana.

If you are interested in becoming involved with the group and its activities, please log on to our website (indo-americanspine.org) and join, or contact Nazie Dana, IASA Program Director at 866.835.5306, or via email at ndana@indo-americanspine.org

S A V E the D A T E

Workshop

E S S E N T I A L S in S P I N E

B A N G A L O R E , I N D I ANOVEMBER 16-17, 2018 | MS RAMAIAH ADVANCED LEARNING CENTER

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