PROGRAM BOOK

22nd Annual Meeting of the AANS/CNS Section on Disorders of the Spine and Peripheral Nerves

March 15-18, 2006

Buena Vista Palace in the Walt Disney World® Resort Lake Buena Vista, Florida

The program book is sponsored in part by an educational grant provided by

Jointly Sponsored by the AANS TABLE OF CONTENTS

FUTURE MEETINGS Welcome ...... 1 March 7-11, 2007 Phoenix, Arizona 2006 Annual Meeting Committees ...... 1

Program-At-A-Glance ...... 2 February 27- March 1, 2008 Lake Buena Vista, Florida General Information ...... 3

PREVIOUS MEETINGS Current and Past Officers ...... 4 2005 Phoenix, Arizona Past Program Committees ...... 6 2004 San Diego, California Awards and Fellowships ...... 7 2003 Wesley Chapel, Florida 2002 Lake Buena Vista, Florida Disclosure Listing ...... 14 2001 Phoenix, Arizona Meeting Agenda 2000 Rancho Mirage, California 1999 Lake Buena Vista, Florida Wednesday, March 15 ...... 17

1998 Rancho Mirage, California Thursday, March 16 ...... 18 1997 Newport Beach, California Friday, March 17 ...... 22 1996 Lake Buena Vista, Florida

1995 Phoenix, Arizona Saturday, March 18 ...... 25 1994 Fort Lauderdale, Florida Exhibitors ...... 27 1993 Tucson, Arizona 1992 Miami, Florida Sponsorship ...... 29 1991 Rancho Mirage, California Poster Numbers and Titles ...... 31 1990 Captiva Island, Florida 1989 Cancun, Mexico Oral Abstracts ...... 38 1988 Phoenix, Arizona Oral Point Abstracts ...... 46 1987 Boca Raton, Florida 1986 San Diego, California Scientific Posters ...... 56

1985 Greenleaf, Florida Awards Program Abstracts ...... 90

2006 Membership Roster ...... 91

Evaluations...... 129

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES WELCOME 1

Dear Colleague: 2006 ANNUAL MEETING COMMITTEE It is our pleasure to welcome you to the 22nd Annual Meeting of the AANS/CNS Annual Meeting Chairperson Section on Disorders of the Spine and Peripheral Nerves. The Annual Meeting Michael W. Groff, MD Committee is delighted that you could join us for a program that promises to be an excellent educational opportunity. Annual Meeting Scientific Program Chairperson We thank the members of the Scientific Program Committee for developing this Mark R. McLaughlin, MD year’s program, as well as the speakers and moderators who have volunteered to Exhibit Chairperson speak on their areas of expertise in the scientific sessions and special courses. The John J. Knightly, MD Scientific Program Committee has put together a fabulous program. This year’s CME Sponsorship Chairperson sessions cover the gamut of cutting-edge techniques and long standing clinical challenges. The meeting continues to grow in stature and we are fortunate to Timothy C. Ryken, MD have speakers with us from the upper echelons of spinal surgery. Several of this year’s topics were selected from last year’s evaluation comments and the 2006 SCIENTIFIC ABSTRACT membership, so we trust the program reflects the objectives of the Spine Section. REVIEW COMMITTEE James S. Harrop, MD This program reflects the interdisciplinary nature of your daily work. World-renowned R. John Hurlburt, MD, PhD investigators from the orthopaedic community have been invited to share their Michael G. Kaiser, MD aptitude. The collaboration with the American Association of Neurological Nurses Ehud Mendel, MD continues to be an important part of the program. Through our close work together, Praveen V. Mummaneni, MD we are able to offer contact hours to non-physician attendees in recognition of the Brian R. Subach, MD importance of their participation in the meeting, which grows each year. Paul H. Young, MD Beyond the scientific program, Buena Vista Palace in the Walt Disney World® Eric L. Zager, MD Resort has many activities for you and your family to enjoy in your free time. Enjoy swimming, tennis and volleyball, then stroll to Downtown Disney® at 2006 SCIENTIFIC ADVISORY sunset for shopping, dazzling entertainment and nightlife. Enjoy the resort’s guest COMMITTEE privileges like continuous transportation to all Disney World® theme parks, dining Joseph T. Alexander, MD with favorite Disney characters, and access to championship Disney® golf courses. Juan C. Bartolomei, MD We hope these activities enhance your experience at the meeting. Jay Y. Chun, MD, PhD Ira M. Goldstein, MD The evaluation incentive program will be in place again this year. We take a Michael W. Groff, MD moment to mention it here because your feedback is vital to the ongoing Regis W. Haid, Jr., MD success of the meeting. At the end of each day, we randomly select one James S. Harrop, MD completed evaluation to award a prize to one lucky attendee. Robert F. Heary, MD R. John Hurlbert, MD, PhD We also wish to acknowledge the exhibitors and sponsors of this year’s meeting. Michael G. Kaiser, MD Without their support, we could not organize this high-quality scientific program. John J. Knightly, MD We strongly encourage you to visit our exhibitors and sponsors in the exhibit Mark R. McLaughlin, MD hall. It’s an efficient way to ensure you are up-to-date with the broad array of Ehud Mendel, MD state-of-the-art technology relevant to spinal surgery. Praveen V. Mummaneni, MD We welcome you to the 22nd Annual Meeting and hope that you will enjoy both Fred Noban, MD the didactic material as well as the camaraderie of your friends and colleagues for Daniel K. Resnick, MD the next few days. Christopher I. Shaffrey, MD Brian R. Subach, MD Paul H. Young, MD Sincerely, Eric L. Zager, MD

2006 POSTER AWARDS & GRADING COMMITTEE Jay Y. Chun, MD, PhD Robert F. Heary, MD Michael W. Groff, MD Mark R. McLaughlin, MD Peter C. Gerszten, MD, PhD Section Chairperson Annual Meeting Chairperson Scientific Program Chairperson Ira M. Goldstein, MD James S. Harrop, MD Nirav K. Shah, MD Sagun K. Tuli, MD, FRCS(C)

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 2 PROGRAM AT-A-GLANCE

WEDNESDAY THURSDAY FRIDAY SATURDAY MARCH 15 MARCH 16 MARCH 17 MARCH 18

MORNING 7:00 AM – 5:00 PM 6:00 AM – 6:00 PM 6:00 AM – 1:00 PM 6:00 AM – 1:00 PM Registration Speaker Ready Room Speaker Ready Room Speaker Ready Room

7:00 AM – 12:45 PM 6:30 – 7:45 AM 6:30 – 7:45 AM 6:30 – 7:45 AM Special Course I Continental Breakfast Continental Breakfast Continental Breakfast

8:00 AM – 12:30 PM 6:30 AM – 6:00 PM 6:30 AM – 1:00 PM 6:30 AM – 1:00 PM Special Course II Registration Registration Registration

9:00 AM – 6:00 PM 6:45 AM – 12:15 PM 7:00 AM – 12:30 PM 9:00 AM – 12:30 PM Speaker Ready Room Scientific Session Scientific Session Scientific Session

9:00 AM – 7:00 PM 9:00 AM – Noon 9:00 – 11:30 AM Exhibit Hall Open Exhibit Hall Open Exhibit Hall Open E-Poster Viewing E-Poster Viewing E-Poster Viewing

9:45 – 10:30 AM 10:15 – 11:00 AM 9:50 – 10:30 AM Beverage Break & Beverage Break & Beverage Break & Demonstration Theater Demonstration Theater Demonstration Theater Presentations – Presentations – Presentations – Exhibit Hall Exhibit Hall Exhibit Hall

12:15 – 1:00 PM 1:00 – 6:00 PM 1:00 – 5:00 PM Lunch & Demonstration Golf Outing Special Course VI Theater Presentations – 1:00 – 5:00 PM Exhibit Hall 1:00 – 5:00 PM Special Courses III & IV Special Course V 1:00 – 5:30 PM AFTERNOON Scientific Sessions 1:00 – 5:00 PM Special Symposium 3:30 – 4:15 PM for Nurses, Nurse Beverage Break & Practitioners, and Demonstration Theater Physician Assistants Presentations – Exhibit Hall

5:30 – 7:00 PM Hours, Special Course Reception in the Options and Placement Exhibit Hall EVENING are subject to change 5:30 – 8:00 PM (no children, please) Opening Reception

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES GENERAL INFORMATION 3

EVALUATION FORM REWARDS PROGRAM CME CREDIT The evaluation process is a key component in providing cutting-edge programming This activity has been planned and at the AANS/CNS Section on Disorders of the Spine and Peripheral Nerves Annual implemented in accordance with the Meeting. Medical registrant feedback on the quality and diversity of the entire Essentials and Standards of the program helps to determine future annual meeting programming. Your views Accreditation Council for Continuing and opinions are valued! Medical Education (ACCME) through the joint sponsorship of AANS and We are providing an opportunity to qualify for prize drawings by completing your the AANS/CNS Section on Disorders evaluations forms. Each time you complete an evaluation form, deposit the form of the Spine and Peripheral Nerves. into the designated evaluation drop box and you will become eligible to win a The ACCME accredits the AANS to prize in the daily drawing. provide continuing medical education to physicians. The AANS designates NO SMOKING POLICY this educational activity for a maximum Smoking is not permitted at any official AANS/CNS Section on Disorders of the of 18.25 credits in Category I credit Spine and Peripheral Nerves Annual Meeting event. toward the AMA Physician’s Recognition Award (PRA). An additional 16.50 DISCLAIMER credits are available through optional The material presented at the 22nd Annual Meeting has been made available programming. by the AANS/CNS Section on Disorders of the Spine and Peripheral Nerves and Each physician should claim only the AANS for educational purposes only. These materials are not intended to those credits that he/she actually represent the only, nor necessarily the best method or procedure appropriate for spent in the educational event. the medical situations discussed, but rather is intended to present an approach, view, statement, or opinion of the faculty, which may be helpful to others who PHYSICIAN ASSISTANT face similar situations. CREDIT All drugs and medical devices used in the United States are administered in Physician assistants will receive a accordance with the Food and Drug Administration (FDA) regulations. These certificate of credit at the general regulations vary depending on the risks associated with the drug or medical scientific program and for any devices compared to products already on the market, and the quality and scope optional events attended. Each of the clinical data available. physician assistant should contact his or her individual membership Some drugs and medical devices demonstrated or described within the print association and certification board publications of the AANS/CNS Section of Disorders of the Spine and Peripheral to determine the requirements for Nerves jointly sponsored by AANS have FDA clearance for use for specific purposes, accepting certificates of credit. or for use only in restricted research settings. The FDA has stated that it is the responsibility of the physician to determine the FDA status of each drug or device NURSING CONTACT he or she wants to use in compliance with applicable laws. HOURS The Special Symposium for Nurses, Neither the content (written or oral) of any course, seminar, or other presentation Nurse Practitioners and Physician in the program, nor the use of a specific product in conjunction therewith, nor Assistants, Meeting the Challenges of the exhibition of any materials by any parties coincident with the program, Caring for the Patient with a Spinal should be construed as indicating endorsement or approval of the views presented, Tumor, is planned in conjunction the products used, or the materials exhibited by the AANS/CNS Section on with the American Association of Disorders of the Spine and Peripheral Nerves jointly sponsored by AANS, or by its Neuroscience Nurses, which is committees, commissions or affiliates. accredited as a provider of nursing continuing education by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC-COA). To meet CE standards, receive the appropriate number of contact hours and a certificate of attendance, participants who are registered nurses (RNs) will be expected to complete and return an evaluation form for this symposium. See pages 24 & 25 for additional information.

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 4 CURRENT AND PAST OFFICERS

CURRENT OFFICERS 2002 1999 Chairperson Chairperson Chairperson Robert F. Heary, MD Nevan G. Baldwin, MD Vincent C. Traynelis, MD Chairperson Elect Chairperson Elect Chairperson Elect Charles L. Branch, Jr., MD Regis W. Haid, Jr., MD Curtis A. Dickman, MD Secretary Secretary Secretary Daniel K. Resnick, MD Charles L. Branch, Jr., MD Nevan G. Baldwin, MD Treasurer Treasurer Treasurer Timothy C. Ryken, MD Gerald E. Rodts, Jr., MD Curtis A. Dickman, MD Immediate Past Chairperson Immediate Past Chairperson Immediate Past Chairperson Gerald E. Rodts, Jr., MD Paul C. McCormick, MD Stephen M. Papadopoulos, MD Members-at-Large Members-at-Large Members-at-Large Joseph T. Alexander, MD Ronald I. Apfelbaum, MD Charles L. Branch, Jr., MD Daniel H. Kim, MD H. Louis Harkey, III, MD Srinath Samudrala, MD Robert F. Heary, MD Lloyd Zucker, MD PAST OFFICERS 2004 2001 1998 Chairperson Chairperson Chairperson Paul C. McCormick, MD Stephen M. Papadopoulos, MD Gerald E. Rodts, Jr., MD Chairperson Elect Chairperson Elect Chairperson Elect Nevan G. Baldwin, MD Vincent C. Traynelis, MD Robert F. Heary, MD Secretary Secretary Secretary Nevan G. Baldwin, MD Vincent C. Traynelis, MD Charles L. Branch, Jr., MD Treasurer Treasurer Treasurer Gerald E. Rodts, Jr., MD Curtis A. Dickman, MD Timothy C. Ryken, MD Immediate Past Chairperson Immediate Past Chairperson Immediate Past Chairperson Curtis A. Dickman, MD Richard G. Fessler, MD, PhD Regis W. Haid, Jr., MD Members-at-Large Members-at-Large Members-at-Large Ronald I. Apfelbaum, MD Charles L. Branch, Jr., MD Joseph T. Alexander, MD H. Louis Harkey, III, MD Mark N. Hadley, MD Ronald I. Apfelbaum, MD Robert F. Heary, MD John E. McGillicuddy, MD Daniel H. Kim, MD

2003 2000 1997 Chairperson Chairperson Chairperson Curtis A. Dickman, MD Richard G. Fessler, MD, PhD Regis W. Haid, Jr., MD Chairperson Elect Chairperson Elect Chairperson Elect Paul C. McCormick, MD Stephen M. Papadopoulos, MD Gerald E. Rodts, Jr., MD Secretary Secretary Secretary Nevan G. Baldwin, MD Vincent C. Traynelis, MD Charles L. Branch, Jr., MD Treasurer Treasurer Treasurer Gerald E. Rodts, Jr., MD Curtis A. Dickman, MD Timothy C. Ryken, MD Immediate Past Chairperson Immediate Past Chairperson Immediate Past Chairperson Vincent C. Traynelis, MD Edward C. Benzel, MD Nevan G. Baldwin, MD Members-at-Large Members-at-Large Members-at-Large H. Louis Harkey, III, MD Charles L. Branch, Jr., MD Joseph T. Alexander, MD Srinath Samudrala, MD Mark N. Hadley, MD Ronald I. Apfelbaum, MD Lloyd Zucker, MD John E. McGillicuddy, MD Robert F. Heary, MD

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES PAST OFFICERS 5

1996 1993 1989 1984 Chairperson Chairperson Chairperson Chairperson Edward C. Benzel, MD Edward C. Tarlov, MD Edward S. Connolly, MD Russell W. Hardy, Jr., MD Chairperson Elect Chairperson Elect Chairperson Elect Secretary Richard G. Fessler, MD, PhD Russell L. Travis, MD Carole A. Miller, MD Stewart B. Dunsker, MD Secretary Secretary Secretary Treasurer Stephen M. Papadopoulos, Arnold H. Menezes, MD Volker K. H. Sonntag, MD Edward S. Connolly, MD MD Treasurer Treasurer Members-at-Large Treasurer Russell L. Travis, MD Russell L. Travis, MD Henry H. Schmidek, MD Peter M. Klara, MD, PhD Immediate Past Chairperson Members-at-Large Immediate Past Chairperson Volker K. H. Sonntag, MD Arnold H. Menezes, MD 1983 Arnold H. Menezes, MD Members-at-Large Donald J. Prolo, MD Chairperson Members-at-Large Edward C. Benzel, MD Sanford J. Larson, MD, PhD Gary L. Rea, MD Gary L. Rea, MD 1988 Secretary Nancy Epstein, MD Chairperson Stewart B. Dunsker, MD John E. McGillicuddy, MD 1992 Stewart B. Dunsker, MD Treasurer Ex-Officio Members Chairperson Secretary Edward S. Connolly, MD Kevin T. Foley, MD Volker K. H. Sonntag, MD Carole A. Miller, MD Members-at-Large Mark N. Hadley, MD Chairperson Elect Treasurer Henry H. Schmidek, MD Edward C. Tarlov, MD Edward C. Tarlov, MD 1995 Secretary Members-at-Large 1982 Chairperson Arnold H. Menezes, MD Phanor L. Perot, Jr., MD Chairperson Arnold H. Menezes, MD Treasurer Volker K. H. Sonntag, MD Sanford J. Larson, MD, PhD Chairperson Elect Russell L. Travis, MD Secretary Edward C. Benzel, MD Members-at-Large 1987 Stewart B. Dunsker, MD Secretary Donald J. Prolo, MD Chairperson Treasurer Stephen M. Papadopoulos,MD Melville P. Roberts, MD Stewart B. Dunsker, MD Edward S. Connolly, MD Treasurer Secretary Members-at-Large Peter M. Klara, MD, PhD 1991 Carole A. Miller, MD Henry H. Schmidek, MD Immediate Past Chairperson Chairperson Treasurer Russell L. Travis, MD Carole A. Miller, MD Edward C. Tarlov, MD 1981 Members-at-Large Chairperson Elect Members-at-Large Chairperson Gary L. Rea, MD, Volker K. H. Sonntag, MD Phanor L. Perot, Jr., MD Nancy Epstein, MD Sanford J. Larson, MD, PhD Secretary Volker K. H. Sonntag, MD John E. McGillicuddy, MD Secretary Arnold H. Menezes, MD Ex-Officio Members Stewart B. Dunsker, MD Treasurer 1986 Kevin T. Foley, MD Treasurer Russell L. Travis, MD Mark N. Hadley, MD Chairperson Edward S. Connolly, MD Members-at-Large George W. Sypert, MD Members-at-Large Donald J. Prolo, MD 1994 Secretary Henry H. Schmidek, MD Melville P. Roberts, MD Henry H. Schmidek, MD Chairperson Treasurer Russell L. Travis, MD 1980 1990 Edward S. Connolly, MD Chairperson Elect Chairperson Chairperson Members-at-Large Arnold H. Menezes, MD Sanford J. Larson, MD, PhD Edward S. Connolly, MD Carole A. Miller, MD Secretary Secretary Chairperson Elect Stephen M. Papadopoulos,MD Stewart B. Dunsker, MD Carole A. Miller, MD 1985 Treasurer Treasurer Secretary Peter M. Klara, MD, PhD Chairperson Edward S. Connolly, MD Volker K. H. Sonntag, MD Russell W. Hardy, MD Immediate Past Chairperson Members-at-Large Treasurer Edward C. Tarlov, MD Secretary Philip R. Weinstein, MD Russell L. Travis, MD Henry H. Schmidek, MD Members-at-Large Members-at-Large Edward C. Benzel, MD Treasurer Arnold H. Menezes, MD Nancy Epstein, MD Edward S. Connolly, MD Donald J. Polo, MD Gary L. Rea, MD Members-at-Large George W. Sypert, MD

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 6 PAST PROGRAM COMMITTEES

2004 Daniel K. Resnick, MD Perry A. Ball, MD Robert J. Martin, MD Joseph T. Alexander, MD Gerald E. Rodts, Jr., MD Allan J. Belzberg, MD John E. McGillicuddy, MD Paul M. Arnold, MD Timothy C. Ryken, MD Brian G. Cuddy, MD Gary L. Rea, MD Andrew T. Daily, MD Kenneth S. Yonemura, MD Curtis A. Dickman, MD Stephen M. Papadopoulos, MD Michael W. Groff, MD Kevin T. Foley, MD Noel I. Perin, MD Regis W. Haid, Jr., MD 2000 H. Louis Harkey, III, MD Moris Senegor, MD Robert F. Heary, MD Joseph T. Alexander, MD James P. Hollowell, MD Michael G. Kaiser, MD Paul M. Arnold, MD David G. Kline, MD 1992 Charles Kuntz IV, MD Nevan G. Baldwin, MD Paul C. McCormick, MD Bennett Blumenkopf, MD Rajiv Midha, MD Perry A. Ball, MD Christopher G. Paramore, MD Charles L. Branch, Jr., MD Daniel K. Resnick, MD Christopher H. Comey, MD Noel I. Perin, MD David W. Cahill, MD, FACS Christopher I. Shaffrey, MD Brian G. Cuddy, MD Charles B. Stillerman, MD Richard G. Fessler, MD, PhD Gregory R. Trost, MD Michael G. Fehlings, MD Stephen M. Papadopoulos, MD Gregory C. Wiggins, MD Allan H. Friedman, MD 1996 Gary L. Rea, MD Mitchell R. Gropper, MD Nevan G. Baldwin, MD 2003 Regis W. Haid, Jr., MD Brian G. Cuddy, MD 1991 Joseph T. Alexander, MD Andrea L. Halliday, MD Kevin T. Foley, MD Joy Aprin, MD Edward C. Benzel, MD H. Louis Harkey, III, MD Allan H. Friedman, MD Benjamin G. Benner, MD Eugene A. Bonaroti, MD Robert F. Heary, MD Regis W. Haid, Jr., MD Lawrence F. Borges, MD Andrew T. Dailey, MD R. John Hurlbert, MD, PhD H. Louis Harkey, III, MD Nancy Epstein, MD Michael G. Fehlings, MD, PhD John Knightly, MD Patrick W. Hitchon, MD Emily D. Friedman, MD Michael W. Groff, MD Carl Lauryssen, MD James P. Hollowell, MD Regis W. Haid, Jr., MD Allan D. Levi, MD, PhD, FRCS Richard K. Osenbach, MD 1990 Robert F. Heary, MD Christopher G. Paramore, MD Allan H. Friedman, MD Bennett Blumenkopf, MD Jaimie M. Henderson, MD Gerald E. Rodts, Jr., MD Noel I. Perin, MD Paul D. Dernbach, MD Michael G. Kaiser, MD William S. Rosenberg, MD Robert B. Snow, MD Nancy Epstein, MD Daniel H. Kim, MD Timothy C. Ryken, MD Richard H. Tippets, MD Edward C. Tarlov, MD Rajiv Midha, MD Robert L. Tiel, MD Dennis G. Vollmer, MD Praveen V. Mummaneni, MD Vincent C. Traynelis, MD 1989 Christopher G. Paramore, MD Christopher J. Wolfla, MD 1995 John C. Godersky, MD Gregory J. Przybylski, MD Eric J. Woodard, MD Charles L. Branch, Jr., MD Patrick W. Hitchon, MD Daniel K. Resnick, MD Seth M. Zeidman, MD David W. Cahill, MD, FACS Arnold H. Menezes, MD Christopher I. Shaffrey, MD Paul R. Cooper, MD Carole A. Miller, MD 1999 Curtis A. Dickman, MD Russell L. Travis, MD 2002 Joseph T. Alexander, MD Michael G. Fehlings, MD Joseph T. Alexander, MD Nevan G. Baldwin, MD Regis W. Haid, Jr., MD 1988 Michael W. Groff, MD Allan J. Belzberg, MD H. Louis Harkey, III, MD Melville P. Roberts, MD Mitchell R. Gropper, MD Charles L. Branch, Jr., MD James P. Hollowell, MD Richard Saunders, MD Regis W. Haid, Jr., MD Brian G. Cuddy, MD Peter M. Klara, MD, PhD Volker K. H. Sonntag, MD Robert F. Heary, MD Richard G. Fessler, MD, PhD John Knightly, MD Russell L. Travis, MD Michael G. Kaiser, MD Michael G. Fehlings, MD John E. McGillicuddy, MD Harold A. Wilkinson, MD Charles Kuntz, IV, MD Kevin T. Foley, MD Eugene Rossitch, Jr., MD Rajiv Midha, MD Regis W. Haid, Jr., MD Charles B. Stillerman, MD 1987 Christopher G. Paramore, MD Andrea L. Halliday, MD Vincent C. Traynelis, MD Joel N. Abromovitz, MD Gregory J. Przybylski, MD H. Louis Harkey, III, MD Timothy Harrington, MD Daniel K. Resnick, MD Noel I. Perrin, MD 1994 Robert S. Hood, MD Gerald E. Rodts, Jr., MD Stephen M. Papadopoulos, MD David W. Cahill, MD, FACS Volker K. H. Sonntag, MD Timothy C. Ryken, MD Gerald E. Rodts, Jr., MD Curtis A. Dickman, MD Brian R. Subach, MD Robert L. Tiel, MD Richard G. Fessler, MD, PhD 1986 Peter G. Gianaris, MD Stanley J. Goodman, MD 2001 1998 H. Louis Harkey, III, MD Barth A. Green, MD Joseph T. Alexander, MD Nevan G. Baldwin, MD Paul C. McCormick, MD John F. Howe, MD Barry D. Birch, MD Charles L. Branch, Jr., MD Russ P. Nockels, MD Hector E. James, MD Michael G. Fehlings, MD Brian G. Cuddy, MD Moris Senegor, MD Randall W. Smith, MD Richard G. Fessler, MD, PhD Richard G. Fessler, MD, PhD Vincent C. Traynelis, MD Volker K. H. Sonntag, MD Regis W. Haid, Jr., MD H. Louis Harkey, III, MD Philip R. Weinstein, MD H. Louis Harkey, III, MD Gerald E. Rodts, Jr., MD 1993 Robert F. Heary, MD Charles L. Branch, Jr., MD 1985 R. John Hurlbert, MD, PhD 1997 David W. Cahill, MD, FACS Barth A. Green, MD Rajiv Midha, MD Ronald I. Apfelbaum, MD Curtis A. Dickman, MD George W. Sypert, MD Stephen L. Ondra, MD Paul M. Arnold, MD Richard G. Fessler, MD, PhD Christopher G. Paramore, MD Nevan G. Baldwin, MD Regis W. Haid, Jr., MD

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES AWARDS & FELLOWSHIPS 7

MERITORIOUS SERVICE AWARD John A. Jane, Sr., MD, PhD John Anthony Jane was born in September 1931 in Chicago, Illinois. He graduated from the University of Chicago with a B.A., cum laude in 1951. He then attended the University of Chicago School of Medicine, receiving his Doctor of Medicine in 1956. He did his internship at the Royal Victoria Hospital at McGill University and returned to begin his neurosurgical residency at the University of Chicago clinics in 1957 with Dr. Sean Mullan. In 1958 he was a Fellow in Neurophysiology at Montreal Neurological Institute with Dr. Herbert Jasper.

In 1959 he was a Senior Fellow in Neuropathology and in 1960 a Demonstrator in Neuropathology, both at McGill University in Montreal. In 1961 he was a Research Assistant in Neurosurgery to Sir Wylie McKissock at Atkinson Morleys Hospital in London, England. In 1962, he was a Research Associate with the Department of Psychology at Duke University with Irving T. Diamond who was his PhD advisor. He then completed his neurosurgical residency in 1963-1964 at the University of Illinois Research and Educational Hospital and the Illinois Neuropsychiatric Institute with Oscar Sugar and Eric Oldberg. The year 1965 found Dr. Jane as Senior Instructor in Neurosurgery at Case Western Reserve University. In 1967, Dr. Jane completed and was awarded a PhD from the University of Chicago, Division of Biological Sciences, Section of Biopsychology. After 4 years at Case Western Reserve, Dr. Jane assumed in 1969, his present position as Professor and Chairman of the Department of Neurosurgery, University of Virginia School of Medicine in Charlottesville, Virginia. MERITORIOUS SERVICE While at Case Western Reserve with Frank Nulsen, he was involved in the training of AWARD RECIPIENTS Donald Becker, Harold Young, and Martin Weiss. Subsequently, at the University of 2006 John A. Jane, Sr., MD, PhD Virginia, in the training of 17 Professors, 11 of whom became Chairmen, 6 Associate 2005 Ulrich Batzdorf, MD Professors, and 8 Assistant Professors. Dr. Jane became a member of the Editorial Board of the Journal of Neurosurgery in 1984. He became the Chairman of the 2004 Russell W. Hardy, Jr., MD Editorial Board in 1990, the Associate Editor in 1991 and in 1992, he was elected 2003 Edward C. Benzel, MD Editor. He is also Editor and founder the of The Journal of Neurosurgery: Spine and Journal 2002 No Award Presented of Neurosurgery: Pediatrics. 2001 Stewart B. Dunsker, MD He is the past Director of the American Board of Neurological Surgery completing his 2000 Arnold H. Menezes, MD term in 1996. Dr. Jane was elected to be Vice President of the Society of Neurological 1999 Volker K. H. Sonntag, MD Surgeons in 1988, and was also elected to be President of the Society in 1993. Among 1998 Russell L. Travis, MD his awards, he received the Grass Prize and Medal of the Society of Neurological Surgeons for Meritorious Research (1985), Herbert Olivecrona Lectureship of the 1997 David G. Kline, MD Karolinska Institute of Stockholm, Sweden (1985), 29th Annual Fellows Day Lecturer, 1996 No Award Presented Montreal Neurological Institute, Montreal, Quebec, Canada (1986), Alumni Award for 1995 No Award Presented Distinguished Service, University of Chicago (1988), Honored Guest, Congress of 1994 Sanford J. Larson, MD, PhD Neurological Surgeons (1995), Honored Guest, Joint Annual Congress of the Surgical Society, Taipei, Taiwan (1996), Sir Wylie McKissock Neuroscience Lecturer, Atkinson 1993 Joseph A. Epstein, ME Morley Neuroscience Centre, London, England (1997), William Feindel Lecturer, 1992 Charles A. Fager, MD Montreal Neurological Institute (1998), Jamieson Memorial Lecturer, Neurosurgical 1991 Frank H. Mayfield, MD Society of Australasia, Australia (1998), Lifetime Achievement Award, American Cleft Palate-Craniofacial Association (1999), Recipient of Kurt Schurmann Professorship, 1990 Ralph B. Cloward, MD Hannover, Germany (1999), Decade of the Brain Medalist, CNS/AANS (1999),the Decade of the Brain Award, American Association of Neurological Surgeons (2000), Schneider Lecturer, American Association of Neurological Surgeons (2000), the Distinguished Service Award by the American Association of Neurological Surgeons (2002), the NSA Medallist, Neurosurgical Society of America (2002), the Distinguished Service Award, Society of Neurological Surgeons (2003), the Cushing Medalist, American Association of Neurological Surgeons (2004), the WFNS Medal of Honour at the XIII World Congress of Neurosurgery Meeting (2005), the Congress of Neurological Surgeons Founder’s Laurel Award (2005), and the AANS/CNS Section on Disorders of the Spine and Peripheral Nerves Meritorious Service Recognition (2006).

He is married to Noella Fortier of Montreal, Quebec, Canada. The Jane’s have four grown children (3 daughters and 1 son), six grandsons and two granddaughters.

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 8 AWARDS & FELLOWSHIPS

AWARDS RESEARCH FUNDING On pages 8–13, general information The AANS/CNS Section on Disorders of the Spine and Peripheral Nerves has regarding section sponsored research established three research grants: the Ronald Apfelbaum Research Award, the and fellowship awards are listed. David Kline Research Award, and the Sanford Larson Research Award. These For more information, visit the awards are intended to establish funding for clinical relevant research related to Spine Section Web site at: the spine and peripheral nerves, and to provide a means of peer review for clinical www.spinesection.org. research projects to help improve the quality of the proposal and therefore, enhance competitiveness for National Institutes of Health (NIH) funding. The awards are also meant to create an annual funding mechanism to establish the AANS/CNS Section on Disorders of the Spine and Peripheral Nerves as a known source for quality clinical research aimed at answering questions pertaining to the treatment of disorders of the spine and peripheral nerves. Depending upon the quality of the award submissions, there may be one award in each category annually.

INTERNATIONAL FELLOWSHIP FUNDING The H. Alan Crockard International Fellowship, will not be awarded in 2006. The Volker K. H. Sonntag International Fellowship, sponsored by Medtronic Sofamor Danek, is awarded annually to a neurosurgical resident or neurosurgeon from outside of the U.S. or Canada to provide supplemental funding for advanced education and research in disorders of the spine in the form of a fellowship experience in the United States or Canada. The amount of each award is $5,000. Applicants must provide a letter of acceptance from the designated mentor and program, a letter of support from their training program director, if applicable, a description of the proposed fellowship with the educational or research goals, and a current curriculum vitae.

DOMESTIC FELLOWSHIP FUNDING The David Cahill Fellowship will not be awarded in 2006. The Ralph Cloward Fellowship, sponsored by Medtronic Sofamor Danek, is awarded annually to one U.S. or Canadian trained neurosurgical resident to provide supplemental funding for advanced education and research in disorders of the spine or peripheral nerves in the form of fellowship training away from their parent institution. The amount of the award is $30,000. Applicants should be residents in training or ABNS eligible fellows, must provide a letter of acceptance from the designated mentor and program, a letter of support from their training program director, a description of the proposed fellowship with the educational or research goals, and a current curriculum vitae.

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES AWARDS & FELLOWSHIPS 9

RONALD APFELBAUM DAVID KLINE RESEARCH AWARD RESEARCH AWARD The Ronald Apfelbaum Research Award, sponsored by The David Kline Research Award, sponsored by Integra, is Aesculap, is dedicated to basic or clinical spine research and dedicated to basic or clinical peripheral nerve research and includes funding up to $15,000. includes funding up to $15,000. It is intended for primary investigators with proposed research It is intended for primary investigators with proposed requiring national level funding, to support the preparation research requiring national level funding, to support the of grant proposals and external consultations and to assist in preparation of grant proposals and external consultations the development of the proposal, planning meetings, and the and to assist in the development of the proposal, planning collection of pilot data. Work that can be completed without meetings, and the collection of pilot data. Work that can be such support (such as literature review and preliminary completed without such support (such as literature review protocol design) should be completed before applying for and preliminary protocol design) should be completed this award. before applying for this award. The format of the proposal should follow that of the NIH The format of the proposal should follow that of the grant package. The applicants should clearly define their NIH grant package. The applicants should clearly define specific aims, include a pertinent literature review, describe their specific aims, include a pertinent literature review, the proposed methodology and plan for analysis of data. describe the proposed methodology and plan for analysis This part of the proposal should not exceed 10 double- of data. This part of the proposal should not exceed 10 spaced pages. A detailed budget and budget justification double-spaced pages. A detailed budget and budget should also be included. The budget should not include justification should also be included. The budget should salary support for the primary investigator or co-investigators. not include salary support for the primary investigator or Also, institutional indirect costs are not to be met using the co-investigators. Also, institutional indirect costs are not to awards. be met using the award.

DANIEL M. SCIUBBA, MD MARCELO MAGALDI RIBEIRO Daniel M. Sciubba, MD, is a senior DE OLIVEIRA, MD, MS resident in the department of neurological surgery at Johns Hopkins A native of Brazil, Dr. Magaldi Ribeiro University. His research interests include de Oliveira was born in Sao Paulo and spinal column and spinal cord tumors, raised in Rio de Janeiro. He studied at the and the main goal of his research time is Federal University of Minas Gerais-UFMG. to conduct translational spinal oncology In 1997, he completed his neurosurgery research under the direction of Dr. Ziya residency and traveled to France, com- Gokaslan, MD. Specifically, he hopes to pleting a one-year general neurosurgery improve treatment of metastatic spine tumors by combining fellowship in Amiens, followed by a one- local delivery of small inhibitory RNA (siRNA) with radiation year neuro-oncology fellowship in Paris. therapy in a rat spine tumor model. He plans on an In 2000, he began a radiosurgery research fellowship at the academic career focused on complex spine and spine University of Virginia, where he earned a Master of Science tumor surgery. degree, completed in 2003. He also spent nine months at British Columbia Children’s Hospital working on a pediatric fellowship.

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 10 AWARDS & FELLOWSHIPS

SANFORD LARSON DAVID CAHILL RESEARCH AWARD FELLOWSHIP The Sanford Larson Research Award, sponsored by DePuy The David Cahill Fellowship is awarded annually to one Spine, is limited to clinical research, and includes funding U.S. or Canadian trained neurosurgical resident, to provide up to $30,000. supplemental funding for advanced education and research in disorders of the spine or peripheral nerves in the form of It is intended for primary investigators with proposed fellowship training away from their parent institution. The research requiring national level funding, to support the amount of the award is $30,000. preparation of grant proposals and external consultations and to assist in the development of the proposal, planning Applicants should be residents in training or ABNS eligible meetings, and the collection of pilot data. Work that can fellows, must provide a letter of acceptance from the be completed without such support (such as literature designated mentor and program, a letter of support review and preliminary protocol design) should be from their training program director, a description of the completed before applying for this award. proposed fellowship with the educational or research goals, and a current curriculum vitae. The format of the proposal should follow that of the NIH grant package. The applicants should clearly define their The David Cahill Fellowship will not be awarded in 2006. specific aims, include a pertinent literature review, describe the proposed methodology and plan for analysis of data. This part of the proposal should not exceed 10 double- spaced pages. A detailed budget and budget justification should also be included. The budget should not include salary support for the primary investigator or investigators. Also, institutional indirect costs are not to be met using the awards.

NEIL DUGGAL, MD Dr. Duggal is an Assistant Professor at the University of Western Ontario and an Associate Scientist at the Robarts Research Institute in London, Canada. Born in Toronto, Dr. Duggal received his medical degree from the University of Ottawa. He completed his residency in neurological surgery at the University of Western Ontario and a fellowship in spinal surgery at the Barrow Neurological Institute. During his residency Dr. Duggal obtained a Masters in Science with a focus on stem cell proteins. His present research efforts focus on the clinical, radiographic and biomechanical outcomes of spinal arthroplasty as well as the epidemiology and biomechanics of spinal trauma. Dr. Duggal’s research has been recognized by the Cervical Spine Research Society and the Royal College of Physicians and Surgeons of Canada.

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES AWARDS & FELLOWSHIPS 11

CLOWARD FELLOWSHIP VOLKER K. H. SONNTAG The Ralph Cloward Fellowship, sponsored by Medtronic INTERNATIONAL Sofamor Danek, is awarded annually to one U.S. or Canadian trained neurosurgical resident, to provide FELLOWSHIP supplemental funding for advanced education and The Volker K. H. Sonntag International Fellowship is research in disorders of the spine or peripheral nerves in sponsored by Medtronic Sofamor Danek and is awarded the form of fellowship training away from their parent annually to a neurosurgical resident or neurosurgeon from institution. The amount of the award is $30,000. outside of the U.S. or Canada to provide supplemental Applicants should be residents in training or ABNS eligible funding for advanced education and research in disorders fellows, must provide a letter of acceptance from the of the spine in the form of a fellowship experience in the designated mentor and program, a letter of support from United States or Canada. The amount of the award is their training program director, a description of the $5,000. proposed fellowship with the educational or research Applicants must provide a letter of acceptance from the guide and a current curriculum vitae. designated mentor and program, a letter of support from their training program director, if applicable, a description of the proposed fellowship with the educational research ZIV WILLIAMS, MD goals, and a current curriculum vitae. Dr. Williams is a currently chief resident in neurosurgery at Massachusetts General Hospital, Harvard Medical School, and ASHOK GUPTA, MD, MCh will be undertaking a peripheral nerve A native of India, Dr. Gupta is presently fellowship at the Mayo Clinic in 2007. working as associate professor and head He received his degree in biochemistry of the Department of Neurosurgery at and cell biology from UC San Diego, and the University of Rajasthan at Govt. medical degree from Stanford University. Medical College, Kota. He received an His principle aims are to integrate his International Guest Scholarship from the interests in functional neurosurgery, peripheral nerve German Society of Surgeons in May, surgery and basic primate neurophysiology in order to 2005. Dr. Gupta obtained his magister understand cognitive signals responsible for motor control, chirurgery in neurosurgery in 1996. In 1999, he completed and to develop new techniques for functionally bypassing a fellowship in radiosurgery and stereotactic neurosurgery at spinal cord and peripheral nerve injuries. Karl Franzes University in Graz, Austria. He is a life member of both the Neurological Society of India and the Indian Medical Association.

CLOWARD FELLOWSHIP RECIPIENTS

2006 Ziv Williams, MD, Boston, MA 2005 John O’Toole, MD, New York, NY 2004 John K. Song, MD, Nashville, TN 2003 Michael P. Steinmetz, MD, Cleveland, OH 2002 Langston T. Holly, MD, Los Angeles, CA 2001 Jason E. Garber, MD, Houston, TX 2000 Larry T. Khoo, MD, Los Angeles, CA 1999 No Award Presented 1998 No Award Presented 1997 No Award Presented 1996 Simcha J. Weller, MD, Boston, MA 1994 Christopher I. Shaffrey, MD, Charlottesville, VA 1995 R. John Hurlbert, MD, PhD, Toronto, ON, Canada 1993 Ziya L. Gokaslan, MD, Houston, TX

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 12 AWARDS & FELLOWSHIPS

The Mayfield Award is presented annually by the AANS/CNS Section on MAYFIELD AWARDS Disorders of the Spine and Peripheral Nerves to the neurosurgical resident BASIC SCIENCE AWARD or BC/BE fellow in North American training, who authors an outstanding TOSHITAKA SEKI, MD manuscript detailing a laboratory or Toshitaka Seki received his medical degree from Asahikawa clinical investigation in the area of Medical University in Japan. After completing his residency spinal or peripheral nerve disorders. training in neurological surgery at the Asahikawa Medical This award is also applicable to University Hospital, Dr. Seki undertook a clinical and research individuals in DO training programs. fellowship in spine and spinal cord surgery at the University of The manuscript for this award is Hokkaido Graduate School of Medicine where he received a presented by attaching it to the related PhD in medical science. Since September 2004, Dr. Seki has abstract in the call for abstract process. been a postdoctoral research fellow in the laboratory of Michael G. Fehlings, MD, PhD, FRCSC at the University of Two awards are available, one for Toronto where he has been examining the cellular and molecular mechanisms clinical research and one for basic of posttraumatic syringomyelia. science research. Each recipient will receive a $1,000 cash award, and an honorarium up to $2,000 to cover the expenses of attendance at the Section’s annual meeting. Abstracts to be considered for the CLINICAL SCIENCE AWARD Mayfield Award should be identified as such on the annual meeting abstract BENSON YANG, MD submission form, and submitted prior Benson Yang, MD is currently a resident at Northwestern to deadline. University. He received his undergraduate degree in electrical engineering and computer science from the Massachusetts Institute of Technology and his medical degree from Yale University. Dr. Yang recently completed subspecialty training in complex and minimally invasive spine surgery at Northwestern. His interests lie in the development and application of novel technologies.

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES AWARDS & FELLOWSHIPS 13

MAYFIELD AWARD RECIPIENTS

2005 1999 1990 Basic Science Basic Science R. John Hurlbert, MD, PhD John Y. K. Lee, MD Steven Casha, MD Toronto, ON, Canada Pittsburgh, PA Toronto, ON, Canada 1989 Clinical Science Clinical Science Richard K. Simpson, Jr., MD Nicholas H. Post, MD Nicholas Theodore, MD Houston, TX New York, NY Phoenix, AZ

2004 1998 1988 No Award Presented Basic Science Tord D. Alden, MD Bryan B. Barnes, MD Charlottesville, VA 1987 Atlanta, GA 1997 John A. Feldenzer, MD Clinical Science Ann Arbor, MI Michael A. Morone, MD, PhD Michael Y. Wang, MD Atlanta, GA Los Angeles, CA 1986 No Award Presented 2003 1996 Basic Science Basic Science 1985 Paul C. Francel, MD No Award Presented Abhijit Guha, MD Troy, VA Toronto, ON, Canada Clinical Science Clinical Science No Award Presented Paul D. Sawin, MD 1984 2002 Iowa City, IA Mark N. Hadley, MD Phoenix, AZ Basic Science 1995 Edward R. Smith, MD Simcha J. Weller, MD Quincy, MA Boston, MA Clinical Science Ketan R. Bulsara, MD 1994 Durham, NC Timothy C. Ryken, MD Iowa City, IA 2001 Basic Science 1993 Ketan R. Bulsara, MD Clinical Science Durham, NC Gerald F. Tuite, MD Ann Arbor, MI Clinical Science Gordon W. Tang, MD Basic Science Atlanta, GA Allan D. Levi, MD, PhD, FRCS Miami, FL 2000 Basic Science 1992 Neill M. Wright, MD Rajiv Midha, MD St. Louis, MO Toronto, ON, Canada

Clinical Science 1991 Viswanathan Rajaraman, MD, FRCS Peter G. Gianaris, MD Newark, NJ Eau Claire, WI

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 14 DISCLOSURE LISTING

DISCLOSURE LISTING Ronald I. Apfelbaum, MD Kevin T. Foley, MD Consultant Consultant The AANS/CNS Section on Disorders Aesculap, Integra Neurosciences Medtronic Sofamor Danek of the Spine and Peripheral Nerves and the AANS control the content and Stock Shareholder (Directly Purchased) Julio C. Furlan, MD, PhD Medtronic Grants/Research Support production of this CME activity and Henry A. Beatty Scholarship, Lawson attempt to assure the presentation Donald P. Atkins, MD, FACS Fellow-Neurology from the Toronto Consultant of balanced, objective information. General & Western Hospital Foundation In accordance with the Standards Abbott, Kyphon, for Commercial Support established Medtronic Sofamor Danek Fred H. Geisler, MD, PhD Grants/Research Support by the Accreditation Council for Ray M. Baker, MD DePuy Spine Continuing Medical Education, Consultant speakers and paper presenters are DePuy Spine, Smith & Nephew Richard D. Guyer, MD asked to disclose any relationship Consultant Honorarium DePuy Spine they or their co-authors have with Smith & Nephew commercial companies which may be Regis W. Haid, Jr. Giancarlo Barolat, MD related to the content of their lecture. Other Financial or Material Support Consultant Medtronic Sofamor Danek Speakers and paper presenters/ Advanced Neuromodulation Systems authors who have disclosed a Tom Hedman, PhD Allan J. Belzberg, MD relationship* with commercial Stock Shareholder (Directly Purchased) Grants/Research Support Orthopeutics companies whose products may DOD, Pfizer, UCB Pharma have a relevance to their Iain H. Kalfas, MD Edward C. Benzel, MD presentation are listed here. Other Financial or Material Support Consultant Z-KAT Abbott, OrthoMEMS *Relationship refers to receipt of royalties, Dean G. Karahalious, MD consultantship, funding by research Other Financial or Material Support Consultant DePuy grant, receiving honoraria for educational Medtronic Sofamor Danek services elsewhere, or any other relation- Charles L. Branch, Jr, MD Grants/Research Support ship to a commercial company that Consultant CINN Foundation provides sufficient reason for disclosure. Medtronic Frank La Marca, MD Darrel S. Brodke, MD Consultant Grants/Research Support Johnson & Johnson, Medtronic DePuy Spine Isador Lieberman, MD, FRCSC J. Kenneth Burkus, MD Stock Shareholder (Directly Purchased) Consultant Axiomed, Merlot OrthopediX Medtronic Sofamor Danek Grants/Research Support Neil J. Cochrane, MBCHB DePuy, Kyphon, Merlot OrthopediX Grants/Research Support Medtronic Sofamor Danek Other Financial or Material Support DePuy, Stryker, TranS1, Inc. Christopher H. Comey, MD Consultant Chris A. Lycette, MD Medtronic Sofamor Danek, Spinewave Grants/Research Support DePuy Acromed Rick Delamarter, MD Grants/Research Support Paul C. McAfee, MD Synthes Other Financial or Material Support Cervitech, DePuy Spine Harel Deutsch, MD Consultant Mark K. McLaughlin, MD EBI, Stryker Consultant Medtronic Sofamor Danek Richard G. Fessler, MD, PhD Other Financial or Material Support DePuy Acromed, Medtronic Sofamor Danek

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES DISCLOSURE LISTING 15

Ehud Mendel, MD, FACS Ashwini D. Sharan, MD Consultant Consultant DePuy Spine Endius, Inc. Honorarium Honorarium AO North America, Synthes Medtronic Neurosurgery William Mitchell, MD Speaker’s Bureau Honorarium Advanced Neuromodulation Systems DePuy Spine Praveen V. Mummaneni, MD Lawrence M. Spetka, MD Consultant Grants/Research Support DePuy Spine, Medtronic DePuy Spine Other Financial or Material Support Christopher I. Shaffrey, MD DePuy Spine, Medtronic Sofamor Danek Honorarium DePuy Spine, Medtronic Sofamore Richard K. Osenbach, MD Danek, Synthes Spine Honorarium Medtronic Joseph B. Stachniak, MD Consultant Stephen M. Papadopoulos, MD Medtronic Stock Shareholder (Directly Purchased) Medtronic Najeeb M. Thomas, MD Consultant Mick J. Perez-Cruet, MD Medtronic Grants/Research Support Abbott Spine, Aesculap, Medtronic Vincent C. Traynelis, MD Sofamor Danek, US Spine Michael Y. Wang, MD Luiz Pimenta, MD, PhD Consultant Consultant Aesculap, Invictus Spine, SeaSpine Johnson & Johnson, Nuvasive, Inc., Grants/Research Support TranS1, Inc. Apatech, DePuy Spine David W. Polly, Jr., MD William C. Welch, MD Consultant Consultant Medtronic Confluent, DePuy Spine, Stryker Spine Ben Bhupendra Pradhan, MD Grants/Research Support Grants/Research Support Zimmer Spine Synthes Spine Neill M. Wright, MD John K. Ratliff, MD Consultant Consultant Nuvasive, Inc. EBI, Stryker Thomas A. Zdeblick, MD Grants/Research Support Consultant Medtronic Medtronic Sofamor Danek Honorarium EBI, Stryker Daniel K. Resnick, MD Consultant Medtronic Gerald E. Rodts, Jr., MD Consultant Medtronic

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 16 NON-DISCLOSURE LISTING

NOTHING TO DISCLOSE Maged Lotfy Abu-Assal, MD Linda E. A. Kanim, MA Frank L. Acosta, MD Kaveh Khajavi, MD, FACS Speakers and paper presenters/ Yong Ahn, MD Larry T. Khoo, MD authors who have reported they Sami I. Aleissa, MD Keun-Young Kim, MD do not have any relationship Joseph T. Alexander, MD Michael A. Kropf, MD with commercial companies are Michael A. Amaral, MD, FACS Motoo Kubota, MD, PhD listed here. Paul M. Arnold, MD Kosuke Kuribayashi, MD Henry E. Aryan, MD Ho Yeon Lee, MD Stephen F. Badylak, DVM, MD, PhD Sang-Ho Ho Lee, MD, PhD Nicholas C. Bambakidis, MD Allan D. Levi, MD, PhD Deborah L. Benzil, MD Nicholas B. Levine, MD Nicholas M. Boulis, MD James J. Lynch, MD Sigita Burneikiene, MD Kevin E. Macadaeg, MD Mark G. Burnett, MD Joel D. MacDonald, MD John B. Butler, MD Melissa Y. Macias, MD, PhD Amayus P. Chandran, PhD Allen H. Maniker, MD Kyoung Suok Cho, MD, PhD Richard Manos, MD Sean D. Christie, MD John E. McGillicuddy, MD Jay Y. Chun, MD Masaki Mizuno, MD, PhD Induk Chung, PhD John J. Moossy, MD Murat Cosar, III, MD Douglas B. Moreland, MD Denis J. DiAngelo, PhD Paul B. Nelson, MD Vassilios Dimopoulos, MD John C. Oakley, MD Stephen E. Doran, MD Katie Orrico, JD Thomas B. Duckard, MD Guillermo Paradiso, MD, PhD Neil Duggal, MD Sung Ho Park Daniel R. Fassett, MD Mick Perez-Cruet, MD Aaron G. Filler, MD Brian Perri Michael A. Finn, MD Madhavan Pisharodi, MD Shee Yan Fong, MD John Pollina, Jr., MD Kontsantinos N. Fountas, MD Gregory J. Przybylski, MD Bridget Fuhrmann, BSN, RN Joe S. Robinson, MD Vanessa Garlisch Toshitaka Seki, MD, PhD Michele Garrett-Heim Kalpesh Shah Ziya L. Gokaslan, MD, FACS Scott A. Shapiro, MD Jeff D. Golan, MD Hormoz Sheikh, MD Oren N. Gottfried, MD Jung Hyun Shim, MD Arthur A. Grigorian, MD Robert J. Spinner, MD Michael W. Groff, MD Michael P. Steinmetz, MD Peter M. Grossi, MD Brian R. Subach, MD Ho-Yeong Kang, MD Robert L. Tiel, MD Pavel Haninec, MD, Prof. Troy M. Trippett, MD Roger Hartl, MD Gregory R. Trost, MD Robert F. Heary, MD Alan T. Villavicencio, MD Virany H. Hillard, MD Frederick Vincent, MD Kim Holderfield, MSc Jeffrey C. Wang, MD Peter H. Hollis, MD Jenifer Wolff John K. Houten, MD Shokei Yamada, MD Patrick Hsieh, MD Benson P. Yang, MD R. John Hurlbert, MD, PhD Wenru Yu, MD Line Jacques, MD Zafer Yuksel, MD John A. Jane, Sr., MD, PhD Eric L. Zager, MD Arthur L. Jenkins, III, MD J. Patrick Johnson, MD Vivek Vivek Joseph, MBBS, FRCS Kyle Judd, BS

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEETING AGENDA 17

WEDNESDAY, MARCH 15 8:00 AM – 12:30 PM SPECIAL COURSE II GREAT HALL WEST 7:00 AM – 12:45 PM SPECIAL COURSE I Coding Update and Review GREAT HALL EAST Additional $200 for medical registrants, includes lunch. Interventional Spine Surgery – Didactic and Hands On Director: Gregory J. Przybylski, MD Faculty: Robert R. Johnson, II, MD, FACS Capacity: 32 Additional $200 for medical registrants, includes lunch. COURSE DESCRIPTION This course will present current issues in spine coding and Director: John C. Oakley, MD review various coding scenarios for correct coding of complex Faculty: Ray M. Baker, MD; Isador Lieberman, MD; spinal procedures. Kevin E. Macadaeg, MD; Mark R. McLaughlin, MD, Richard M. Spiro, MD, MPH LEARNING OBJECTIVES Upon completion of this course, participants should be able to: COURSE DESCRIPTION • Recognize the newest changes in CPT coding. This session will offer didactic and hands on sessions with • Review the methodology for correct spine coding. various techniques used for the diagnosis and treatment of • Identify specific coding scenarios that can be difficult to common conditions affecting the spine. Topics will include: code and bring clarity to the relevant scenarios. Epidural Injections, Selective Nerve Root Injections, Facet and ______Nerve Root Rhizotomy, Nucleoplasty, Discogram, Vertebroplasty 8:00 AM Introduction and New Codes for 2006 and Kyphoplasty techniques. Gregory J. Przybylski, MD 8:15 AM Surgical Modifiers LEARNING OBJECTIVES Gregory J. Przybylski, MD Upon completion of this course, participants should be able to: 9:15 AM 22000 Series Codes • Describe basic spinal injections. Robert R. Johnson, II, MD, FACS • Review the indications for spine interventional procedures. 10:15 AM 63000 Series Codes • Recognize patients with vertebral compression fractures. ______Robert R. Johnson, II, MD, FACS 7:00 AM Welcome and Announcements 11:15 AM Beverage Break John C. Oakley, MD 11:30 AM Coding Scenarios 7:10 AM Epidural Injections Robert R. Johnson, II, MD, FACS Ray M. Baker, MD 12:15 PM Panel Discussion 7:30 AM Nerve Root Injections Robert R. Johnson, II, MD, FACS and Kevin E. Macadaeg, MD Gregory J. Przybylski, MD 7:50 AM Facet and Nerve Root Rhizotomy 12:30 PM Adjournment Richard M. Spiro, MD, MPH ______8:10 AM Nucleoplasty Kevin E. Macadaeg, MD 1:00 – 5:00 PM SPECIAL COURSE III 8:30 AM Discogram GREAT HALL EAST Ray M. Baker, MD Moving Your Practice to the Digital 8:50 AM Vertebroplasty and Kyphoplasty Age/Office Automation Isador Lieberman, MD 9:10 AM Panel Discussion Capacity: 100 Ray M. Baker, MD; Isador Lieberman, MD; Additional $200 for medical registrants, includes lunch. Kevin E. Macadaeg, MD; John C. Oakley, MD; and Director: Joel D. MacDonald, MD Richard M. Spiro, MD, MPH Faculty: Brian R. Greer; David W. Polly, Jr., MD; Ashwini D. 9:45 AM Beverage Break Sharan, MD 10:00 AM Participants walk to OR trucks outside for the hands-on skills lab. 10:15 AM Hands-on Skills Lab 12:30 PM Questions & Answers 12:45 PM Adjournment ______

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 18 MEETING AGENDA

COURSE DESCRIPTION 1:00 PM Introduction This course will address how to evaluate, purchase, and Christopher I. Shaffrey, MD implement a practice management system and electronic 1:10 PM Artificial Disc Replacement Using Charité: health record into your office. The pearls and pitfalls of Overview and Update implementing a “paperless” office will be discussed. Fred. H. Geisler, MD 1:30 PM Artificial Disc Replacement Using Maverick: LEARNING OBJECTIVES Overview and Update Upon completion of this course, participants should be able to: Brian R. Subach, MD • Describe the criteria by which to evaluate utilization and effectiveness of electronic medical records. 1:50 PM Artificial Disc Replacement Using Flexicor: • Discuss negotiating contracts with vendors and pricing Overview and Update protection. Charles D. Theofilos, MD • Discuss market trends and vendor performance. 2:10 PM Artificial Disc Replacement Using Prodisc: ______Overview and Update 1:00 PM Welcome and Announcements Rick Delamarter, MD Joel D. MacDonald, MD 2:30 PM Beverage Break 1:10 PM EMR and PMIS: Alphabet Soup 2:45 PM A Case for Anatomy Preservation Surgery Ashwini D. Sharan, MD Vadim N. Bikmullin, MD, PhD 1:55 PM Telemedicine and the Handshield 3:10 PM Stem Cell Technologies Joel D. MacDonald, MD Jeffrey C. Wang, MD 2:40 PM Beverage Break 3:45 PM Tissue Regeneration 2:55 PM Using the Internet as a Medical Resource Stephen Badylak, DVM, PhD, MD Brian R. Greer 4:20 PM Annular Repair 3:40 PM Pay For Performance (P4P)/ Christopher I. Shaffrey, MD Outcomes Assessments in YOUR Practice 4:45 PM Panel Discussion David W. Polly, Jr., MD Stephen Badylak, DVM, PhD, MD; Vadim N. 4:25 PM Panel Discussion Bikmullin, MD; Rick Delamarter, MD; Fred H. Brian R. Greer; Joel D. MacDonald, MD; David W. Geisler, MD; Christopher I. Shaffrey, MD; Polly, Jr., MD; Ashwini D. Sharan, MD Brian R. Subach, MD; Charles D. Theofilos, MD; 5:00 PM Adjournment Jeffrey C. Wang, MD ______5:00 PM Adjournment ______1:00 – 5:00 PM SPECIAL COURSE IV GREAT HALL WEST 5:30 – 8:00 PM OPENING RECEPTION Motion Maintenance and Disc CROWN HALL Regeneration

Capacity: 100 Additional $200 for medical registrants, includes lunch. THURSDAY, MARCH 16

Director: Christopher I. Shaffrey, MD 6:45 – 7:00 AM WELCOME & ANNOUNCEMENTS Faculty: Stephen Badylak, DVM, PhD, MD; GREAT HALL NORTH & CENTER Vadim N. Bikmullin, MD, PhD; Rick Delamarter, MD; Robert F. Heary, MD, Section Chair Fred H. Geisler, MD, PhD; Brian R. Subach, MD; Charles D. Michael W. Groff, MD, Annual Meeting Chair Theofilos, MD; Jeffrey C. Wang, MD Mark R. McLaughlin, MD, Scientific Program Chair

COURSE DESCRIPTION 7:00 – 9:25 AM SCIENTIFIC SESSION I World Leaders and investigators will discuss the benefits and detriments of current technology and research in disc repair, The Evolution of Cervical Spine Surgery biological replacement, and arthroplasty. Moderator: Vincent C. Traynelis, MD Faculty: Regis W. Haid, Jr., MD; Praveen V. Mummaneni, MD; LEARNING OBJECTIVES Gregory R. Trost, MD Upon completion of this course, participants should be able to: • Recognize indications and pitfalls of arthroplasty. SESSION DESCRIPTION • Identify the advantages of motion preservation. This course will present the current cutting edge techniques for • Recognize indications for less invasive treatments of the treatment of cervical spine disease. spinal disorders.

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEETING AGENDA 19

LEARNING OBJECTIVES • 10:44 – 10:51 AM Upon completion of this session, participants should be able to: 102. Complications with Cervical Arthroplasty • Recognize the newest technologies for cervical fusion. Neil Duggal, London, ON, Canada; Gwynedd E. Pickett, MD • Recognize the biological and biomechanical aspects of FRCS(C), London, ON, Canada; Lali Sekhon, MD, PhD, Spine cervical arthroplasty. Nevada, NV; William Sears, Sydney, Australia • Review the current experiences of senior surgeons that have experience with this technology. • 10:51 – 10:56 AM Discussion ______7:00 AM Cutting-Edge Cervical Fusion: • 10:56 – 11:03 AM BMP/Biologics/Polymers 103. Schwann Cell Transplantation Improves Praveen V. Mummaneni, MD Reticulospinal Fiber Growth and Forelimb Strength 7:30 AM Current Status of Cervical Arthroplasty After Severe Cervical Spinal Cord Contusion Regis W. Haid, Jr., MD Kyoung-Suok Cho, MD, PhD, Seoul, Republic of Korea; 8:00 AM Early Experience with Cervical Discs: Chun-Kun Park, MD, PhD, Seoul, Republic of Korea; Seok-Gu Materials and Imaging Kang, MD, PhD, Seoul, Republic of Korea; Pil-Woo Huh, MD, Gregory R. Trost, MD PhD, Seoul, Republic of Korea; Do-Sung Yoo, MD, PhD, Seoul, Republic of Korea; Dal-Soo Kim, MD, PhD, Seoul, 8:30 AM Pearls and Pitfalls of Cervical Arthroplasty Republic of Korea; Damien Pearse, PhD, Miami, FL; Dalton Vincent C. Traynelis, MD Dietrich, Miami, FL 9:00 AM Panel Discussion Regis W. Haid, Jr., MD; Praveen V. Mummaneni, MD; • 11:03 – 11:10 AM Vincent C. Traynelis, MD; and Gregory R. Trost, MD 104. A Prospective, Multi-Center, Randomized Clinical ______Trial Evaluating Minimally Invasive Versus Open Pedicle 9:25 – 9:40 AM The Future of Spine Screw Instrumentation Robert F. Heary, MD Mick Perez-Cruet, MD, MSc, Southfield, MI; Hormoz Sheikh, Southfield, MI; Boyd Richards, DO, Southfield, MI; Ali Aragi, ______MD, Plano, TX; Mark Spoonamore, MD, Los Angeles, CA; 9:40 – 9:45 AM Meritorious Service Recognition Randall McCafferty, MD, Dayton, OH; Peter Lennarson, MD, Recipient: John A. Jane, Sr., MD, PhD Dayton, OH; William Tobler, MD, Cincinnati, OH ______• 11:10 – 11:17 AM 9:45 – 10:30 AM BEVERAGE BREAK WITH EXHIBITORS 105. The Nerve Grafting, Nerve Transfer, End-To-Side EVENT CENTER Neurorrhaphy and Muscle Transfer in the Treatment of “What’s New” Session #1 Brachial Plexus Injury in the Exhibit Hall Demo Theater Pavel Haninec, MD, Prague, Czech Republic; Robert Tomáˆs, Moderator: Daniel K. Resnick, MD MD, Prague, Czech Republic; Filip Sámal, MD, Prague, Czech Republic; Ladislav Houst’ava, MD, Prague, Czech Republic; ______Petr Dubovy, RN, Brno, Czech Republic 10:30 AM - 12:15 PM ORAL ABSTRACT PRESENTATIONS Moderator: Ziya L. Gokaslan, MD, FACS • 11:17 – 11:22 AM Discussion

• 10:30 – 10:37 AM • 11:22 – 11:29 AM 100. Revisability of the Charité Artificial Disc 106. The Use of Allograft Bone for Posterior C1-2 Fusion Replacement – Analysis of 688 Patients (Revisited) Enrolled in the US IDE Study of the Charité Artificial Disc Virany Huynh Hillard, MD, Salt Lake City, UT; Daniel Fassett, Paul McAfee, MD, Sparks, MD; Fred H. Geisler, MD, MD, Salt Lake City, UT; Meic H. Schmidt, MD, Salt Lake Chicago, IL; Sam Saiedy, MD, Baltimore, MD; Richard City, UT; Ronald I. Apfelbaum, MD, Salt Lake City, UT Guyer, MD, Dallas, TX; John Regan, MD, Los Angeles, CA; Scott Blumenthal, MD, Dallas, TX • 11:29 – 11:36 AM 107. Complications and Retrieval Management of the • 10:37 – 10:44 AM Charité Lumbar Artificial Disk: A Prospective 3-Year 101. Comparison of Osteophyte Formation in Patients Experience with 250 Disks with the BRYAN Disc and Patients with ACDF Luiz Pimenta, MD, PhD, São Paulo, Brazil; Roberto C. Diaz, Stephen M. Papadopoulos, MD, Phoenix, AZ; Vincent C. MD, São Paulo, Brazil; Luis E. Guerrero, MD, São Paulo, Traynelis, MD, Iowa City, IA; Jeffrey P. Rouleau, PhD, Brazil; Claudio Tatsui, MD, São Paulo, Brazil Minneapolis, MN

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 20 MEETING AGENDA

• 11:36 – 11:43 AM LEARNING OBJECTIVES 108. Strategies and Techniques for Correction of Upon completion of this session, participants should be able to: Degenerative and Post-Surgical Cervical Kyphotic • Explain the various options in treating lumbar spine disease Deformity from an anterior approach. Brian Perri, DO, Los Angeles, CA; Adetokunbo Oyelese, MD, • Identify patients that may have better outcomes with Los Angeles, CA; Robert S. Bray, MD, Los Angeles, CA; posterior approaches. J. Patrick Johnson, MD, Los Angeles, CA • Recognize the rationale for approaching the spine either anteriorly or posteriorly. • 11:43 – 11:48 AM Discussion PART I: ANTERIOR • 11:48 – 11:55 AM 1:00 PM Lumbar Arthroplasty is Better Than ALIF 109. Thoracolumbar Vertebral Reconstruction After Fred H. Geisler, MD Surgery for Metastatic Spinal Tumors: Long-Term 1:15 PM ALIF is Better Than Arthroplasty Outcomes Richard G. Fessler, MD Alan Villavicencio, MD, Boulder, CO; Rod Oskouian, MD, 1:30 PM Current Status of Lumbar Arthroplasty Charlottesville, VA; Clifford Roberson, MD, Los Angeles, CA; Ray M. Baker, MD John K. Stokes, MD, Austin, TX; Jongsoo Park, MD, Stanford, CA; Christopher Shaffrey, MD, Charlottesville, VA; J. Patrick 2:00 PM Complications of Lumbar Arthroplasty Johnson, MD, Los Angeles, CA André Van Ooji, MD 2:15 PM Lumbar Arthroplasty: My Perspective • 11:55 AM – 12:02 PM Paul McAfee, MD 110. Segmental Kyphosis after Bryan Disc Arthroplasty Shee Yan Fong, MBBS, FRCS, Calgary, AB, Canada; Stephan DuPlessis, MD, Calgary, AB, Canada; Steven Casha, MD, PhD, PART II: POSTERIOR FRCS, Calgary, AB, Canada; John R.. Hurlbert, MD, PhD, 2:30 PM Dynamic Stabilization is the Way to Go FRCS, Calgary, AB, Canada William C. Welch, MD 2:45 PM PLIF or TLIF is Better Than Dynamic Stabilization • 12:02 – 12:09 PM Charles L. Branch, Jr., MD 111. Comparison of Multiple Level Versus Single Level 3:00 PM Panel Discussion Cervical Disk Replacement – 178 Consecutive Prostheses Joseph T. Alexander, MD; Ray M. Baker, MD; Paul McAfee, MD, Sparks, MD; Luiz Pimenta, MD, PhD, São Charles L. Branch, Jr., MD; Richard G. Fessler, MD; Paulo, Brazil; Alan Crockard, London, United Kingdom; Andy Fred H. Geisler, MD; Paul McAfee, MD; William C. Cappuccino, Buffalo, NY; Bryan Cunningham, Baltimore, MD Welch, MD, André Van Ooji, MD ______12:09 – 12:20 PM Discussion ______3:30 – 4:15 PM BEVERAGE BREAK WITH EXHIBITORS 12:20 – 1:00 PM LUNCH WITH EXHIBITORS “What’s New” Session #3 “What’s New” Session #2 in the Exhibit Hall Demo Theater in the Exhibit Hall Demo Theater Moderator: Paul M. Arnold, MD, FACS Moderator: Michael W. Groff, MD ______4:15 – 5:30 PM CONCURRENT ORAL POINT 1:00 – 3:30 PM SCIENTIFIC SESSION II PRESENTATIONS The Evolution of Lumbar Spine Surgery Session I Anterior/Posterior Moderator: Ehud Mendel, MD, FACS • 4:15 – 4:19 PM Moderator: Joseph T. Alexander, MD 200. Safety of Outpatient Anterior and Posterior Cervical Faculty: Ray M. Baker, MD; Charles L. Branch, Jr., MD; Richard Spine Surgery in a Community Hospital G. Fessler, MD; Fred H. Geisler, MD; Paul McAfee, MD; William Gregory J. Przybylski, MD, Edison, NJ; William Mitchell, MD, C. Welch, MD, André Van Ooij, MD Edison, NJ

SESSION DESCRIPTION • 4:19 – 4:23 PM This course will review the advantages and disadvantages 201. Comparison of Radiographic Outcomes of Anterior of anterior and posterior approaches to the spine. Panel Lumbar Interbody Fusion (ALIF) Versus Transforaminal discussions will allow experts to voice their opinions regarding Lumbar Interbody Fusion (TLIF) benefits of each technique. Patrick C. Hsieh, MD, Chicago, IL; Sean Salehi, MD, Chicago, IL; Stephen Ondra, MD, Chicago, IL; Tyler R. Koski, MD, Chicago, IL; John C. Liu, MD, Chicago, IL

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEETING AGENDA 21

• 4:23 – 4:27 PM • 4:58 – 5:02 PM 202. Lumbar Total Disc Replacement: A 2 To 3 Year 209. Minimally Invasive Lateral Mass Screw Fixation Report from the United States Clinical Trial for the in the Cervical Spine: Initial Clinical Experience with Prodisc-L Prosthesis Long-Term Follow-Up Hyun W. Bae, MD, Santa Monica, CA; Ben B. Pradhan, MD, Michael Y. Wang, MD, Los Angeles, CA; Allan D.O. Levi, MD, MSc, Santa Monica, CA; Michael A. Kropf, MD, Santa PhD, Miami, FL; Bryan C. Oh, MD, Los Angeles, CA Monica, CA; Linda EA Kanim, MA, Santa Monica, CA; Rick B. Delamarter, MD, Santa Monica, CA • 5:02 – 5:06 PM 210. Posteromedian Extracavitary Approach to the • 4:27 – 4:31 PM Thoracolumbar Spine: A Single Incision Approach 203. Biomechanical Comparison of the Charité and for Circumferential Decompression, Reconstruction, Prodisc-L Lumbar Disc Prostheses and Arthrodesis Kevin T. Foley, MD, Memphis, TN; Denis J. DiAngelo, PhD, Nicholas B. Levine, MD, Cincinnati, OH; Charles Kuntz, MD, Memphis, TN; Brian Morrow, BS, Memphis, TN; John Cincinnati, OH; Robert J. Bohinski, MD, PhD, Cincinnati, OH German, MD, Albany, NY; Rudolph Bertagnoli, MD, Straubing, Germany; Jung Song, PhD, Memphis, TN; • 5:06 – 5:10 PM Thomas Mroz, MD, Cleveland, OH 211. CGRP and GAP43 Increase and Colocalize in Allodynic Rats Following SCI and Stem Cell • 4:31 – 4:35 PM Transplantation 204. A Retrospective Comparative Study of Intraoperative Melissa Y. Macias, MD, PhD, Milwaukee, WI; Mara C. Bacon, EMG-Based Neuromonitoring of Percutaneous Pedicle BS, Milwaukee, WI; Shekar N. Kurpad, MD, PhD, Milwaukee, WI Screw Placement and Post-Operative Computed Tomgraphic Scan Confirmation • 5:10 – 5:14 PM Hormoz Sheikh, MD, Southfield, MI; Mick Perez-Cruet, MD, 212. Neodisc – Design, Testing and Early Clinical Results MSc, Southfield, MI of a Textile/Elastomeric Cervical Disc Replacement Alan McLeod, PhD, Taunton, United Kingdom; Chris • 4:35 – 4:39 PM Reah, PhD, Taunton, United Kingdom; Andre Jackowski, MD, 205. MRI Morphologic Predictors of SPECT Positive Facet Birmingham, United Kingdom Arthropathy in Patients with Axial Back Pain Keun-Young A. Kim, MD, Los Angeles, CA; Michael Y. Wang, • 5:14 – 5:18 PM MD, Los Angeles, CA 213. Spinal Deformity Following Selective Dorsal Rhizotomy for Spasticity • 4:39 – 4:43 PM Jeff D. Golan, MD, Montreal, PQ, Canada; Jeffery A. Hall, MD, 206. Multimodality Intraoperative Neurophysiological FRCS(C), Montreal, PQ, Canada; Jean-Pierre Farmer, MD, Monitoring for Adult Tethered Cord Syndrome FRCS(C), Montreal, PQ, Canada Micro-neurosurgery Guillermo Paradiso, Toronto, ON, Canada; Gabriel Lee, • 5:18 – 5:30 PM Discussion MBBS, FRACS, Toronto, ON, Canada; Roger Sarjeant, BS, Toronto, ON, Canada; Ly Hoang, BS, Toronto, ON, Canada; • 5:30 PM Adjournment Eric M. Massicotte, MD, FRCS(C), Toronto, ON, Canada; ______Michael Fehlings, MD, PhD, FRCS, Toronto, ON, Canada 4:15 – 5:30 PM CONCURRENT ORAL POINT PRESENTATIONS • 4:43 – 4:47 PM Session II 207. Unilateral Versus Bilateral Cage and Pedicle Screw Moderator: Jay Y. Chun, MD, PhD Placement for Single Level Fusion. A Prospective Comparison • 4:15 – 4:19 PM Douglas B. Moreland, MD, Buffalo, NY; Gregory A. Czajka, 214. Comparison of Outcomes After Lumbar Artificial MPAS, PA-C, Buffalo, NY; Jennifer Weaver, RPA-C, Buffalo, NY Disc Replacement Surgery in Worker’s Compensation Versus Non-Compensation Patients • 4:47 – 4:54 PM Discussion Hyun W. Bae, MD, Santa Monica, CA; Ben B. Pradhan, MD, MSc, Santa Monica, CA; Michael A. Kropf, MD, Santa • 4:54 – 4:58 PM Monica, CA; Linda E.A. Kanim, MA, Santa Monica, CA; 208. Development of an Animal Model of Post-Traumatic Rick B. Delamarter, MD, Santa Monica, CA Syringomyelia Associated with Adhesive Arachnoiditis: Implications for an Enhanced Understanding of the • 4:19 – 4:23 PM Pathobiology and for the Development of Novel 215. Effects of Age on Perioperative and Intermediate- Therapeutic Approaches Term Clinical Outcomes and Fusion Rates After Toshitaka Seki, MD, PhD, Toronto, ON, Canada; Multilevel 360-Degree Lumbar Fusion Michael G. Fehlings, MD, PhD, FRCS, Toronto, ON, Canada Frank L. Acosta, Jr., MD, San Francisco, CA; Henry E. Aryan, MD, San Francisco, CA; Christopher P. Ames, MD, San Francisco, CA

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 22 MEETING AGENDA

• 4:23 – 4:27 PM • 5:04 – 5:08 PM 216. A Key Role for FAS Mediated Apoptosis in the 224. Inosine Versus Oscillating Field Stimulation Pathobiology of Cervical Spondylotic Myelopathy: Plus Inosine in Treating Experimental Chronic Evidence from Human Tissue and a Mutant Mouse Model Spinal Cord Injury Wenru Yu, MD, Toronto, ON, Canada; Tianyi Liu, Toronto, Scott A. Shapiro, MD, Indianapolis, IN; Scott Purvines, MD, ON, Canada; Darryl C. Baptiste, PhD, Toronto, ON, Canada; Indianapolis, IN; Richard Borgens, PhD, Indianapolis, IN Michael G. Fehlings, MD, PhD, Toronto, ON, Canada • 5:08 – 5:12 PM • 4:27 – 4:31 PM 225. Clinical Outcome in Patients Undergoing 217. Artificial Cervical Pedicle Screw Reconstruction for Anterior Cervical Discectomy and Fusion Using Degenerative and Neoplastic Disease: Intermediate-term Anterior Plating System Clinical and Radiographic Results Alan T. Villavicencio, MD, Boulder, CO; Sigita Burneikiene, Frank L. Acosta, Jr., MD, San Francisco, CA; Henry E. Aryan, MD, Boulder, CO; Evan Pushchak, BA, Boulder, CO; MD, San Francisco, CA; Christopher P. Ames, MD, Jeffrey J. Thramann, MD, Boulder, CO San Francisco, CA • 5:12 – 5:16 PM • 4:31 – 4:35 PM 226. Spinal Cord Uptake and Targeted Motor Neuron 218. Results of a Modified Paramedian Transpedicular Delivery using the Crushed Sciatic Nerve Model Approach with Radical Bone Resection for Intradural, Thais Federici, Cleveland, OH; James K. Liu, Cleveland, OH; Extramedullary Tumors of the Ventral Cervicothoracic Qingshan Teng, Cleveland, OH; Mary Garrity-Moses, Spine Cleveland, OH; Jun Yang, Cleveland, OH; Nicholas M. Boulis, Frank L. Acosta, Jr., MD, San Francisco, CA; Henry E. Aryan, Cleveland, OH MD, San Francisco, CA; Christopher P. Ames, MD, San Francisco, CA • 5:16 – 5:20 PM 227. Initial Experience in C1/2 Arthrodesis Using • 4:35 – 4:39 PM BMP-2 and Allograft Chips 219. Evaluation of Correction of Sagittal Plane John K. Houten, MD, Bronx, NY Cervical Spine Deformities with Anterior ACDF with Dynamic Plating • 5:20 – 5:30 PM Discussion Daniel R. Fassett, MD, Salt Lake City, UT; Kyle Judd, BS, Salt Lake City, UT; Randy Clark, BS, Salt Lake City, UT; • 5:30 PM Adjournment Ronald Apfelbaum, MD, Salt Lake City, UT ______

• 4:43 – 4:52 PM Discussion 5:30 – 7:00 PM RECEPTION IN THE EXHIBIT HALL

• 4:52 – 4:56 PM 221. MR Imaging Clarity of the Bryan, Prodisc-c, Prestige LP and PCM Cervical Arthroplasty Devices FRIDAY, MARCH 17 James J. Lynch, MD, FRCS, Reno, NV; Lali Sekhon, MD, PhD FRCS, Reno, NV; Paul A. Anderson, MD, Madison, WI; 7:00 – 7:05 AM ANNOUNCEMENTS Neil Duggal, MD FRCS(C), London, ON, Canada; Regis W. GREAT HALL NORTH & CENTER Haid, MD, Atlanta, GA; John Heller, MD, Atlanta, GA; Robert F. Heary, MD, Section Chair Dan Riew, MD, St. Louis, MO; Kevin Seex, MBBS, FRACS, Michael W. Groff, MD, Annual Meeting Chair Sydney, Australia Mark R. McLaughlin, MD, Scientific Program Chair

• 4:56 – 5:00 PM 7:05 – 9:45 AM SCIENTIFIC SESSION III 222. Correction of Cervical Kyphotic Deformity via Special Technology Session 360° Fusion: Long Term Follow Up with a Standardized Analysis Director: Gerald E. Rodts, Jr., MD Praveen V. Mummaneni, MD, Atlanta, GA; Sanjay Dhall, MD, Faculty: Deborah L. Benzil, MD; Christopher H. Comey, MD; Atlanta, GA; Gerald E. Rodts, MD, Atlanta, GA; Regis W. Haid, Richard Fessler, MD; Kevin T. Foley, MD; Brian R. Greer; Iain H. MD, Atlanta, GA Kalfas, MD; Isador Lieberman, MD; Najeeb Thomas, MD

• 5:00 – 5:04 PM SESSION DESCRIPTION 223. Mortality, Neurological Outcome and Axonal Survival This course will give an overview to the participants on what following Spinal Cord Injury in a Geriatric Population new technologies are available for the spine surgeon in the Julio C. Furlan, MD, PhD, MBA, Toronto, ON, Canada; year 2006. Focus will be on usable, practical devices and Michael G. Fehlings, MD, FRCS(C), Toronto, ON, Canada improvements in the OR that can improve spine surgery.

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEETING AGENDA 23

LEARNING OBJECTIVES • 11:07 – 11:14 AM Upon completion of this session, participants should be able to: 113. Radiographic Analysis of the Prestige® ST Cervical • Recognize available radiological guidance systems that Disc: Results from a Prospective Randomized Controlled can be implemented in the OR. Clinical Trial • Summarize the newest diagnostic imaging techniques. J. Kenneth Burkus, MD, Columbus, GA; Thomas A. Zdeblick, • Explain the benefits and pitfalls of frameless stereotactic MD, Iowa City, IA; Vincent C. Traynelis, MD, Iowa City, IA guidance. • Discuss how telemedicine can be incorporated into spine • 11:14 – 11:21 AM practices to increase efficiency. 114. Lumbar Intervertebral Disc Stabilization (LIDS): ______A Stand-alone, Unilateral, Lumbar Fusion Technique 7:05 – 7:20 AM The OR and Tools of the Future Madhavan Pisharodi, MD, Brownsville, TX; Amayur P. Gerald E. Rodts, Jr., MD Chandran, PhD, Brownsville, TX 7:20 – 7:35 AM Current and Future Minimally Invasive Techniques • 11:21 – 11:27 AM Discussion Kevin T. Foley, MD 7:35 – 7:50 AM Microendoscopic Discectomy (MED) • 11:27 – 11:34 AM Christopher H. Comey, MD 115. eXtreme Lateral Interbody Fusion (XLIF): The Initial U.S. Experience 2003-2004 7:50 – 8:05 AM Spinal Endoscopic Approaches to Neill M. Wright, MD, St. Louis, MO the Thoracic/Lumbar Spine Richard Fessler, MD • 11:34 – 11:41 AM 8:05 – 8:20 AM Minimally Invasive Lumbar Fusion 116. Positional Peripheral Nerve Injury in Spine Surgery: Najeeb Thomas, MD Is There a Potential Role for Intraoperative Monitoring? 8:20 – 8:35 AM Vertebral Augmentation Arthur Grigorian, MD, PhD, Macon, GA; Vassilios Isador Lieberman, MD Dimopoulos, MD, Macon, GA; Induk Chung, PhD, Macon, GA; Bridget Fuhrmann, BSN, RN, Macon, GA; 8:35 – 8:50 AM Telemedicine, the Internet and the Kim Holderfield, MSc, Macon, GA; Joe S. Robinson, MD, Spine Surgeon Macon, GA Brian R. Greer 8:50 – 9:05 AM Spine Surgery: Image Guidance of • 11:41 – 11:48 AM the Future 117. Long-term Radiographic Evaluation of 331 Patients Iain Kalfas, MD after Anterior Cervical Discectomy and Fusion with 9:05 – 9:20 AM Radiosurgery of the Spine Dynamic Plating Deborah L. Benzil, MD Daniel R. Fassett, MD, Salt Lake City, UT; Kyle Judd, BS, Salt 9:20 – 9:45 AM Panel Discussion with ARS Lake City, UT; Randy Clark, BS, Salt Lake City, UT; Ronald Deborah L. Benzil, MD; Christopher H. Apfelbaum, MD, Salt Lake City, UT Comey, MD; Richard Fessler, MD; Kevin T. Foley, MD; Brian R. Greer, MD; Iain Kalfas, • 11:48 – 11:55 AM Discussion MD; Isador Lieberman, MD; Gerald E. Rodts, Jr., MD; Najeeb Thomas, MD • 11:55 AM – 12:02 PM ______118. Extraforaminal Lumbar Interbody Fusion: A New 9:45 – 10:15 AM Fellowship Awards & Update Technique for Outpatient Lumbar Fusion Surgery Gregory J. Przybylski, MD, Edison, NJ; William Mitchell, MD, ______Edison, NJ 3:30 – 4:15 PM BEVERAGE BREAK WITH EXHIBITORS • 12:02 – 12:09 PM “What’s New” Session #4 119. Minimally Invasive Transforaminal Lumbar Interbody in the Exhibit Hall Demo Theater Fusion and Pedicle Screw Fixation: An Excellent Technique Moderator: Richard M. Spiro, MD, MPH For Treatment of Chronic Lower Back Pain Secondary to Spondylolisthesis or Degenerative Disc Disease With or ______Without Associated Stenosis 11:00 AM – 12:30 PM ORAL ABSTRACT PRESENTATIONS Mick Perez-Cruet, MD, MSc, Southfield, MI; Moderator: R. John Hurlbert, MD, PhD Hormoz Sheikh, MD, Southfield, MI • 11:00 – 11:07 AM • 12:09 – 12:16 PM 112. Cervical Disc Replacement – Longer-Term (2-year) 120. Cervical Arthroplasty Versus Fusion at Two Levels: Range of Motion and Clinical Outcomes Follow-Up with What are the Biomechanical Differences? the ProDisc-C Prosthesis Kevin T. Foley, MD, Memphis, TN; Denis J. DiAngelo, PhD, Rick B. Delamarter, MD, Santa Monica, CA; Hyun W. Bae, Memphis, TN MD, Santa Monica, CA; Linda E.A. Kanim, MA, Santa Monica, CA; Michael A. Kropf, MD, Santa Monica, CA; Ben B. Pradhan, MD, MSc, Santa Monica, CA

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 24 MEETING AGENDA

• 12:16 – 12:23 PM 2:05 PM Basics of EMG 121. Cervical Disc Arthroplasty with the Prestige ST Robert L. Tiel, MD Device: One and Two Year Results from a Multi-Center 2:25 PM Basics of MR Neurography Randomized Controlled Trial Aaron G. Filler, MD, PhD Praveen V. Mummaneni, MD, Atlanta, GA; Regis W. Haid, 2:45 PM Questions & Answers MD, Atlanta, GA; Joseph B. Stachniak, MD, Richardson, TX; Wade M. Ceola, MD, Springfield, MO; Paul D. Sawin, MD, 3:00 PM Beverage Break Winter Park, FL 3:20 PM Brachial Plexus Injuries: Anatomy and Management ______John E. McGillicuddy, MD 12:30 – 1:00 PM Annual Business Meeting 3:40 PM Outcomes for Nerve Injury and Reconstructive Strategies ______Robert J. Spinner, MD 1:00 – 6:00 PM Golf Outing 4:00 PM Painful Neuromas Pre-registration is required. Allan J. Belzberg, MD ______4:20 PM Peripheral Nerve Tumors Line Jacques, MD 1:00 – 5:00 PM CONCURRENT SESSION 4:40 PM Questions & Answers with Illustrated Cases SPECIAL COURSE V ABC’s of Peripheral Nerve Surgery 5:00 PM Adjournment ______Additional $200 for medical registrants, includes lunch. Complimentary for Residents and Fellows 1:00 – 5:00 PM CONCURRENT SESSION Co-Director: Robert J. Spinner, MD and Eric L. Zager, MD Faculty: Allan J. Belzberg, MD; Aaron G. Filler, MD, PhD; Holly A Special Symposium for Nurses, S. Gilmer-Hill, MD; Line Jacques, MD; Allen H. Maniker, MD; Nurse Practitioners and Physician Assistants– John E. McGillicuddy, MD; Robert L. Tiel, MD Meeting the Challenges of Caring for COURSE DESCRIPTION the Patient with a Spinal Tumor This didactic course will detail the ABC’s of peripheral nerve Additional $110 for medical registrants, includes lunch. surgery. It is targeted to practicing surgeons, senior level residents and fellows. Co-Directors: Shannon Hagy, BSN, CNRN and Andrea L. Strayer, NP, CNRN LEARNING OBJECTIVES Faculty: Edward C. Benzel, MD; Robert D. Hager, MMSC, PAC; Upon completion of this course, participants should be able to: Michael P. Steinmetz, MD; Christina M. Stewart-Amidei, MSN, • Convey basic information on diagnosis and management RN, APN, CNRN, CCRN of common nerve injuries, nerve entrapments and nerve disorders. COURSE DESCRIPTION • Prepare the residents for the written board examinations and This special symposium for nurses and physicians assistants will the young neurosurgeons for the oral board examinations on focus on meeting the challenges of caring for the patient with a nerve topics and questions. spinal tumor. After a discussion of the significance of the prob- • Review the diagnosis and differential diagnoses of nerve lem, neurosurgical decision making and goals of treatment will conditions, particularly those that have overlap to medical be presented. Perioperative care considerations and adjunctive and spinal conditions. treatment options will be reviewed. The symposium will close • Distinguish those nerve conditions needing emergent and with a thought provoking session on “When urgent management versus those that can be managed in Enough is Enough.” a more delayed fashion. • Recognize common peripheral nerve conditions and LEARNING OBJECTIVES distinguishing these from the unusual conditions, which Upon completion of this course, participants should be able to: should be referred to subspecialists. • Discuss the significance of spinal tumors and the neurosurgical ______decision making for patients with a spinal tumor. 1:00 PM Introduction • Analyze perioperative care considerations, adjunctive Robert J. Spinner, MD treatment options and when neurosurgical treatment is 1:05 PM Nerve Emergencies: Pearls and Pitfalls no longer indicated. ______Allen H. Maniker, MD 1:00 PM Introduction 1:25 PM Entrapment Neuropathies: Upper Extremity Shannon Hagy, BSN, CNRN and Eric L. Zager, MD Andrea L. Strayer, NP, CNRN 1:45 PM Entrapment Neuropathies: Lower Extremity Holly Gilmer-Hill, MD

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEETING AGENDA 25

1:05 PM Spinal Tumors Demographics LUMBAR ARTHORPLASTY Shannon Hagy, BSN, CNRN 7:20 AM Is the Best Treatment for Lumbar DDD 1:35 PM Neurosurgical Treatment Fred H. Geisler, MD Michael P. Steinmetz, MD 7:25 AM Is Not a Good Treatment for Lumbar DDD 2:05 PM The Role of the Physician Assistant André Van Ooji, MD Robert D. Hager, MMS, PAC 7:30 AM Is the Best Treatment for Lumbar DDD Rebuttal 2:35 PM Post-Operative Care Fred H. Geisler, MD Shannon Hagy, BSN, CNRN 7:32 AM Is Not a Good Treatment for Lumbar DDD Rebuttal 3:05 PM Beverage Break André Van Ooji, MD 3:20 PM Adjunctive Treatment Options 7:34 AM Audience Vote Using ARS Christina M. Stewart-Amidei, MSN, RN, APN, CNRN, CCRN ADJACENT LEVEL DISEASE 3:50 PM When Enough Is Enough 7:35 AM Arthroplasty Will Decrease Adjacent Level Disease Edward C. Benzel, MD Stephen M. Papadopoulos, MD 4:20 PM Questions & Answers 7:40 AM Arthroplasty Will Not Decrease Adjacent 5:00 PM Adjournment Level Disease Edward C. Benzel, MD 7:45 AM Arthroplasty Will Decrease Adjacent Level SATURDAY, MARCH 18 Disease Rebuttal Stephen M. Papadopoulos, MD 7:00 AM ANNOUNCEMENTS 7:47 AM Arthroplasty Will Not Decrease Adjacent Level ______Disease Rebuttal Edward C. Benzel, MD 7:05 – 9:00 AM 7:49 AM Audience Vote Using ARS David Cahill Memorial Controversies Session LUMBAR DISCOGRAPHY Moderators: R. John Hurlbert, MD, PhD and 7:50 AM Lumbar Discography Is Efficacious for Dx and Rx Christopher I. Shaffrey, MD Ray M. Baker, MD Faculty: Ronald I. Apfelbaum, MD; Ray M. Baker, MD; 7:55 AM Lumbar Discography Is Not Efficacious Edward C. Benzel, MD; Richard G. Fessler, MD; Anthony K. Richard G. Fessler, MD Frempong-Boadu, MD; Larry T. Khoo, MD; Stephen M. 8:00 AM Lumbar Discography Is Efficacious for Dx and Rx Papadopoulos, MD; William C. Welch, MD Rebuttal Ray M. Baker, MD SESSION DESCRIPTION Through a debate presentation format, controversial clinical 8:02 AM Lumbar Discography Is Not Efficacious Rebuttal management decisions will be presented with experts arguing Richard G. Fessler, MD their perspective on what the literature supports. 8:04 AM Audience Vote Using ARS

LEARNING OBJECTIVE ASYMPTOMATIC CERVICAL CORD COMPRESSION Upon completion of this session, participants should be able to: 8:05 AM A Case for Observation • Discuss the indications for surgery in the management of Anthony K. Frempong-Boadu, MD asymptomatic spinal cord compression. 8:10 AM A Case for Surgery NEUROPHYSIOLOGICAL MONITORING Ronald I. Apfelbaum, MD 7:05 AM Monitoring: Standard of Care in Spine Surgery 8:15 AM A Case for Observation Rebuttal William C. Welch, MD Anthony K. Frempong-Boadu, MD 7:10 AM Monitoring Is Not the Standard of Care 8:17 AM A Case for Surgery Rebuttal Larry T. Khoo, MD Ronald I. Apfelbaum, MD 7:15 AM Monitoring: Standard of Care in Spine 8:19 AM Audience Vote Using ARS Surgery Rebuttal 8:20 AM Questions & Answers William C. Welch, MD 7:17 AM Monitoring Is Not the Standard of Care Rebuttal Larry T. Khoo, MD 7:19 AM Audience Vote Using ARS

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 26 MEETING AGENDA

8:40 – 10:10 AM SCIENTIFIC SESSION IV LEARNING OBJECTIVES Pain and the Spine Surgeon Upon completion of this session, participants should be able to: • Outline the current infrastructure that exists with regards to Director: John C. Oakley MD medical politics. Faculty: Giancarlo Barolat, MD; Richard K. Osenbach, MD; • Recognize the competing factors and compelling reasons to David S. Sinclair, MD; John J. Moossy, MD implement a concerted effort to unify and align our society’s interests with other spine lobby organizations. SESSION DESCRIPTION ______This session will review state-of-the-art uses of pharmacology 10:50 AM The Public Image of the Physician and neural augmentation devices for the treatment of pain. James Bean, MD Special attention will be devoted to the management of the 11:00 AM Mr. Spine Surgeon Goes to Washington opioid dependant patient in clinical practice. Troy M. Tippett, MD 11:10 AM Cooperation of Societies with a Common LEARNING OBJECTIVES Interest/Doctors for Medical Liability Reform Upon completion of this session, participants should be able to: Katie Orrico, JD • Review appropriate narcotic weaning regimens for patients 11:20 AM The State of Medical Liability in the US undergoing spinal surgery. Paul B. Nelson, MD • Describe the current pharmacological options available for caring for these patients. 11:30 AM Key Note Address: The Medical Liability Crisis • Recognize indications for surgical pain management with and What Physicians Can Do About It neural augmentations and stimulation. Paul Starr, PhD ______12:20 PM Questions & Answers 8:40 AM RSD/CRPS/SMP Management 12:45 PM Adjournment Giancarlo Baralot, MD ______8:55 AM Pharmacologic Options for the Spine Surgeon Richard K. Osenbach, MD 1:00 – 5:00 PM SPECIAL COURSE VI 9:10 AM Surgical Planning for the Opioid Dependent Patient Board Review for Spine Surgery and David S. Sinclair, MD Peripheral Nerve 9:25 AM Pain Pump/SCS for Failed Back Additional $110 for medical registrants, includes lunch. John J. Moossy, MD Director: Ehud Mendel, MD, FACS 9:40 AM Panel Discussion Using the ARS Faculty: Daniel K. Resnick, MD; Allen H. Maniker, MD; Alan Levi, Giancarlo Baralot, MD; John J. Moossy, MD; MD, PhD, FRCS Richard K. Osenbach, MD; David S. Sinclair, MD

______COURSE DESCRIPTION 10:10 – 10:50 AM BEVERAGE BREAK WITH EXHIBITORS In a case presentation format participants will engage in a “What’s New” Session #5 simulated oral boards examination covering spine and peripheral nerve cases commonly seen at the ABNS examination. in the Exhibit Hall Demo Theater Moderator: James S. Harrop, MD LEARNING OBJECTIVES ______Upon completion of this session, participants should be able to: 10:50 AM -12:30 PM SCIENTIFIC SESSION V • Summarize the most common peripheral nerve cases that might be presented on an oral board examination. Your Environment: • Review common spine case scenarios that might be presented. The Spine Playing Field • Discuss incorporating an alga rhythm format in creating a systematic approach to the answering oral examination Co-Directors: Mark R. McLaughlin, MD and questions. John A. Jane, Sr., MD, PhD ______Faculty: James Bean, MD; Paul B. Nelson, MD; Katie Orrico, JD; 1:00 PM Introduction Troy M. Tippett, MD; Paul Starr, PhD Ehud Mendel, MD, FACS 1:05 PM Spine Cases SESSION DESCRIPTION Alan Levi, MD, PhD, FRCS and Daniel K. Resnick, MD This session will focus on the socioeconomic environment of the spine surgeon. The forces in place and the potential future 2:35 PM Beverage Break scenarios will be discussed. Insights into what spine surgeons 2:50 PM Peripheral Nerve Cases can do to improve their position within the political environ- Alan Levi, MD, PhD, FRCS and Allen H. Maniker, MD ment will be discussed. 5:00 PM Adjournment ______

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES EXHIBITORS 27

EXHIBIT HOURS Aesculap Inc. Axiom Worldwide 3773 Corporate Parkway 9423 Corporate Lake Drive Thursday, March 16 Center Valley, PA 18034 Tampa, FL 33634 9:00 AM – 7:00 PM P: (610)797-9300 P: (813)249-6444 F: (610)791-6888 F: (813)249-6445 Friday, March 17 www.aesculapusa.com www.axiomworldwide.com 9:00 AM – Noon Booth 125 Booth 128 Saturday, March 18 9:00 – 11:30 AM Alphatec Spine Inc. Cervitech, Inc. 2051 Palomar Airport Road, Ste. 100 300 Roundhill Drive Carlsbad, CA 9201 Rockaway, NJ 07866 P: (760)431-9286 P: (973)625-9696 F: (760)431-9823 F: (973)625-4445 www.alphatecspine.com www.cervitech.com Booth 301 Booth 208

American Association of Congress of Neurological Surgeons Neurological Surgeons 10 N. Martingale Rd., Ste. 190 5550 Meadowbrook Drive Schaumburg, IL 60173 Rolling Meadows, IL 60008-3852 P: (847)240-2500 P: (847)378-0500 F: (847)240-0804 F: (847)378-0600 www.neurosurgeon.org www.AANS.org Booth 104 Booth 410 DePuy Spine, Anspach Companies a Johnson & Johnson company 4500 Riverside Drive 325 Paramount Drive Palm Beach Gardens, FL 33410 Raynham, MA 02767 P: (561)627-1080 P: (800)451-2006 F: (561)627-1265 F: (508)687-8671 www.anspach.com www.depuyspine.com Booth 315 Booth 211

AOSpine North America EBI Spine PO Box 1658 100 Interpace Parkway West Chester, PA 19380 Parsippany, NJ 07054-1149 P: (610)344-2015 P: (973)299-9300 F: (610)344-2016 F: (973)299-0391 www.aospinena.org www.ebimedical.com Booth 224 Booth 219

ArthroCare Corporation Ellman Innovations 680 Vaqueros Avenue 3333 Royal Ave. Sunnyvale, CA 94085-3523 Oceanside, NY 11572 P: (408)736-0224 P: (516)594-3333 F: (408)736-0226 F: (516)881-3002 www.arthrocare.com www.ellman.com Booth 311 Booth 309

ASCEND 751 Miller Drive SE, Suite F1 Leesburg, VA 20175 P: (703)554-1258 F: (703)777-4338 www.ascendspine.org Booth 123

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 28 EXHIBITORS

Endius, Inc. Kimberly-Clark NuVasive, Inc. 23 West Bacon Street Ballard Medical 4545 Towne Centre Court Plainville, MA 02762 12050 Lone Peak Parkway San Diego, CA 92121 P: (508)643-0983 Draper, UT 84020 P: (858)909-1800 F: (508)695-2501 P: (801)523-3428 F: (858)909-2000 www.endius.com F: (801)523-5370 www.nuvasive.com Booth 100 www.kimberlyclark.com Booth 129 Booth 415

Fonar Corporation Orthofix, Inc. 110 Marcus Drive Kyphon Inc. 1720 Bray Central Drive Melville, NY 1174 1221 Crossman Avenue McKinney, TX 75069 P: (631)694-2929 Sunnyvale, CA 94089 P: (469)742-2724 F: (631)753-5150 P: (408)548-6500 F: (469)742-2722 www.fonar.com F: (408)548-6501 www.orthofix.com Booth 411 www.kyphon.com Booth 206 Booth 108 Globus Medical Osteotech, Inc. 303 Schell Lane Life Instrument Corporation 51 James Way Phoenixville, PA 19460 14 Wood Road Eatontown, NJ 07724 P: (610)415-9000 Braintree, MA 02184 P: (732)542-2800 F: (610)415-9144 P: (781)849-0109 F: (732)578-6688 www.globusmedical.com F: (781)849-0128 www.osteotech.com Booth 406 www.lifeinstruments.com Booth 200 Booth 116 Integra Pioneer Surgical Technology 311 Enterprise Drive Lippincott Williams & Wilkins 375 River Park Circle Plainsboro, NJ 08536 5311 Carson Street Marquette, MI 49855 P: (609)275-0500 Saint Cloud, FL 34771 P: (800)557-9909 F: (609)799-3297 P: (407)892-2067 F: (866)604-9909 www.integra-ls.com F: (407)892-2067 www.pioneersurgical.com Booth 220 Booth 409 Booth 130

Journal of Neurosurgery Market Access Partners Pisharodi Surgicals 1224 Jefferson Park Ave., Ste. 450 3236 Meadowview Rd. 942 Wildrose Lane Charlottesville, VA 22903 Evergreen, CO 80439 Brownsville, TX 78520 P: (434)924-5503 P: (303)526-1900 P: (956)541-6725 F: (434)924-2702 F: (303)526-7920 F: (956)544-6090 www.thejns-net.org www.marketaccesspartners.com www.pisharodi_surgicals.com Booth 416 Booth 417 Booth 305

K2M, LLC Medtronic PMT Corporation Ste. F1 751 Miller Drive, SE 1800 Pyramid Place 1500 Park Road Leesburg, VA 20175 Memphis, TN 38132-1719 Chanhassen, MN 55317 P: (703)777-3155 P: (800)876-3133 P: (952)470-0866 F: (703)777-4338 F: (901)332-3920 F: (952)470-0865 www.k2m.com www.medtronic.com www.pmtcorp.com Booth 119 Booth 111 Booth 101

New England Compounding Center Priority Consult 697 Waverly Street 506 Oak Street Framingham, MA 01701 Cincinnati, OH 45251 P: (508)820-0606 P: (513)569-5228 F: (508)820-1616 www.priorityconsultspine.com www.neccrx.com Booth 222 Booth 422

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES EXHIBITORS 29

Scanlan International, Inc. St. Francis Medical Technologies, Inc. TranS1, Inc. One Scanlan Plaza 960 Atlantic Avenue, Ste. 102 411 Landmark Dr. Saint Paul, MN 55107 Alameda, CA 94501 Willmington, NC 28412-6303 P: (651)298-0997 P: (510)337-2606 P: (910)332-1693 F: (651)298-0018 F: (510)337-2698 www.trans1inc.com www.scanlangroup.com www.sfmt.com Booth 218 Booth 107 Booth 122 W. B. Saunders/Mosby Scientx USA Stryker P.O. Box 2739 1015 Maitland Center Commons 2725 Fairfield Road Lake Mary, FL 32795-2739 Suite 106A Kalamazoo, MI 49002 P: (407)322-7384 Maitland, FL 32751 P: 800-762-2775 F: (407)322-7384 P: (407)571-2555 www.stryker.com Booth 317 F: (407)571-2556 Booth 205 www.scientxusa.com Zimmer Spine Booth 300 Synthes Spine 7375 Bush Lake Road 1302 Wrights Lane East Minneapolis, MN 55439 SeaSpine, Inc. West Chester, PA 19380 P: (952)857-5682 2302 La Mirada Drive P: (610)719-5000 F: (952)857-5982 Vista, CA 92081 F: (610)719-5100 www.zimmerspine.com P: (760)727-8399 Booth 225 Booth 118 F: (760)727-8891 www.seaspine.com Booth 117 The AANS/CNS Section on Disorders of the Spine and Spine Surgical Innovations Peripheral Nerves gratefully acknowledges the following 40 Norfolk Avenue South Easton, MA 02375 companies for their generous sponsorship of the 2006 P: (508)238-3351 Annual Meeting: F: (508)238-3807 www.holmed.net PLATINUM PARTNERS Booth 418 DePuy Spine, a Johnson & Johnson company Spine Wave, Inc. 2 Enterprise Drive Medtronic Sofamor Danek Shelton, CT 06484 P: (203)944-9494 F: (203)944-9493 Synthes Spine www.spinewave.com Booth 105 DIAMOND SPONSOR

Spineology Inc Stryker 7200 Hudson Blvd. N, Ste. 205 St. Paul, MN 55128-7055 SAPPHIRE SPONSORS P: (651)256-8500 F: (651)256-8505 Integra www.spineology.com Kimberly-Clark Ballard Medical Booth 321 Medical Education & Research Institute NuVasive, Inc. Zimmer Spine

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 30 EXHIBIT FLOOR PLAN

EXHIBIT HALL / EVENT CENTER

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES POSTER NUMBERS AND TITLES 31

E- POSTERS 303 308 To assist you in finding specific Objective Clinical Outcome In Vitro Study of Traumatic Loading posters that you may be interested Following Microendoscopic After Implanting the Bryan Cervical in viewing, e-posters are located in Discectomy (MED) for Lumbar Disc Prosthesis the back of the exhibit hall on five Herniated Intervertebral Disks Neil Duggal, MD, FRCS(C), London, computer terminals. E-posters are Using SF-36, Visual Analog Scale, ON, Canada; Neil Crawford, PhD, located behind Booth 422 to the and Oswestry Disability Index Barrow Neurological Institute, AZ; right of the demo theater. The Dae-Hyun Kim, MD, Chicago, IL; Robert Chamberlain, MS, Barrow scientific poster abstracts can be Kurt M. Eichholz, MD, Chicago, IL; Neurological Institute, AZ; Seungwon found on pages 56-90. John Song, MD, Chicago, IL; Sean Baek, Barrow Neurological Institute, AZ Three poster awards will be given at Christie, MD, PhD, Chicago, IL; Melody Hrubes, BS, Chicago, IL; John this meeting. The top three e-posters 309 will be announced during the Awards E. O'Toole, MD, Chicago, IL; Richard Return to Work Analysis of Patients Session on Friday, March 17th. G. Fessler, MD, PhD, Chicago, IL Treated with an Artificial Cervical All posters displayed by Thursday, Disc or an Arthrodesis March 16 at 12:00 PM will be eligible 304 for these awards. Vincent Traynelis, MD, Iowa City, IA; Bioabsorbable Cervical Spacers Paul Anderson, MD, Madison, WI; in the Treatment of Multilevel Newton H. Metcalf, BS, Memphis, TN 300 Degenerative Disc Disease Open Versus MAST Lumbar Kaveh Khajavi, MD, FACS, Decatur, GA; 310 Interbody Fusion Erin G. Mihelic, PA-C, Decatur, GA; Clinical and Radiographic Outcomes Sean D. Christie, MD, FRCS(C), James Malcolm, MD, FACS, Marietta, GA of Thoracic and Lumbar Pedicle Halifax, NS, Canada; John K. Song, Subtraction Osteotomy for Fixed MD, Chicago, IL; Edward Abraham, 305 Sagittal Imbalance. MD, FRCS(C), Saint John, NB, Canada; Corpectomy Followed by Melody Hrubes, Chicago, IL; Richard Benson P. Yang, MD, Chicago, IL; Instrumentation with Titanium G. Fessler, MD, Chicago, IL Stephen L. Ondra, MD, Chicago, IL; Cages and rhBMP for Vertebral Larry A. Chen, BS, Chicago, IL; Osteomyelitis HeeSoo Jung, BA, Chicago, IL; Tyler R. 301 Henry E. Aryan, MD, San Francisco, Koski, MD, Chicago, IL; Sean A. Salehi, Targeted Microinjection of Cells CA; Frank L. Acosta, Jr., MD, San MD, Chicago, IL into the Ventral Horn Utilizing a Francisco, CA; Christopher P. Ames, Novel Delivery System in Pigs San Francisco, CA 311 John B. Butler, MD, Cleveland, OH; Porous Coated Motion Cervical Nicholas Boulis, MD, PhD, Cleveland, 306 (PCM) Disk Replacement in OH; Dileep Nair, MD, Cleveland, OH; Modified Pedicle Subtraction Adjacent Segment Disease – Baker Ken, PhD, Cleveland, OH; Osteotomy to Correct Thoracic Clinical Follow up of 40 Cases Clive Svendson, PhD, Madison, WI; Kyphotic Deformity: A Cadaveric Shearwood McClelland, III, MD, Paul McAfee, MD, Sparks, MD; Luiz Study Cleveland, OH Pimenta, MD, PhD, Sao Paulo, Brazil; Peter M. Grossi, MD, Durham, NC; Matthew Scott-Young, Queensland, Shahid M. Nimjee, PhD, Durham, NC; Australia; Andy Cappuccino, Buffalo, NY 302 Louis N. Radden, DO, Durham, NC; Operative Failure of Percutaneous Ashtoush A. Pradhan, MD, Durham, 312 Endoscopic Lumbar Discectomy: NC; Robert E. Isaacs, MD, Durham, NC A Radiological Analysis of 55 Cases. Intervertebral rhBMP-2 for Transforaminal Lumbar Sang-Ho Lee, MD, PhD, Seoul, 307 Interbody Fusion Republic of Korea; Byeng Uk Kang, Bryan Cervical Disc Prosthesis MD, Seoul, Republic of Korea; Yong Alan T. Villavicencio, MD, Boulder, CO; Implantation Causes Kyphotic Ahn, MD, PhD, Seoul, Republic of Sigita Burneikiene, MD, Boulder, CO; Deformity: A Myth? Decreased Korea; Gun Choi, MD, PhD, Seoul, E. Lee Nelson, MD, Boulder, CO; Pain and Improved Functioning Republic of Korea; Young-Geun Choi, Ketan R. Bulsara, MD, Columbia, MO; Seen Without Kyphosis in Patients MD, Seoul, Republic of Korea; Kwang Jeffrey J. Thramann, MD, Boulder, CO Treated for Spondylotic Up Ahn, MD, Seoul, Republic of Korea Radiculopathy Neil J. Cochrane, Southport, Australia

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 32 POSTER NUMBERS AND TITLES

313 318 323 Comparison of Sagittal and Coronal Clinical Experience with the Total Cervical Artificial Disc Alignment of the Cervical Spine Absorbable Anterior Cervical Plate Replacement with the PCM After One to Three-level Artificial for Single Level ACDF (Porous Coated Motion) Disk. Disc Replacements (ProDisc-C) Justin F. Fraser, MD, New York, NY; Prospective 3 Years Follow Up Versus fusion Nicole Sorrentino, PA, New York, NY; Clinical and Radiological Study, Ben B. Pradhan, MD, MSc, Santa Roger Hartl, MD, New York, NY 230 Discs Performed Monica, CA; Hyun W. Bae, MD, Luiz Pimenta, MD, PhD, Sao Paulo, Santa Monica, CA; Michael A. Kropf, Brazil; Paul McAfee, MD, St Josephs 319 MD, Santa Monica, CA; Linda E.A. Medical Center, MD; Roberto Diaz, Kanim, MA, Santa Monica, CA; Rick B. Overexpression of Protease Nexin I MD, Sao Paulo, Brazil; Andy Delamarter, MD, Santa Monica, CA Provides Neuroprotection and Capuccino, MD, Buffalo Spine Center, Blocks Neuroinflammation After NY; Claudio Tatsui, MD, Sao Paulo, Spinal Cord Injury in Mice Brazil; Luis E. Guerrero, MD, Sao 314 Paul M. Arnold, MD, FACS, Kansas Paulo, Brazil; Bryan Cunningham, Total Disc Replacement Versus City, KS; M. Farooque, MD, Veterans MSc, Union Memorial Hospital, MD; Fusion as a Salvage Treatment for Administration Medical Center, MO; Alan Crockard, MD, PhD, London, Failed Back Surgery Syndrome M. Bilgen, MD, Veterans Administration United Kingdom Rick B. Delamarter, MD, Santa Monica, Medical Center, MO; B. Citron, MD, CA; Hyun W. Bae, MD, Santa Monica, Veteran's Administration Medical 324 CA; Michael A. Kropf, MD, Santa Center, MO; B. Festoff, MD, Veteran’s Monica, CA; Linda E.A. Kanim, MA, Administration Medical Center, MO A Novel Biomechanically Superior Santa Monica, CA; Ben B. Pradhan, Means of Minimally Invasive MD, Santa Monica, CA Transfacet Non-Screw-Rod Based 320 Fixation: Early Clinical Experience XLIF: One Surgeon’s Interbody and Biomechanical Data 315 Fusion Technique of Choice Larry T. Khoo, MD, Los Angeles, CA; Biomechanical Evaluation of a Novel William Smith, MD, Las Vegas, NV Andrew Cappuccino, Lockport, NY; Anterior Cervical Plate System Bryan Cunningham, MSc, Baltimore, Darrel S. Brodke, MD, Salt Lake City, MD; Adebukola Onibokun, MD, Los 321 UT; Randy Clark, BS, Salt Lake City, UT; Angeles, CA Kent N. Bachus, PhD, Salt Lake City, Charité Lumbar Artificial Disc UT Retrieval by Minimally Invasive Lateral Approach (XLIF): A Case 325 Report In Vivo Image Based 3-D Finite 316 Luiz Pimenta, MD, PhD, Sao Paulo, Element Analysis of L5-S1 Charité In Vitro Biomechanics of Multi-level Brazil; Roberto Díaz, MD, Sao Paulo, Artificial Disc Implant Cervical Disc Arthroplasty Brazil Robert Nicholson, BA, Ann Arbor, MI; Kevin T. Foley, MD, Memphis, TN; Chia-Ying Lin, PhD, Ann Arbor, MI; Denis J. DiAngelo, PhD, Memphis, TN; Barunashish Brahma, MD, Ann Arbor, 322 John S. Schwab, MS, Memphis, TN; MI; Scott Hollister, PhD, Ann Arbor, MI; John German, MD, Albany, NY; Kelly Multimodality Evoked Potential Frank La Marca, MD, Ann Arbor, MI Scrantz, MD, Memphis, TN Monitoring for Intradural Spinal Cord Lesions of the Cervical and Thoracic Spine: Prospective 326 317 Long-term Clinical Evaluation of Laminectomy for Cervical Initial Clinical and Radiographic 22 Cases Spondylotic Myelopathy in Results of a Minimally Invasive Frederick Vincent, MD, Toronto, ON, Elderly Patients Presacral Approach for L5-S1 Canada Mark G. Burnett, MD, Phoenix, AZ; Interbody Fusion Thomas S. Metkus, BS, Philadelphia, Frank L. Acosta, Jr., MD, San PA; Sherman C. Stein, MD, Francisco, CA; Henry E. Aryan, MD, Philadelphia, PA San Francisco, CA; Christopher P. Ames, MD, San Francisco, CA

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES POSTER NUMBERS AND TITLES 33

327 332 337 How to Predict Best Results from A Long-Term Clinical Outcome Spontaneous Resolution of the Bypass Coaptation for Cervical Analysis of Minimally Invasive Syringomyelia Associated with Root Avulsion Cervical Foraminotomy Chiari Type 1 Malformation Shokei Yamada, MD, PhD, Loma Larry T. Khoo, MD, Los Angeles, CA; Motoo Kubota, MD, PhD, Chiba, Linda, CA; Gordon W. Peterson, MD, Murat Cosar, MD, Los Angeles, CA; Japan; Ado Tamiya, Chiba, Japan; Loma Linda, CA; Bruce A. Everett, MD, Adebukola Onibokun, MD, Los Naokatsu Saeki, Chiba, Japan; Akira FACS, Fontana, CA; Daniel J. Won, Angeles, CA Yamaura, Chiba, Japan; Toshio MD, FACS, Fontana, CA; Javed Siddiqi, Fukutake, Chiba, Japan MD, PhD, FRCS, Colton, CA 333 Real-time CT-guided Percutaneous 338 328 Thoracic Disc Decompression with CT-SPECT Fusion Imaging for Restoration and Maintenance of Laser Assisted Spinal Endoscopy Diagnosing Painful Lumbar Facet Coronal and Sagittal Lumbar Spinal for Symptomatic Thoracic Disc Joint Arthropathy Alignment with a Semi-Constrained Herniation Matthew McDonald, MBBS, FRAC, Multi-level Lumbar Total Disc Ho-Yeong Kang, MD, Seoul, Republic Adelaide, Australia; Robert Cooper, Arthroplasty (ProDisc-L) of Korea; Sang-Hyeop Jeon, MD, MD, Adelaide, Australia; Michael Y. Ben B. Pradhan, MD, MSc, Santa Seoul, Republic of Korea; Sang-Ho Lee, Wang, MD, Los Angeles, CA Monica, CA; Hyun W. Bae, MD, Santa MD, PhD, Seoul, Republic of Korea; Monica, CA; Michael A. Kropf, MD, Ho Yeon Lee, MD, PhD, Seoul, 339 Santa Monica, CA; Linda E.A. Kanim, Republic of Korea; Won-Chul Choi, MA, Santa Monica, CA; Rick B. MD, Seoul, Republic of Korea Does Minimally Invasive Technique Delamarter, MD, Santa Monica, CA Limit The Ability to Prepare a Disc Space for Interbody Fusion? 334 Peter M. Grossi, MD, Durham, NC; 329 Percutaneous Endoscopic Lumbar Ashtoush A. Pradhan, MD, Durham, Motion-Preserving Dynamic Discectomy for Upper Lumbar Disc NC; Shahid M. Nimjee, PhD, Durham, Posterior Stabilization of the Herniation NC; Roger E. McLendon, MD, Lumbar Spine: Early Results from Yong Ahn, MD, PhD, Seoul, Republic Durham, NC; Robert E. Isaacs, MD, the US Clinical Trial with the of Korea; Sang-Ho Lee, MD, PhD, Durham, NC Dynesys System Seoul, Republic of Korea; Soo Taek Hyun W. Bae, MD, Santa Monica, CA; Lim, MD, PhD, Seoul, Republic of 340 Ben B. Pradhan, MD, MSc, Santa Korea; Sang-Hyun Keem, MD, Seoul, Monica, CA; Linda EA Kanim, MA, Republic of Korea; Dong-Yeob Lee, Treatment of Cervical Degenerative Santa Monica, CA; Rick B. Delamarter, MD, Seoul, Republic of Korea Disease: A Comparison of MD, Santa Monica, CA Arthrodesis Versus Laminoplasty Masaki Mizuno, MD, PhD, Hisai Mie, 335 Japan; Yoshichika Kubo, MD, PhD, 330 Evaluation of the Misonix Hisai Mie, Japan; Shigehiko Niwa, MD, Is Excessive Bone Formation Ultrasound Osteotome Device PhD, Hisai Mie, Japan; Keita Kuraishi, Associated with the Use of rhBMP2 in Sheep Laminectomies MD, Hisai Mie, Japan; Shiro Waga, in Minimal Access PLIF/TLIF? William C. Welch, MD, FACS, MD, PhD, Hisai Mie, Japan Vivek Joseph, MBBS, FRCS, Toronto, Pittsburgh, PA; Wendy Fellows-Mayle, ON, Canada; Y. Raja Rampersaud, MD, PhD, Pittsburgh, PA; Michael Sharts, 341 FRCS(C), Toronto, ON, Canada MD, Pittsburgh, PA; Patricia L. Karausky, BSN, RN, Pittsburgh, PA 360º Minimal Invasive Axial Percutaneuos L5-S1 Fusion (AxiaLIF). 331 2 Years Clinical and Radiological PEEK Interbody Spacers Filled with 336 Follow-up Allograft Chips in Anterior Cervical The Utility of MR Neurography in Luiz Pimenta, MD, PhD, Sao Paulo, Discectomy and Fusion Brachial Plexus Imaging Brazil; Roberto C. Diaz, MD, Sao Aubrey S. Okpaku, MD, Bronx, NY; Aaron G. Filler, MD, PhD, Santa Paulo, Brazil; Claudio Tatsui, MD, Sao John K. Houten, MD, Bronx, NY Monica, CA Paulo, Brazil; Luis E. Guerrero, MD, Sao Paulo, Brazil; Andrew Cragg, MD, Minneapolis, MN

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 34 POSTER NUMBERS AND TITLES

342 347 352 Safety and Feasibility of Potential for Radiation Dose Anterior Lumbar Interbody Fusion Percutaneous Lumbar Spine Reduction by Performing Followed by Percutaneous Pedicle Pedicle Screw Fixation as an Percutaneous Kyphoplasty under Screw Fixation for the Revision Outpatient Procedure Intraoperative Fluoro-based CT Surgery in the Lumbar Spine John Pollina, Jr., MD, Buffalo, NY; Guidance Sang-Ho Lee, MD, PhD, Seoul, P. Jeffrey Lewis, MD, FACS, Buffalo, NY; Sigita Burneikiene, MD, Boulder, CO; Republic of Korea; Byeng Uk Kang, Jennifer Weaver, RPA-C, Buffalo, NY Alan T. Villavicencio, MD, Boulder, CO; MD, Seoul, Republic of Korea; Yong Ketan R. Bulsara, MD, Columbia, MO; Ahn, MD, PhD, Seoul, Republic of Jeffrey J. Thramann, MD, Boulder, CO Korea; Gun Choi, MD, PhD, Seoul, 343 Republic of Korea; Young-Geun Choi, MR and CT Characteristics of MD, Seoul, Republic of Korea; Kwang 348 Materials Used for Artificial Cervical Up Ahn, MD, Seoul, Republic of Korea Disc Replacements Comparison of Motion at Treated and Untreated Adjacent Segments James J. Lynch, MD, FRCS, FI, Reno, 353 NV; Jun-Young Yang, MD, St. Louis, After Single to Three-level Disc Feasibility Study of Percutaneous MO; Ty Bae, MD, St. Louis, MO; Fang Replacement Versus Fusion in the Axial Lumbar Fusion: Interim Results Zhu, MD, St. Louis, MO; Bret Taylor, Cervical Spine MD, St. Louis, MO; Paul Young, MD, Ben B. Pradhan, MD, MSc, Santa Luiz Pimenta, MD, PhD, Sao Paulo, St. Louis, MO; Greg Marik, MSME, Monica, CA; Hyun W. Bae, MD, Santa Brazil; Larry T. Khoo, MD, Los Angeles, Memphis, TN; K. Dan Riew, MD, St. Monica, CA; Michael A. Kropf, MD, CA; Murat Cosar, MD, Los Angeles, Louis, MO Santa Monica, CA; Linda E.A. Kanim, CA; Roberto Diaz Orduz, MD, Sao MA, Santa Monica, CA; Rick B. Paulo, Brazil; Andrew Cragg, MD, Sao Delamarter, MD, Santa Monica, CA Paulo, Brazil; Fernando Bellera, MD, 344 Sao Paulo, Brazil Fusion Rates in the Cervical Spine 349 Justin Fraser, MD, New York, NY; 354 Roger Hartl, MD, New York, NY Stand-Alone PLIF with Ray TFC in 103 Cases: Perioperative Incidence of the Piriformis Complications and 5-Year Follow-Up Syndrome in Patients with 345 Sacroiliac Dysfunction Kosuke Kuribayashi, MD, Osaka, Japan Vertebral Artery Injury Diagnosed Michael A. Amaral, MD, FACS, Atlanta, with Computed Tomographic GA; Alan B. Lippitt, MD, Atlanta, GA; Angiography in Patients Harboring 350 Vickie Sims, PT, Atlanta, GA Blunt Cervical Spine Trauma Prevalence of Obesity in Elective Thoracolumbar Fusions and Relation Vassilios G. Dimopoulos, MD, Macon, 355 GA; Kostas N. Fountas, MD, PhD, to Complication Incidence Comparison of Microsurgical Versus Macon, GA; Theofilos G. Machinis, Nimesh Patel, MD, Chicago, IL; Minimally Invasive Approaches in MD, Macon, GA; Carlos H. Feltes, MD, Bradley Bagan, MD, Chicago, IL; Harel Bilateral Decompression of Lumbar Macon, GA; Joe S. Robinson, MD, Deutsch, MD, Chicago, IL; John K. Spinal Stenosis FACS, Macon, GA; Arthur A. Grigorian, Ratliff, MD, Philadelphia, PA MD, Macon, GA Maged L. Abu-Assal, MD, Loma Linda, CA; Samer Ghostine, MD, Loma Linda, 351 CA 346 An Economic Analysis of Lumbar Use of Continous Intraoperative Total Disc Replacement vs. Fusion 356 Electromyographic Potential Richard D. Guyer, MD, Plano, TX; John Cadaveric Morphometric Study of Nerve Root Monitoring During J. Regan, MD, Beverly Hills, CA; Scott S2 Alar Screws Decompression of Patients with G. Tromanhauser, MD, Boston, MA; Symptomatic Lumbar Radiculopathy Richard Toselli, MD, Raynham, MA Michael Y. Wang, MD, Los Angeles, Larry T. Khoo, MD, Los Angeles, CA; CA; Michael Groff, MD, Indianapolis, Murat Cosar, MD, Los Angeles, CA; IN; Anthony Kim, MD, Los Angeles, Adebukola Onibokun, MD, Los CA Angeles, CA; Murisiku Raifu, MD, Los Angeles, CA

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357 362 366 Radiographic Outcome Following Predictive Factors for Subsequent Management of Deep Spine Anterior Alone Stabilization for Vertebral Fracture after Infections with Vacuum-assisted Thoracolumbar Burst Fractures Percutaneous Vertebroplasty Closure; A Retrospective Study of Michael P. Steinmetz, MD, Madison, Yong Ahn, MD, PhD, Seoul, Republic 15 Patients WI; Greg Trost, MD, Madison, WI; of Korea; Sang-Ho Lee, MD, PhD, John B. Butler, MD, Cleveland, OH; Daniel Resnick, MD, Madison, WI Seoul, Republic of Korea; Sang-Hyun Alex Jones, MD, New Orleans, LA; Keem, MD, Seoul, Republic of Korea; Richard Schlenk, MD, Cleveland, OH; Chan Shik Shim, MD, PhD, Seoul, Isador Lieberman, MD, Cleveland, OH; 358 Republic of Korea Edward Benzel, MD, Cleveland, OH Pain Outcome and Vertebral Body Height Restoration in Patients Undergoing Kyphoplasty 363 367 Carlos H. Feltes, MD, Macon, GA; Percutaneous Ventral Lumbar Total Disc Replacement Kostas N. Fountas, MD, PhD, Macon, Decompression for Degenerative from a Direct Lateral Approach GA; Theofilos G. Machinis, MD, Lumbar Spondylolisthesis in Luiz Pimenta, MD, PhD, Sao Paulo, Macon, GA; Vassilios G. Dimopoulos, Medically Compromised Geriatric Brazil; Roberto Diaz, MD, Sao Paulo, MD, Macon, GA; Mozaffar A. Kassam, Patients Brazil MD, Macon, GA; Kim W. Johnston, Ho Yeon Lee, MD, PhD, Seoul, MD, FACS, Macon, GA; Joe S. Republic of Korea; Sang-Ho Lee, MD, 368 Robinson, MD, FACS, Macon, GA PhD, Seoul, Republic of Korea; Yong Ahn, MD, PhD, Seoul, Republic of Subjective and Objective Variability Korea; Dong-Yun Kim, MD, Seoul, in Assessing Lumbar Spinal Stenosis 359 Republic of Korea; Won-Chul Choi, on Magnetic Resonance Imaging Prevertebral Soft Tissue Thickness MD, Seoul, Republic of Korea Sami I. Aleissa, MD, Calgary, AB, Safety Guidelines for Discharge Canada; A. Alarjani, Calgary, AB, After Anterior Cervical Discectomy Canada; R. Hu, Calgary, AB, Canada; 364 Will F. Beringer, DO, Normal, IL; Keith Steve Casha, Calgary, AB, Canada Kattner, DO, Bloomington, IL; Ann Initial Clinical Outcomes of a Stroink, MD, Bloomington, IL Minimally Invasive Lumbar Interbody Fusion (MiLIF) 369 Multi-Center Study Management of Atlantoaxial 360 Richard E. Manos, MD, San Diego, CA; Degenerative Pannus of the Elderly Instrumented Posterior Lumbar Mitchell Hardenbrook, MD, with Tranoral Odontoidectomy and Interbody Fusion with Mineralized Portsmouth, VA; Michael Liu, MD, Posterior C1-C2 Fusion Collagen Matrix and Bone Marrow Salem, OR; William Sukovich, MD, Michael A. Finn, MD, Salt Lake City, Aspirate as a Bone Graft Substitute Portsmouth, VA; Thomas Sweeney, UT; Ronald I. Apfelbaum, MD, Salt Lawrence M. Spetka, MD, Toledo, OH; MD, Sarasota, FL; Todd Kuether, MD, Lake City, UT; Daniel R. Fassett, MD, Ethel Parker, BS, Toledo, OH Portland, OR Salt Lake City, UT

361 365 370 Three-dimensional Fluoro-based One Year Follow-up on the First 40 A New Approach for Kyphoplasty CT Guidance for Complex Spinal Patients Using Cortoss for Treating and/or Vertebroplasty of Sacral Surgery Vertebral Compression Fractures in Insufficiency Fractures Alan T. Villavicencio, MD, Boulder, CO; Vertebroplasty and Kyphoplasty Donald P. Atkins, MD, FACS, Sigita Burneikiene, MD, Boulder, CO; Hyun Bae, MD, Santa Monica, CA; San Antonio, TX; James Dix, MD, Ketan R. Bulsara, MD, Columbia, MO; Philip Maurer, MD, Philadelphia, PA; San Antonio, TX Jeffrey J. Thramann, MD, Boulder, CO William Beutler, MD, Harrisburg, PA; Walter Peppelman, DO, Harrisburg, PA; Raymond Linovitz, MD, Encinitas, CA; Erik Westerlund, MD, Encinitas, CA; Timothy Peppers, MD, Encinitas, CA; Isador Lieberman, MD, Cleveland, OH; Choll Kim, MD, PhD, San Diego, CA; Federico Girardi, MD, New York, NY

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371 376 381 Asymetric Pedicle Subtraction Percutaneous Endoscopic Cervical Posterior Lumber Interbody Fusion: Osteotomy with Partial Discectomy with WSH Working Comparative Analysis of a Minimally Vertebrectomy for Correction Channel Scope for Noncontained Invasive Versus an Open Approach of Fixed Combined Coronal Cervical Disc Herniation: Minimum David Levy, BS, Omaha, NE; Julie and Sagittal Imbalance: A New Twist 2 Year Follow-up Walsh, MPAS PA-C, Omaha, NE; Mark on an Old Technique Sang-Ho Lee, MD, PhD, Seoul, N. Robinson, MD, Omaha, NE; Bruce J. Patrick Johnson, MD, Los Angeles, Republic of Korea; Won-Chul Choi, Baron, DO, Omaha, NE; Christian CA; Hooman Melamed, MD, Los MD, Seoul, Republic of Korea; Schlaepfer, MD, Omaha, NE; Stephen Angeles, CA; Leonel A. Hunt, MD, Los Seungcheol Lee, MD, Seoul, Republic E. Doran, MD, Omaha, NE Angeles, CA; Robert S. Pashman, MD, of Korea; Ho Yeon Lee, MD, PhD, Los Angeles, CA; Neel Anand, MD, Los Seoul, Republic of Korea; Yong Ahn, 382 Angeles, CA; W. Putnam Wolcott, MD, MD, PhD, Seoul, Republic of Korea; Los Angeles, CA Bhanot Arun, MD, Seoul, Republic of Stand-Alone Anterior Lumbar Korea Discectomy and Fusion (ALDF) with Plate: Initial Experience 372 Frank L. Acosta, Jr., MD, San Francisco, 377 Anterior Rod Placement in CA; Henry E. Aryan, MD, San Thoracolumbar Corpectomy: Class II Cervical Outcomes Francisco, CA; Christopher P. Ames, A Biomechanical Study Thomas B. Ducker, MD, Annapolis, MD, San Francisco, CA Michael Groff, Indianapolis, IN; James MD; Stephen E. Faust, MD, Annapolis, Z. Mason, Little Rock, AR; Scott H. MD; Loretta Brady, RN, Annapolis, MD 383 Purvines, St. Louis, MO; Robert B. Sloan, Indianapolis, IN; Kevin O’Neill, Maverick Artificial Disc Removal 378 Indianapolis, IN Due to Metal Allergy The Tops Lumbar Facet Replacement Alan T. Villavicencio, MD, Boulder, CO; System. Biomechanical Evaluation, Sigita Burneikiene, MD, Boulder, CO 373 Operative Data, and Preliminary 360º Lumbar Fusion with Clinical Results 384 Minimally Invasive Surgical Larry T. Khoo, MD, Los Angeles, CA; Technique: Results in 100 cases Murat Cosar, MD, Los Angeles, CA; Biomechanics of Asymmetric Peter H. Hollis, MD, Great Neck, NY; Luiz Pimenta, MD, PhD, Sao Paolo, Lumbar Pedicle Screw Combinations Chris M. Overby, MD, Great Neck, NY; Brazil; Roberto Diaz, MD, Sao Paolo, Zafer Yüksel, MD, Phoenix, AZ; Kemal Mark Eisenberg, MD, Great Neck, NY Brazil Yücesoy, MD, Phoenix, AZ; Seungwon Baek, MS, Phoenix, AZ; Volker K.H. Sonntag, MD, FACS, Phoenix, AZ; Neil 374 379 R. Crawford, PhD, Phoenix, AZ Comparison of FluoroNav and The Results of Minimal Invasive ISO-C 3-D Image-Guidance Optimesh Graft Technique for 385 Navigation for Thoracic Pedicle Stand-Alone Lumbar Interbody Screw Placement Fusion in Spondylolisthesis Biomechanical Benefits of Nonsurgical Exogenous Crosslink Graham C. Hall, Indianapolis, IN; Larry T. Khoo, MD, Los Angeles, Therapy (NEXT) Dean G. Karahalios, MD, Chicago, IL; CA; Murat Cosar, MD, Los Angeles, Eric A. Potts, MD, Indianapolis, IN CA; Adebukola Onibokun, MD, Thomas Hedman, PhD, Los Angeles, Los Angeles, CA; Sandi Lam, MD, CA; Brendan Chuang, MD, PhD, Los Angeles, CA Los Angeles, CA 375 Value of the Maximum Canal Compromise and Spinal Cord 380 Compression for Evaluation of Development of a Thoracoscopic Neurological Status and Prediction Implantation Technique for Spinal of Neurological Outcome after Reconstruction After Vertebrectomy Acute Traumatic Spinal Cord Injury Using the Synex Cage Julio C. Furlan, MD, PhD, MBA, Oren N. Gottfried, MD, Salt Lake Toronto, ON, Canada; Michael G. City, UT; Paul Klimo, MD, Salt Lake Fehlings, MD, FRCS(C), Toronto, ON, City, UT; Meic H. Schmidt, MD, Canada Salt Lake City, UT

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386 392 397 Addition of a Cross-link to the C-1 The Efficacy of Percutaneous Value of Magnetic Resonance Lateral Mass/C2 Pedicle Screw Endoscopic Interlaminar Discectomy Imaging in Mouse Models of Spinal Fixation Construct: A Biomechanical (PEID) on L5-S1 Disc Herniation Cord Injury Study Jung Hyun Shim, MD, Suwon, Paul Arnold, MD, Kansas City, KS; John Hamilton, MD, Albany, NY; David Republic of Korea; Choon Keun Park, M. Bilgen, MD, Kansas City, MO; Pinilla-Arias, MD, Madrid, Spain; Mary MD, Suwon, Republic of Korea; Dong B. Alhafez, MD, Kansas City, MO; Bilancini, MS, Los Angeles, CA; Hamid Hyun Kim, MD, Suwon, Republic of N. Berman, MD, Kansas City, MO; Miraliakbar, MD, Los Angeles, CA; Carl Korea; Jae Keon Kim, MD, Suwon, B. Festoff, MD, Kansas City, MO Lauryssen, MD, Los Angeles, CA; J. Republic of Korea; Jang Hoe Hwang, Patrick Johnson, MD, Los Angeles, CA MD, Suwon, Republic of Korea 398 Extrapedicular Unilateral 387 393 Vertebroplasty Electrical Stimulation DC of Interspinous Locker Fixation with Harel Deutsch, MD, Chicago, IL Posterior Lumbar Interbody Fusion Ligamentoplasty for Lumbar Michael Groff, MD, Indianapolis, IN Stenosis or Degenerative Spondylolisthesis 399 Sang-Ho Lee, MD, PhD, Seoul, Bone Scan Imaging for Selective 388 Republic of Korea; Byungjoo Jung, Percutaneous Vertebroplasty in Comparative Analysis of Lumbar MD, Seoul, Republic of Korea; Won Osteoporotic Vertebral Fractures Lordosis After Lumbar Spinal Fusion Gyu Choi, MD, PhD, Seoul, Republic Harel Deutsch, MD, Chicago, IL Using the Wilson Frame and of Korea; Ho Yeon Lee, MD, PhD, Jackson Table Seoul, Republic of Korea; Won-Chul Sung Ho Park, Seoul, Republic Choi, MD, Seoul, Republic of Korea of Korea

394 389 Neural Prosthetic Implants in Posterior Lumbar Interbody Fusion Spinal Cord: Direct Activation of Combined with Instrumented Muscles with Multishank Single Postero-Lateral Fusion– A Series of Unit Stimulation Electrodes 75 Patients Arthur L. Jenkins, III, MD, New York, NY; Kalpesh Shah, Glasgow, United Stanislaw Sobotka, PhD, New York, NY Kingdom; Kumar Periasamy, Glasgow, United Kingdom; Eugene Wheelwright, Glasgow, United 395 Kingdom Kyphoplasty for Treatment of Traumatic Anterior Column Compression Fractures 390 Dennis E. McDonnell, MD, La Crosse, Uniplate for Anterior Cervical WI; Polly A. Davenport-Fortune, NP, Discectomy and Fusion CNRN, La Crosse, WI; Melissa Lenz, Instrumentation BA, La Crosse, WI Chris A. Lycette, MD, Allentown, PA

396 391 Biomechanical Comparison of RhBMP-2 retention in a Vertebral Isolated Occipitoatlantal Posterior Body Fracture Stabilization Device Fixation Techniques (OptiMesh) Nicholas Bambakidis, MD, Phoenix, Hyun W. Bae, MD, Santa Monica, CA; AZ; Iman Feiz-Erfan, MD, Phoenix, AZ; Ben B. Pradhan, MD, MSc, Santa Eric M. Horn, MD, Phoenix, AZ; L. Monica, CA; Li Zhao, MD, PhD, Santa Fernando Gonzalez, Phoenix, AZ; Monica, CA; Pamela Wong, BS, Santa Volker K.H. Sonntag, MD, FACS, Monica, CA; Linda E.A. Kanim, MA, Phoenix, AZ; Seungwon Baek, MS, Santa Monica, CA; Rick B. Delamarter, Phoenix, AZ; Zafer Yüksel, MD, MD, Santa Monica, CA Phoenix, AZ; Neil R. Crawford, PhD, Phoenix, AZ

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ORAL ABSTRACT 100. Revisability of the Charité 101. Comparison of Osteophyte Artificial Disc Replacement — Formation in Patients with the PRESENTATIONS Analysis of 688 Patients Enrolled Bryan Disc and Patients with ACDF These scheduled presentations will in the US IDE Study of the Stephen M. Papadopoulos, MD, be held in the plenary session room Charité Artificial Disc Phoenix, AZ; Vincent C. Traynelis, MD, Thursday, March 16th and Friday, Paul McAfee, MD, Sparks, MD; Fred Iowa City, IA; Jeffrey P. Rouleau, PhD, March 17th. Each presentation is Geisler, MD, Chicago, IL; Sam Saiedy, Minneapolis, MN made by the primary author and MD, Baltimore, MD; Richard Guyer, Introduction: Cervical arthroplasty will be seven minutes long, followed MD, Dallas, TX; John Regan, MD, Los not only maintains motion at the by short discussion periods through Angeles, CA; Scott Blumenthal, MD, operative level, but also may reduce Dallas, TX out each session. adjacent level degeneration in com- Introduction: This study analyzes the parison to ACDF. Evidence of degener- revision cases evolving from the ative changes can be detected on prospective, randomized, multi-center, lateral radiographs. FDA-regulated IDE clinical trial of the Methods: Pre-operative, 12-month, Charité disk replacement. and 24-month lateral films were Methods: A total of 668 patients retrospectively digitized for 139 meeting the inclusion and exclusion patients with the Affinity® Anterior criteria were enrolled at 14 centers Cervical Cage System, 64 patients across the United States. with the Bryan® Cervical Disc Results: Of the 589 patients with prosthesis, and 15 patients with the ® TDR in this review, 52 (8.8%) required Cornerstone-SR Allograft Implant. reoperation. Of the 99 patients with Anterior osteophyte area and protru- lumbar fusion, 10 (10.1%) required sion were quantified for both the reoperation. Of this group, 29 patients inferior and superior aspects of the with TDR (4.9 %) and 10 patients with vertebrae at the operative disc space lumbar fusion (10.1 %) required sup- and the disc spaces above and below. plemental fixation. There were 24 TDR Data was compared using ANOVA patients who underwent a repeated with Bonferroni’s adjustment for anterior retroperitoneal approach with multiple comparisons. removal of the prosthesis. 7 of the 24 Results: The changes in total osteo- TDR prostheses requiring removal phyte area at the index disc space were revised to another Charité from the pre-operative time point to Artificial Disc, usually of smaller size. both the 12- and 24-month time The mean time to removal in all points were statistically less for Bryan patients was 9.6 months (range = than Affinity and Cornerstone. Bryan 3 days - 34 mos). Overall, 29 had less new osteophyte area than patients had posterior exploratory Cornerstone on the inferior vertebra laminectomies and pedicle screw at the disc space above the operative instrumentation performed as a level over the period from 0 to 12 salvage procedure. All 13 patients with months. Bryan had less new osteo- iatrogenic neurological signs resolved phyte protrusion than Affinity on the following posterior nerve root decom- inferior vertebra at the disc space pression. below the operative level over the Conclusions: Lumbar TDR with the period from 0 to 24 months. Charité Artificial Disc did not “burn Conclusions: Osteophyte formation at any bridges” during primary insertion or adjacent to a Bryan disc was either with one third being revisable to a statistically similar or less than the new motion preserving prosthesis and osteophyte formation at or adjacent two thirds being successfully convert- to Affinity or Cornerstone-SR ACDF ed to anterior interbody fusion or pos- devices. This result suggests that terior pedicle screw arthrodesis, the implantation of BRYAN disc results in a original alternative procedure. At two reduction in the rate of adjacent level years or more follow-up, 92.4% degeneration compared to ACDF. (544/589) of patients receiving TDR with the Charité Artificial Disc had a successfully functioning prosthesis with a mean of over 7 degrees of flexion/extension mobility.

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES ORAL ABSTRACTS 39

102. Complications with Cervical 103. Schwann Cell Transplantation 104. A Prospective, Multi-Center, Arthroplasty Improves Reticulospinal Fiber Growth Randomized Clinical Trial Evaluating Neil Duggal, London, ON, Canada; and Forelimb Strength After Severe Minimally Invasive Versus Open Gwynedd E. Pickett, MD, FRCS(C), Cervical Spinal Cord Contusion Pedicle Screw Instrumentation London, ON, Canada; Lali Sekhon, Kyoung-Suok Cho, MD, PhD, Seoul, Mick Perez-Cruet, MD, MSc, South- MD, PhD, Spine Nevada, NV; William Republic of Korea; Chun-Kun Park, MD, field, MI; Hormoz Sheikh, Southfield, Sears, Sydney, Australia PhD, Seoul, Republic of Korea; Seok-Gu MI; Boyd Richards, DO, Southfield, MI; Introduction: Spinal arthroplasty is Kang, MD, PhD, Seoul, Republic of Ali Aragi, MD, Plano, TX; Mark Spoon- becoming more widely available for Korea; Pil-Woo Huh, MD, PhD, Seoul, amore, MD, Los Angeles, CA; Randall the treatment of degenerative cervical Republic of Korea; Do-Sung Yoo, MD, McCafferty, MD, Dayton, OH; Peter disc disease. While this new technolo- PhD, Seoul, Republic of Korea; Dal-Soo Lennarson, MD, Dayton, OH; William gy may offer benefit over arthrodesis, Kim, MD, PhD, Seoul, Republic of Tobler, MD, Cincinnati, OH it also requires the acquisition of new Korea; Damien Pearse, PhD, Miami, FL; Introduction: Interest in minimally operative techniques, and introduces Dalton Dietrich, Miami, FL invasive spine (MIS) surgery is due in new potential complications. We Introduction: Schwann cells (SC), the part to technological advances and a analyzed our early series of patients myelinating glial cells of the peripheral desire to reduce approach related treated with the Bryan® cervical disc nervous system, have been previously morbidity. The benefits of MIS vs open prosthesis to determine the frequency shown to promote regeneration of surgery particularly as it applies to of perioperative complications. propriospinal neurons and brainstem spinal instrumentation has not been Methods: We prospectively recorded neurons (only in the presence of thoroughly investigated. operative data, complications, clinical neurotrophic factors or cAMP elevation) Methods: We conducted a random- and radiographic outcomes in all after grafting into the injured spinal ized prospective, multi-center clinical patients who received the Bryan® cord. In the current study we examined trial of 54 patients (33 males and 21 artificial cervical disc in two tertiary if fluid SC grafts transplanted into a females) receiving either minimally care centers since 2001. Patients clinically-relevant moderate contusion invasive (n=39) or open (n=15) underwent standard anterior cervical injury of the cervical (C5) spinal cord, pedicle screw instrumentation for the discectomy followed by arthroplasty a location closer to the cell bodies of treatment of degenerative lumbar at one to three levels. axotomized neurons, could support spine disorders. Levels instrumented supraspinal axon growth. Results: Ninety-six discs were implant- included 3 at L3-4, 16 at L4-5, 22 at ed in 74 patients. The perioperative Methods: Adult female Fischer rats L5-S1, and 13 at L4-5 and L5-S1. complication rate was 6.2% per received a severe (C5) cervical contu- Patients in both groups underwent operated level. One patient developed sion (1.1 mm displacement injury with interbody fusion. a retropharyngeal hematoma requiring a single, brief displacement of <20 Results: Operative time averaged 317 evacuation. Neurological worsening msec) using the Electromagnetic Spinal min open versus 346 min for MIS occurred in 3 patients. Intraoperative Cord Injury Device (ESCID) developed cases. Blood loss averaged 522 cc for migration of the prosthesis was at Ohio State University. At 1 wk post- open versus 168 cc for MIS cases. observed in one bi-level case, while injury, 2 million SCs transduced to Post-operative VAS scores decrease by delayed migration occurred in one express green fluorescent protein (GFP) 25% in the open versus 34% in the patient with post-operative segmental by lentiviral vectors were transplanted in MIS group at 2 weeks, by 57% in the kyphosis. Another patient with severe DMEM media into the injury site. Injury- open versus 66% in the MIS group at post-operative segmental kyphosis only animals served as controls. After 3 months and by 46% in the open required revision with a custom behavioral assessment, animals were versus 55% in the MIS group at 6 lordotic prosthesis. Heterotopic anterogradely traced from the reticular months. Average hospital stay was 3 ossification and spontaneous fusion formation using dextran rhodamine. days for the MIS group and 4 days for occurred in 2 cases; motion was Results: Histological analysis showed the open group. Complications includ- preserved in the remaining 94 that numerous labeled reticulospinal ed 1 graft failure in the MIS group prostheses. Partial dislocation of the fibers had penetrated the SC grafts, a requiring reoperation and 5 complica- prosthesis in extension occurred in 1 phenomenon not seen following tions in the open group. transplantation of SCs into the injured patient with preoperative segmental Conclusions: This study showed thoracic spinal cord. Furthermore, hypermobility, the first reported failure increased operative times in patients ® significant improvements in upper of a Bryan prosthesis. Twenty-five undergoing MIS instrumentation and limb strength were observed following percent of patients reported neck and fusion while blood loss was less, out- SC transplantation. shoulder pain in late follow-up. There comes over time were improved, and was a trend towards increased Conclusions: The current study hospital stays were shortened com- kyphosis of the C2-7 curvature demonstrates that SCs alone are capa- pared to patients undergoing more post-operatively. ble of supporting modest supraspinal traditional instrumentation and fusion. Conclusions: The Bryan® disc prosthe- axon growth when the site of axon sis was effective in maintaining spinal injury is closer to the cell body of motion. Major perioperative and the axotomized neuron. (Supported device-related complications were by the CRPF, NINDS09923, infrequent. NIHPOINS38665, Buoniconti Fund and The Miami Project).

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 40 ORAL ABSTRACTS

105. The Nerve Grafting, Nerve 106. The Use of Allograft Bone for 107. Complications and Retrieval Transfer, End-To-Side Neurorrhaphy Posterior C1-2 Fusion (Revisited) Management of the Charité Lumbar and Muscle Transfer in the Virany Huynh Hillard, MD, Salt Lake Artificial Disk: A Prospective 3 Year Treatment of Brachial Plexus Injury City, UT; Daniel Fassett, MD, Salt Lake Experience with 250 Disks Pavel Haninec, MD, Prague, Czech City, UT; Meic H. Schmidt, MD, Salt Luiz Pimenta, MD, PhD, São Paulo, Republic; Robert Tomás, MD, Prague, Lake City, UT; Ronald I. Apfelbaum, Brazil; Roberto C. Diaz, MD, São Czech Republic; Filip Sámal, MD, MD, Salt Lake City, UT Paulo, Brazil; Luis E. Guerrero, MD, Prague, Czech Republic; Ladislav Introduction: Iliac crest autograft is São Paulo, Brazil; Claudio Tatsui, MD, HousÈava, MD, Prague, Czech Republic; the gold-standard for bone grafting São Paulo, Brazil Petr Dubovy, RN, Brno, Czech Republic in posterior atlantoaxial arthrodesis Introduction: Total disk replacement Introduction: Despite the improve- procedures. Although autograft has (TDR) and motion preservation tech- ment over the last decade in surgical provided excellent fusion results, it can niques represent some of the most techniques for the brachial plexus, have significant donor site morbidity. advanced treatment for lumbar surgical outcome and functional Allograft has performed suboptimally degenerative disk disease, however restoration of the affected arm are for fusion in this procedure, which is in some circumstances complications still very limited. Favorable surgical primarily an onlay procedure. We occur and revision of the prothesis outcomes have been reported in 60% have modified the technique to allow is needed. We present our experience of patients. placement of bicortical iliac crest with complications in our 250 Charité Methods: Total of 200 brachial allograft in an interpositional manner disk series over a 3 year follow-up plexus injury operations have been and describe and review the results of period. performed by the first author in 192 our bone grafting technique between Methods: Prospective study of 193 consecutive patients. Besides the C1 and C2 using allograft. patients that underwent TDR with the standard techniques, the perineurial Methods: We retrospectively reviewed Charité artificial disk between January suture after creation of epineurial 225 consecutive patients operated on 2002 and September 2005, complica- window has been used for end-to-side between 1991 and 2005 in whom at tions reported throughout the course neurorrhaphy. least one C1-2 transarticular screw was of the study were reviewed, including Results: Functional recovery was placed. Age, sex, clinical indication, the ones that required re-operation. accomplished in 90% of nerves follow- instrumentation, graft source, opera- The surgical technique of a novel ing external neurolysis, 83% following tive time, blood loss, and fusion minimal invasive approach to remove nerve grafting, 54% following end-to- assessment, and complications were the device is described. end neurotization, 64,3% following all reviewed retrospectively. Results: 193 patients with mean age end-to-side neurotization and 89% Results: One hundred eighty-seven of 42.5 years, underwent TDR with following muscle transfer. We achieved patients underwent iliac crest auto- 250 Charité. 9.1% of the total patients the best results with regional nerves graft harvest and 38 patients had reported persistence of pain, 0.6% used as donors for nerve transfer. The donor iliac crest allograft for the presented transitional pos-operative difference was significant especially posterior atlantoaxial arthrodesis. neurological defict, no infections. for the musculocutaneus nerve as a The average age in the autograft 8.3% had suboptimal implantation recipient: 93% of functional recovery group was 49.7 (range 17-90) and in and bad aligment (i.e. 2.8% second- when regional nerves were used, 48% the allograft group was 59.6 (range ary segment scoliosis), 2.8% presented when extraplexal nerves were used 21-89). Operative time was reduced subsidence, and 2.3% presented (p=0.005). Use of the medial pectoral by 30 minutes in the allograft patients heterotopic ossification. 5 patients nerve as a donor led to the most and estimated blood loss (mean=240 underwent minimally invasive lateral favorable functional recovery in 88% cc, 70% of patients had less than 150 transpsoas XLIF (extreme lateral of cases. According to the electro- cc EBL) was reduced by over 30%. All interbody fusion) for removal of the physiological data, even use of clearly patients with greater than 12 months prosthesis and placement interbody partially denervated intraplexal donor follow-up achieved fusion. fusion device, that was supplemented nerves resulted to the more favorable Conclusions: We describe a technique with pedicle screws. No intraoperative recovery than use of extraplexal for interpositional bone grafting complications were reported, mean nerves. End-to-side neurorrhaphy was between C1 and C2 that has allowed surgical time was 80,3 minutes, and performed predominantly for neuroti- for use of allograft with excellent all patients had good clinical outcome. zation of the axillary nerve and func- fusion results. The potential benefits of Conclusions: TDR is not free of com- tional recovery (62%) was very similar this allografting technique include plications and the knowledge of low to the use of other common donors. reduced operative time, decreased morbidity strategies for revision must Conclusions: Better functional recov- blood loss, and elimination of iliac be employed to reduce the colateral ery was achieved using regional crest donor site morbidity. damage associated substitution or (intraplexal) nerves as donors of motor removal of the device, we demostrated fibers. End-to-side anastomosis is an that a minimal invasive XLIF can safely alternative method with results similar achieve this goal. to the other donors of motor fibres.

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108. Strategies and Techniques 109. Thoracolumbar Vertebral 110. Segmental Kyphosis After for Correction of Degenerative Reconstruction After Surgery for Bryan Disc Arthroplasty and Post-Surgical Cervical Kyphotic Metastatic Spinal Tumors: Shee Yan Fong, MBBS, FRCS, Calgary, Deformity Long-Term Outcomes AB, Canada; Stephan DuPlessis, MD, Brian Perri, DO, Los Angeles, CA; Alan Villavicencio, MD, Boulder, CO; Calgary, AB, Canada; Steven Casha, Adetokunbo Oyelese, MD, Los Angeles, Rod Oskouian, MD, Charlottesville, VA; MD, PhD, FRCS, Calgary, AB, Canada; CA; Robert S. Bray, MD, Los Angeles, CA; Clifford Roberson, MD, Los Angeles, John R. Hurlbert, MD, PhD, FRCS, J Patrick Johnson, MD, Los Angeles, CA CA; John K. Stokes, MD, Austin, TX; Calgary, AB, Canada Introduction: Cervical Kyphotic Defor- Jongsoo Park, MD, Stanford, CA; Introduction: The aim of this study mity (CKF) may result from degenera- Christopher Shaffrey, MD, was to investigate factors associated tive disease of the spine, ankylosing Charlottesville, VA; J. Patrick Johnson, with segmental kyphosis after Bryan spondylitis or may occur following MD, Los Angeles, CA disc replacement. decompressive laminectomy. Patients Introduction: Metastatic spinal Methods: Prospective study of a frequently experience pain with or tumors continue to represent a major consecutively enrolled cohort of without progressive neurological problem for patients and treating patients treated in a single center deficits and surgical management is physicians. The purpose of this study using the Bryan cervical disc prosthesis often challenging. We present an was to assess quantitatively the func- for single-level segmental reconstruc- algorithm for the classification, tional outcome, quality of life, and tion in the surgical treatment of management and correction of degen- survival rates of patients after major cervical radiculopathy and/or erative and post-surgical CKF based reconstructive spine surgery. myelopathy. Static and dynamic lateral upon experience with 15 patients. Methods: A prospective database radiographs were digitally analyzed in Methods: Flexion and extension cervi- was established and 58 patients were 10 patients undergoing Bryan disc cal spine radiographs were obtained in identified who had undergone thora- arthroplasty throughout a minimum 3 all patients and CKF was classified as columbar vertebral reconstruction for month follow-up period. Observations reducible (R-CKF), partially reducible metastatic spinal tumors between were compared to pre-operative studies (PR-CKF) or fixed (F-CKF) based on the March 1993 and October 1999. looking for predictive factors of post- degree of sagittal realignment with Surgical indications included disabling operative spinal alignment. neck extension. High-resolution CT pain (92%) and/or progressive neuro- Results: Postoperative endplate angles scans with reconstructed images were logical dysfunction (60%). through the Bryan disc in the neutral then obtained on PR-CKF and F-CKF Results: Forty-nine patients (85%) position were kyphotic in 9 of 10 patients to determine the degree of had clinical improvement in pain as patients. Compared to preoperative fusion within the facet and uncoverte- demonstrated based on the Owestry endplate angulation there was a mean bral joints. Single-stage anterior pain scale (p less than 0.05); 60% change of -7° (towards kyphosis) in cervical discectomy with complete, demonstrated improvement in their postoperative endplate alignment bilateral release of the anterolateral neurological status. The mean neuro- (p=0.007, 95%CI -6° to -13°). This annular ligaments, allograft fusion logical improvement in Frankel grade correlated significantly with postopera- (ACDF) and plating was utilized to was 1.2 (p less than 0.05). The 12- tive reduction in posterior vertebral achieve restoration of normal lordosis in month survival rate was 65%, and all body height of the caudal segment R-CKF patients and PR-CKF patients patients who were ambulatory after (p=0.011, r2=0.575) and postopera- without extensive joint fusion. Deformity surgery remained so until the time of tive FSU kyphosis (p=0.032, r2=0.46). in PR-CKF and F-CKF patients with exten- death. Instrumentation failure requir- Despite intraoperative distraction, sive joint fusion was corrected utilizing ing repeated operation occurred in postoperative FSU height was signifi- initial posterior facet osteotomies two patients (3.5%), and in 12 cantly reduced, on average by 1.7 mm followed by ACDF with or without patients (21%) local tumor recurrence (p=0.040, 95%CI 0.5-2.8 mm). plating and finally with posterior lateral necessitated repeated surgery. There mass instrumentation. Electrophysio- Conclusions: Asymmetrical end-plate were no cases of neurological deficit preparation occurs because of sub- logical monitoring under general or death related to surgery. anesthesia was performed in all cases. optimal coordinates to which the Conclusions: Major anterior thora- milling jig is referenced. Although Results: Complete restoration of nor- columbar vertebral reconstruction is an segmental motion is preserved, Bryan mal lordosis was achieved in all cases effective treatment for local tumor con- disc arthroplasty demonstrates a with no perioperative mortality or trol. More importantly, we have propensity towards kyphotic orienta- progression of neurological deficits. We demonstrated that surgical treatment tion through the prosthesis likely as a discuss treatment algorithm, strategies can significantly improve the quality result of intra-operative lordotic dis- and surgical techniques as well as out- of life by improvement of pain control traction. FSU angulation tends towards comes for patients with this condition. and maintenance of ambulation during kyphosis and FSU height is decreased Conclusions: Surgical correction of the patient's remaining life span. in the postoperative state from lack of complex non-ankylosing spondylitis anterior column support. Bryan cervi- CKFs may be feasibly and safely cal disc arthroplasty should not be approached using a stepwise treatment performed when reconstruction or algorithm and combination of surgical maintenance of cervical lordosis is techniques. desirable.

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 42 ORAL ABSTRACTS

111. Comparison of Multiple Level 112. Cervical Disc Replacement – 113. Radiographic Analysis of the Versus Single Level Cervical Disk Longer-Term (2-Year) Range of Prestige® ST Cervical Disc: Results Replacement-178 Consecutive Motion and Clinical Outcomes from a Prospective Randomized Prostheses Follow-Up with the ProDisc-C Controlled Clinical Trial Paul McAfee, MD, Sparks, MD; Luiz Prosthesis J. Kenneth Burkus, MD, Columbus, Pimenta, MD,PhD, Sao Paulo, Brazil; Rick B. Delamarter, MD, Santa Monica, GA; Thomas A. Zdeblick, MD, Iowa Alan Crockard, London, United King- CA; Hyun W. Bae, MD, Santa Monica, City, IA; Vincent C. Traynelis, MD, dom; Andy Cappuccino, Buffalo, NY; CA; Linda E.A. Kanim, MA, Santa Iowa City, IA Bryan Cunningham, Baltimore, MD Monica, CA; Michael A. Kropf, MD, Introduction: As cervical arthroplasty Introduction: This prospective study Santa Monica, CA; Ben B. Pradhan, becomes a potential treatment option, of 178 prosthetic implantations ana- MD, MSc, Santa Monica, CA it is important for spine surgeons to lyzed single level versus multiple level Introduction: After encouraging results understand the performance of disc cervical arthroplasty. with lumbar arthroplasty, trials for replacement devices. We looked at the Methods: Fifty-five patients under- cervical spine arthroplasty have been extensive radiographic evaluation went single level Porous Coated completed in the US. This paper repre- required in the IDE study protocol for Motion (PCM) versus fifty-four patients sents the longest follow-up outcomes the Prestige ST Cervical Disc and underwent 109 multilevel PCM cervi- studies with cervical disc replacements present the preliminary results of cal arthroplasties — double level, 43 in the US with (ProDisc-C). radiographic analysis from the study. cases; three levels, 7 cases, and four Methods: This is a prospective ran- Methods: Five hundred forty-two levels, 4 cases. Sixteen PCM cases had domized controlled trial of ProDisc-C patients were randomly assigned to been performed as complex revision intervertebral arthroplasty versus either the investigational group (276 procedures. The demographics anterior cervical fusion. Thirty patients patients) who received the Prestige between Group S and Group M were were enrolled. Clinical outcomes were ST disc or the control group (266 very similar: mean age of patients, recorded with the Visual Analog Scale patients) who had an arthrodesis with gender, severity of neurologic symp- (VAS) for both neck and arm pain, and cortical ring allograft and an ATLANTIS toms and distribution of radicular and Oswestry disability questionnaires. anterior cervical plate. Patients are myeloradicular symptoms. Results: Average flexion-extension evaluated at the following study inter- Results: There were no deaths, no motion went from 9 degrees preoper- vals: preoperative, 6 weeks, and 3, 6, infections, and no instances of iatro- atively to about 1 degree (no motion) 12, and 24 months after surgery genic neurologic progression in either at over 12 months postoperatively in with anteroposterior, lateral, lateral the single level or the multiple level the fusion group, but was well-pre- flexion-extension, and left-right lateral arthroplasty group. The mean follow served from 11 to 12.5 degrees in the bending radiographic views. An inde- up was 19.6 months. The self disc replacement group. Side-bending pendent radiology firm reviews all assessment outcomes instruments went from 6 degrees to 2 degrees (no radiographs and each radiograph consistently showed more improve- motion) in the fusion group, versus undergoes specific measurements by ment for the multilevel cases. The 5.9 to 5 degrees in disc replacement two physicians. We measured angula- mean improvement in the NDI for the patients. Outcome scores revealed tion and anteroposterior translatory single cases was 43.8% (+/- 20.9) significant improvements in VAS and movement at the treated level and versus the multilevel cases mean Oswestry scores for both groups. By adjacent levels, disc space height, and improvement in NDI was 64.8% six months, VAS (neck) was down lateral-bending angulation. Computer (+/- 33.7). The Mean improvement in from 6.6 to 2.4 in arthroplasty pattern recognition technology further the VAS showed the same relationship patients, and 6.2 to 2.6 in fusion. VAS quantifies motion-analysis parameters. — single level mean improvement (arm) was down from 4.7 to 2.4 and Results: At the 12-month interval, the 58.1% (29.3) versus the multilevel 6.5 to 2.9 in arthroplasty and fusion Prestige ST device maintained pre- cases mean VAS improvement was patients respectively. Oswestry scores operative angulation to within 1° in 65.5% (+/- 33.0). similarly decreased from 25 to 9 and investigational patients. In the Conclusions: With the Porous Coated 24 to 13 at over 12 months in arthro- arthrodesis group, motion dropped to Motion cervical arthroplasty the inci- plasty and fusion patients respectively. below 1° of angulation, and adjacent- dence of reoperation did not increase Conclusions: Our results suggest that level-angulation measurements show a proportionately higher as the number cervical disc replacement is a viable relative increase in motion at the supe- of cervical levels requiring instrumen- alternative for preservation of motion rior segment. The device maintained tation increased. This study indicates at affected vertebral levels without disc space height without migration that the current five prospective compromising clinical outcomes, and from the implanted position, and randomized FDA clinical trials compar- with the additional upside of preven- computer analysis demonstrated a ing arthroplasty with anterior cervical tion of adjacent segment degenera- physiologic center of rotation. fusion will underestimate the true tion. Longer-term safety and efficacy Conclusions: Preliminary radiographic benefits of cervical arthroplasty studies are in progress. evaluation indicates that the Prestige because they are not capturing the ST device is performing according to data on multiple level application. its design intent.

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114. Lumbar Intervertebral Disc 115. eXtreme Lateral Interbody 116. Positional Peripheral Nerve Stabilization (LIDS): A Stand-alone, Fusion (XLIF): The Initial U.S. Injury in Spine Surgery: Is There a Unilateral, Lumbar Fusion Technique Experience 2003-2004 Potential Role for Intraoperative Madhavan Pisharodi, MD, Brownsville, Neill M. Wright, MD, St. Louis, MO Monitoring? TX; Amayur P. Chandran, PhD, Introduction: The treatment of Arthur Grigorian, MD, PhD, Macon, Brownsville, TX lumbar DDD with a minimally-invasive GA; Vassilios Dimopoulos, MD, Introduction: A reliable, ‘stand-alone’ lateral trans-psoas technique (XLIF) has Macon, GA; Induk Chung, PhD, posterior stabilization and fusion previously been presented as small Macon, GA; Bridget Fuhrmann, BSN, technique has been eluding spine case series, describing the advantages RN, Macon, GA; Kim Holderfield, MSc, surgeons. Pisharodi Device (PD) is a of placement of a large interbody graft Macon, GA; Joe S. Robinson, MD, biconvex implant, assembled inside with small incisions, short operative Macon, GA the disc space that conforms to the times, and short hospital stays. This Introduction: The role of neuro- shape of the disk space and allows retrospective study reports the U.S. physiologic intraoperative monitoring good area of graft to bone contact to XLIF experience from 2003-2004 to (NIOM) in preventing peripheral nerve give optimal stabilization and fusion. demonstrate the safety and repro- injury due to operative positioning has A feasibility study involving PD was ducibility of the XLIF technique in a been proposed in the literature. The performed followed by a multi-center larger patient series. purpose of our current communica- prospective randomized study with Methods: 145 XLIF patients treated tion is to assess the contribution of cages as control, following a protocol by 20 U.S. surgeons were identified NIOM to early recognition of periph- approved by the Food and Drug from an industry database. Operative eral nerve compression in lumbar Administration (FDA). data (#levels, operative time, blood spinal cases with apparent optimal Methods: The study involved 103 loss, complications) and postoperative positioning. patients (aged 18-59 years) with low details (ambulation, length of stay) Methods: The records and intraopera- back pain. After simple discectomy, were analyzed. The XLIF procedure is tive neurophysiological monitoring the disc space was filled with bone a direct-lateral, retroperitoneal, trans- reports of 853 consecutive patients from iliac crest. The biconvex piece of psoas approach to the interbody undergoing lumbar spine surgery in the PD was inserted first horizontally space. Nerve avoidance technology our institution have been retrospec- and rotated 90 degrees, the end-piece was used to safely traverse the psoas tively reviewed. Unilateral upper glided along and fastened with the in all patients. After diskectomy, an extremity SSEP changes were identi- biconvex piece with a screw, to form interbody spacer was placed, and fied, and intraoperative maneuvers a compact unit. PD is implanted uni- depending on surgeon preference, such as repositioning of the involved laterally. was either left stand-alone, or was extremity and intraoperative monitor- Results: The patients had follow-up supplemented laterally or posteriorly. ing response were noted. Intraopera- evaluations at 3, 6, 12 and 24 months Results: #levels: 72% (1), 22% (2), tive findings were correlated with after the surgery and this included, 5% (3), 1% (4). Site: L4/5 (37%), L3/4 postoperative outcome. clinical (pain status, work status, (33%), L2/3 (24%), L1/2 (6%). Filler: Results: All patients were operated in muscle strength and reflexes), and BMP (52%), DBM (39%), autograft the prone position. Preoperatively, radiological (flexion/extension, disc (9%). 20% of cases were stand-alone patients’ position was found to be height, implant status including interbody, 23% lateral rod-screw, 58% optimal with adequate protection of migration) studies. Follow-up evalua- posterior pedicle screws. Nerve detec- pressure points. Intraoperative moni- tion 3 months after the surgery tion monitoring identified a nearby toring revealed an abrupt decrease of showed significant improvement in nerve in 46% of cases. Average opera- unilateral upper extremity SSEPs pain level and radiological evidence tive time: 74 minutes. Average blood amplitude in ten cases. All patients of 100% fusion and maintenance of loss: 88ml. Most patients ambulated had immediate restoration of SSEPs disc height. Eighty-one patients have the same day of surgery and were after repositioning and relief of completed 24 months’ follow-up. discharged the next day. No major mechanical compression of the Conclusions: PD is assembled inside complications occurred. ipsilateral upper extremity. No the disk space and implanted unilater- Conclusions: All 145 patients were postoperative upper extremity deficit ally to reduce the tissue loss and to treated successfully, illustrating the was observed. give maximum graft to bone contact technique’s safety and reproducibility, Conclusions: In our series intraopera- for optimal fusion. LIDS procedure with short operative times, low blood tive monitoring detected position using PD is a simple, safe and reliable loss, early ambulation, and short related peripheral nerve mechanical surgical technique done as a good hospital stays without major or lasting compression in all cases. We believe stand-alone stabilization and fusion complication. that in spine surgery NIOM plays an procedure. important role in preventing unex- pected peripheral nerve injury due to improper extremity position or unde- tected movement.

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 44 ORAL ABSTRACTS

117. Long-Term Radiographic 118. Extraforaminal Lumbar Inter- 119. Minimally Invasive Transforami- Evaluation of 331 Patients After body Fusion: A New Technique for nal Lumbar Interbody Fusion and Anterior Cervical Discectomy and Outpatient Lumbar Fusion Surgery Pedicle Screw Fixation: An Excellent Fusion with Dynamic Plating Gregory J. Przybylski, MD, Edison, NJ; Technique For Treatment of Chronic Daniel R. Fassett, MD, Salt Lake City, UT; William Mitchell, MD, Edison, NJ Lower Back Pain Secondary to Spondylolisthesis or Degenerative Kyle Judd, BS, Salt Lake City, UT; Randy Introduction: Current minimally- Clark, BS, Salt Lake City, UT; Ronald Disc Disease With or Without invasive lumbar fusion techniques use Associated Stenosis Apfelbaum, MD, Salt Lake City, UT expandable retraction through a tradi- Introduction: Dynamic anterior cervi- tional unilateral PLIF/TLIF approach. Mick Perez-Cruet, MD, MSc, cal plating is theorized to improve This limits access to the contralateral Southfield, MI; Hormoz Sheikh, MD, fusion rates in ACDF by allowing for disc space, requires exposure of the Southfield, MI load sharing of the interbody graft to thecal sac and two nerve roots, and Introduction: Minimally invasive provide for optimum bone healing, necessitates a larger diameter device. lumbar fusion and instrumentation but large long-term follow-up studies This prospective study examines techniques preserve the normal have not been reported with dynamic application of a fixed 18mm tube to anatomical integrity of the spine and plating in ACDF. performing an extraforaminal lumbar may improve patient outcomes. How- Methods: A retrospective review was interbody fusion (ELIF) with pedicle ever, outcomes using this technique performed on 395 patients who had fixation on an outpatient or 23 have not been thoroughly evaluated. ACDF with dynamic plating with at hour stay. Methods: A retrospective review of least 6 months follow-up. Sixty-four Methods: 29 patients underwent 51 consecutive patients (28 with patients were excluded for acute ELIF and pedicle fixation. Most had spondylolisthesis, 1with retrolisthesis, trauma, previous cervical spine spondylolisthesis, mechanical back 1 with spondylolysis and 21 with procedures, or supplementation with pain, and unilateral radiulopathy. degenerative disc disease) was con- posterior instrumentation. Anterior- Pedicle fixation was performed ducted. Patients completed visual posterior, lateral, and flexion-extension through a single 18mm tube. Patients analoge scale (VAS), Oswestry radiographs were reviewed to deter- were discharged on the same day or Disability Index (ODI), and short mine settling and to evaluate for after overnight stay and underwent form-36 (SF-36) pre-operatively and at fusion. Measurements of motion follow-up evaluation at one, three, six, 2 weeks, 3 months, 6 months and 24 between spinous processes were and twelve months. Outcomes were months post-operatively. Post-opera- performed under high magnification measured with preoperative and post- tive CT was preformed to confirm on a PACS workstation. Magnification- operative SF-36 questionnaires. Addi- graft and instrumentation placement. corrected motion less than 1.0 mm tional parameters studied included Results: The average length of pre- was deemed a fusion. operative duration, EBL, postoperative operative back pain symptoms was 8.3 Results: Single-level ACDF was pain management, return to work, years. Twenty-two patients had mod- reviewed in 135 patients with fusion and radiographic fusion. erate to severe lumbar stenosis. The rates of 34.6%, 59.3%, 84.8%, and Results: More than one third were average total operative time was 256 98.9% at 3, 6, 12, and 24 months discharged same day. None required +/- 47 min and estimated blood loss follow-up. Two-level ACDF was readmission, and none had post- was 224 cc +/- 63 cc. The average evaluated over 312 instrumented operative CSF leak. Median operative length of hospitalization was 4.2 days. interspaces in 156 patients with fusion duration was 4 hours; median EBL was VAS-score was reduced from 7.7 pre- rates of 27.9%, 52.4%, 78.7%, and 250cc. 13 had sufficient blood for cell operatively to 2.89, ODI was reduced 93.1% at 3, 6, 12, and 24 months saver return with a median volume of from 44.4 pre-operatively to 22.4 and follow-up. Three-level ACDF was eval- 100cc. One patient developed tran- SF-36 scores improved greatly at aver- uated for 135 instrumented levels in sient foot weakness, and one third age 17 month follow-up. Prolo scores 45 patients with fusion rates of 46.8%, developed transient neuropathic pain. were 76.4% excellent, 21.5% good, 60.2%, 77.5%, and 80.2% at 3, 6, 12, Subsequent limited direct root expo- 1.96% fair. Fusion rate was 98% at and 24 months follow-up. Five sure significantly reduced this prob- one year follow up. No patient patients had 4-level ACDF with 95% lem. One had a pseudoarthrosis returned with transitional syndromes of interspaces fused at 1-year follow- requiring revision. 22 had significant during the course of the study. Com- up. Eighty percent of the settling improvement in multiple SF-36 scales plications included one patient with a occurred within one month. at last follow-up. permanent nerve root injury and one Conclusions: Dynamic cervical plating Conclusions: ELIF is an effective alter- graft failure requiring return to OR. can provide for stability and load- native to performing lumbar interbody Conclusions: Minimally invasive trans- sharing needed to provide for fusion using familiar extraforaminal foraminal interbody fusion is an effec- optimum fusion rates in ACDF. anatomy and minimizing exposure of tive and safe method in experienced neural elements. This technique allows hands for treating patients with chron- performance of instrumented lumbar ic debilitating back pain. fusion on an outpatient basis.

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES ORAL ABSTRACTS 45

120. Cervical Arthroplasty Versus 121. Cervical Disc Arthroplasty with Fusion at Two Levels: What are the the Prestige ST Device: One and Biomechanical Differences? Two Year Results from a Multi- Kevin T. Foley, MD, Memphis, TN; Center Randomized Controlled Trial Denis J. DiAngelo, PhD, Memphis, TN Praveen V. Mummaneni, MD, Atlanta, Introduction: The purpose of this GA; Regis W. Haid, MD, Atlanta, GA; study was to compare the biomechan- Joseph B. Stachniak, MD, Richardson, ical effects of adjacent two-level TX; Wade M. Ceola, MD, Springfield, placement of a cervical disc prosthesis MO; Paul D. Sawin, MD, Winter Park, FL with simulated fusion at the same Introduction: We present preliminary levels. results from four centers participating Methods: Six fresh human cadaveric in the ongoing Prestige ST prospec- spines (C2-T1) were tested in flexion, tive, randomized IDE study comparing extension, lateral bending, and axial arthroplasty to fusion for treatment of rotation under displacement control. single-level cervical disease. Three different conditions were evalu- Methods: 120 patients with sympto- ated: the harvested spine, the spine matic cervical disc disease were ran- with C5-6 and C6-7 disc replacement domized to receive either the Prestige using the Prestige LP prosthesis, and ST device (n=66) or ACDF with plate two-level (C5-7) fusion. Fusion was fixation (n=54). Entrance criteria simulated using a custom-designed included single-level (C3-7) disc screw and clamp apparatus. The disease with concordant radiculopa- spines were tested to a target moment thy. Demographics of the treatment of 3Nm. Measurements included indi- groups were similar. The C5-C6 and vidual vertebral motion, total spine C6-C7 levels were the most frequently rotation, and applied loads. operated. Patients were evaluated with Results: The use of the two-level neck and arm visual analog scales cervical disc prosthesis maintained the (VAS), neck disability index (NDI), biomechanical integrity of the spine and SF-36 preoperatively, and at relative to the intact harvested state. each postoperative interval. Dynamic Motion patterns for the prosthesis at X-rays were obtained at all intervals both operated and adjacent segments and segmental motion at the operated did not undergo any significant levels quantified. changes relative to the harvested Results: Preoperative and operative condition. In contrast, the fusion variables were similar between treat- procedure resulted in a significant ment groups. Postoperatively, all reduction in motion at the operated outcome scores improved for both levels and increased motion at the groups. However, outcomes scores for adjacent segments compared to patients receiving the Prestige ST both the harvested and arthroplasty device trend better than those for the spine conditions. fusion group at virtually every data Conclusions: Two-level cervical collection point. In most instances the arthroplasty with the Prestige LP disc differences are statistically significant. produced spinal motion patterns that Radiographic analysis shows the were comparable to the harvested Prestige device to maintain/restore seg- spine at both the operated and mental motion. No revision surgeries adjacent levels. Simulated fusion, on have occurred in the Prestige group the other hand, markedly reduced and two revisions have occurred in the motion at the operated levels and ACDF group. produced a compensatory increase in Conclusions: Preliminary analysis of motion at adjacent segments. From a data from the Prestige ST IDE study biomechanical point of view, 2-level suggests that cervical disc arthroplasty cervical arthroplasty yielded a spine affords at least equivalent outcomes that was much closer to the baseline for patients with single-level cervical (unoperated) state than did fusion. disc disease.

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 46 ORAL POINT ABSTRACTS

ORAL POINT ABSTRACT 200. Safety of Outpatient Anterior 201. Comparison of Radiographic and Posterior Cervical Spine Surgery Outcomes of Anterior Lumbar PRESENTATIONS in a Community Hospital Interbody Fusion (ALIF) Versus These scheduled presentations will Gregory J. Przybylski, MD, Edison, NJ; Transforaminal Lumbar Interbody be held in concurrent sessions on William Mitchell, MD, Edison, NJ Fusion (TLIF) Thursday, March 16th. Each Introduction: Cervical surgery is tradi- Patrick C. Hsieh, MD, Chicago, IL; presentation by the primary author tionally inpatient. Safety of outpatient Sean Salehi, MD, Chicago, IL; Stephen will be four minutes in length followed cervical surgery is unknown. This Ondra, MD, Chicago, IL; Tyler R. periodically by discussion periods of prospective study compares inpatient Koski, MD, Chicago, IL; John C. Liu, seven minutes. and outpatient results. MD, Chicago, IL Methods: All 101 patients having Introduction: Interbody fusion is an cervical surgery over a 33 month effective treatment for debilitating period in a community hospital were back pain. Anterior lumbar interbody prospectively studied. Procedures, fusion (ALIF) and transforaminal lum- admission method, operative duration, bar interbody fusion (TLIF) are two EBL, and complications were compared. procedures that are commonly used to achieve lumbar interbody arthrode- Results: 29/40 having anterior surgery sis. To date, there is no prospective (25 1-2 level ACDF, 3 1-level randomized study demonstrating that corpectomy) were discharged within one procedure is superior to the other. 4 hrs. None required readmission; one Particularly, there are no data compar- had transient hoarseness. 11/40 ing ALIF versus TLIF regarding their stayed overnight (four were inpatients abilities to alter foraminal height, with fracture/dislocation). Among SDS local/regional lordosis, or sagittal patients, 1 had transoral surgery, 1 balance. corpectomy for neoplasm, and 5 had ACDF ( 3 1-level and 2 3-level). 2/2 Methods: The medical records and patients with anterior-posterior surgery radiographs of 32 ALIF patients and were inpatients with staged deformity- 25 TLIF patients from 2000 to 2004 correction or fracture with ankylosing were retrospectively reviewed. Clinical spondylitis. 36/58 patients having pos- data and radiographic measurements terior surgery (24 1-3 level foramino- including pre-operative and post- tomies, 8 mulitilevel laminectomy with operative foraminal height, local disc instrumented fusion, 4 laminectomy angle, and lumbar lordosis were for stimulator electrodes, 1 for C2 obtained. Descriptive statistics were schwannoma) were discharged within determined, and a direct comparison 4 hrs. None required readmission; of values obtained from the two none had complications. 22/58 studied groups was performed. patients stayed overnight (fourteen Results: Our results indicate that ALIF inpatients had spine/cord injuries or is superior to TLIF in its ability to tumor). Among SDS patients, 5 had restore foraminal height, local disc instrumented PCF, 1 had intradural angle, and lumbar lordosis. On aver- surgery, 1 had C1C2 fusion, and 2 age, ALIF increase foraminal height by had laminectomy. 2 postoperative 18.1 percent, whereas TLIF decreased hematomas (3-7 days postoperatively) it by 0.4 percent. In addition, ALIF occurred in inpatients; one from anti- increased local disc angle by 8.3 coagulation and the other from trau- degree and lumbar lordosis by 6.2 matic epidural rostral to bilateral facet degree, but TLIF decrease local disc dislocation. angle by 0.1 degree and lumbar Conclusions: Selected outpatient cer- lordosis by 0.4 degree. A restoration of vical surgery can be performed safely. local disc angle by 8 degree at L5-S1 Outpatient 1-2 level ACDF and poste- translates to approximately 5.6 cm rior foraminotomy can be routinely improvement in sagittal balance. performed. Outpatient 1 level corpec- Conclusions: Anterior lumbar inter- tomy and multilevel laminectomy with body fusion is superior to transforami- instrumented fusion may be per- nal lumbar interbody fusion in its abili- formed as an outpatient, but the ty to restore foraminal height, local smaller number treated requires addi- disc angle, and lumbar lordosis. tional study before recommending routine outpatient surgery.

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES ORAL POINT ABSTRACTS 47

202. Lumbar Total Disc 203. Biomechanical Comparison of 204. A Retrospective Comparative Replacement: A 2 to 3 Year Report the Charité and Prodisc-L Lumbar Study of Intraoperative EMG-based from the United States Clinical Trial Disc Prostheses Neuromonitoring of Percutaneous for the Prodisc-L Prosthesis Kevin T. Foley, MD, Memphis, TN; Pedicle Screw Placement and Post- Hyun W. Bae, MD, Santa Monica, CA; Denis J. DiAngelo, PhD, Memphis, TN; operative Computed Tomgraphic Ben B. Pradhan, MD, MSc, Santa Brian Morrow, BS, Memphis, TN; John Scan Confirmation Monica, CA; Michael A. Kropf, MD, German, MD, Albany, NY; Rudolph Hormoz Sheikh, MD, Southfield, MI; Santa Monica, CA; Linda E.A. Kanim, Bertagnoli, MD, Straubing, Germany; Mick Perez-Cruet, MD, MSc, MA, Santa Monica, CA; Rick B. Jung Song, PhD, Memphis, TN; Southfield, MI Delamarter, MD, Santa Monica, CA Thomas Mroz, MD, Cleveland, OH Introduction: Minimally invasive Introduction: The advantage of TDR Introduction: Different paradigms percutaneous pedicle screw instru- over fusion is that motion-prservation exist in the design of total disc arthro- mentation attempts to reduce may prevent accelerated degeneration plasty devices. The purpose of this approach related morbidity. Intra- at adjacent levels. Recently, the FDA study was to compare the in vitro bio- operative electrophysiologic stimula- has approved the use of the Charité mechanics of a more constrained ball- tion of screws can potentially improve artificial disc for single-level degenera- and-socket design (Prodisc-L) and a the safety of this procedure. A critical tive disc disease. Often however, disc less constrained mobile-bearing design analysis of intra-operative pedicle degeneration is not limited to one (Charité). The performance of the disc stimulation correlating with post- level. This is a report on the longest prostheses was compared to harvested operative CT has not been conducted. follow-up of a prospective randomized and fused spine conditions. Methods: A retrospective chart analy- controlled study of TDR (ProDisc-L) Methods: Twelve human cadaveric sis was conducted of twenty patients versus circumferential fusion for one lumbar spines (L1-sacrum) were tested receiving percutaneous lumbar pedicle and two-level DDD. in flexion, extension, lateral bending, screws. 78 screws were tested intraop- Methods: This is an analysis of motion and axial rotation under displacement eratively using electrical stimulation. and outcome at 2 to 3 years for the control. Four conditions were evaluat- The CT-scans were evaluated for screw first 194 patients enrolled in the study ed: harvested spine (n=12), L5-S1 placement using a 5 tier grading at our institute, including both ‘ran- lumbar disc replacement using system as follows: grade 1-screw domized’ and ‘continued access’ arms. Prodisc-L (n=6) or Charité (n=6), and within cortical bone of the pedicle, In the randomized arm (81 patients), L5-S1 pedicle screw fixation (n=12). grade 2-screw violates medial wall of 58 received disc replacements and 23 The spines were loaded to a target pedicle but did not require return to had fusion procedures. Patients rated moment of 8Nm. For axial rotation OR, grade 3-screw violated medial themselves with VAS and ODI scores. tests, a 100N compressive load was cortical bone and required return to Pain, disability, motion, and patient applied. Measurements included OR, grade 4-screw violated lateral satisfaction were evaluated as func- vertebral motions, total spine rotation, cortical bone but did not require tions of treatment. and applied loads. return to OR and finally grade 5 screw Results: TDR significantly reduced Results: There were no significant differ- violated lateral cortical bone requiring pain and disability at earlier evalua- ences in normalized motion responses return to OR. Electromyographic tions (6 months). At final follow-up, at the implanted level for the Prodisc-L thresholds and computed tomographic the improvement on both VAS and spines compared to the harvested scans were evaluated separately and ODI were similar for TDR (7.4 to 3.5 spines, except for left axial rotation and compared to assesses the accuracy of and 31 to 16) and fusion patients extension. Significant differences electromyographic screw stimulation (7.0 to 3.5, and 30 to 18) (p LT 0.05). between the Charité and harvested technique. Greater motion was seen at L4-L5 for spines occurred in left and right lateral Results: Post-operative CT grading of TDR patients (p LT 0.05). A similar bending. Significant differences existed pedicle screws confirmed 69 as grade trend was noted at L5-S1 (p GT 0.05). between the fused condition and the 1, 8 as grade 4, and 1 as grade 3. There were no device-related compli- harvested, Prodisc-L, and Charité None were grades 2 or 5 which would cations. Patient satisfaction was conditions for all loading modes. require return to the OR. Average over 90%. Conclusions: Compared to the intact screw stimulation threshold of grade 1 Conclusions: Results demonstrate that spine, both disc prostheses (Prodisc-L was 26.4 mAmps, grade 3 was 20 lumbar TDR is a safe and effective and Charité) maintained lumbar mAmps, and grade 4 was 20.3 alternative to fusion for intractable mobility and stability. The Prodisc-L mAmps. One patient had initial multi-level discogenic pain. The design limited motion in extension stimulation threshold below 8 mAmps ProDisc-L allows safe and effective and axial rotation, whereas the less requiring screw repositioning intra- TDR at more than one-level. constrained Charité design provided operatively with post-op CT showing Intermediate-term follow-up results, increased mobility in lateral bending. grade 1. up to three years, are presented. Although the optimal kinematics for Conclusions: Intraopertive percuta- lumbar disc prostheses remains neous screw stimulation seems to be unknown, there are demonstrable an excellent technique to confirm biomechanical differences between adequacy of screw placement. these devices.

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205. MRI Morphologic Predictors of 206. Multimodality Intraoperative 207. Unilateral versus Bilateral SPECT Positive Facet Arthropathy in Neurophysiological Monitoring for Cage and Pedicle Screw Placement Patients with Axial Back Pain Adult Tethered Cord Syndrome for Single Level Fusion. A Microneurosurgery Keun-Young A. Kim, MD, Los Angeles, Prospective Comparison CA; Michael Y. Wang, MD, Los Guillermo Paradiso, Toronto, ON, Douglas B. Moreland, MD, Buffalo, Angeles, CA Canada; Gabriel Lee, MBBS, FRACS, NY; Gregory A. Czajka, MPAS, PA-C, Toronto, ON, Canada; Roger Sarjeant, Introduction: While it is increasingly Buffalo, NY; Jennifer Weaver, RPA-C, BS, Toronto, ON, Canada; Ly Hoang, Buffalo, NY clear that facet arthropathy is a signifi- BS, Toronto, ON, Canada; Eric M. cant contributor to axial back pain, a Massicotte, MD, FRCS(C), Toronto, Introduction: A controversial question major barrier to understanding this ON, Canada; Michael Fehlings, MD, in Posterior Lumbar Interbody Fusion disease has been the lack of studies PhD, FRCS, Toronto, ON, Canada (PLIF) is if single side pedicle screw elucidating the relationship between and rod construct is sufficient for Introduction: The role of multimodality structural degenerative facet changes selected single level PLIF’s which intraoperative neurophysiological mon- and evidence of active joint inflamma- require a posterior construct or itoring (M-IOM) in adult tethered cord tion. This study investigates structural syndrome (ATCS) has not previously tension band. (MRI) characteristics that predict been assessed in detail. The aim of this Methods: PLIF using bilateral cages pathology on functional (SPECT) study is to evaluate the M-IOM in and bilateral pedicle screws (Group I, imaging. assisting microneurosurgery for ATCS. N,86) was compared with PLIF using a Methods: 431 patients without Methods: M-IOM included posterior single midline cage and single side spondylolisthesis underwent SPECT tibial nerve somatosensory evoked pedicle screws (Group II, N,66). Both imaging for chronic back pain. 31 potentials (PT-SSEPs), continuous Groups included equal proportions of patients had at least one “hot lesion." electromyographic (C-EMG) monitor- degenerative disk disease (80 vs. 75 Exclusion of areas affected by surgery ing of the L2 to S4 myotomes, and percent) and Grade I Spondylolisthesis. yielded 32 positive joints out of a total evoked electromyography (E-EMG). At a minimum of 6 months, patients of 230 facets. Qualitative features Statistical analysis included sensitivity, were evaluated for fusion and by a were evaluated, including synovial specificity and predictive values. pain VAS and the Oswestry Disability and cartilaginous discontinuities, Index (ODI) (compliance, 34 percent). Results: Between 1994-2004, surgery heterogeneous bone patterns, synovial for ATCS was performed in 62 cases. Results: Comparing Groups I and II, hooking, and cupping osteophyte Of these, detailed neurophysiological the average length of stay was 4.1 formation in the lateral joint. records were available in 44 patients (S.D., 1.4) vs. 3.6 (1.3) days (p,0.014), Quantitative features were evaluated, (19 males, 25 females, age: 43 ± 15 blood loss was 215 (192) vs. 127 including asymmetry in size, joint years, range: 19-72 years), which form (106) mL (p,0.0003),and operative space narrowing, lateral & medial the basis of this study. Postoperatively, time was 114 (36) vs. 98 (35) mins. synovial content, and variations in two patients developed new neurolog- (p,0.007). There were 4 complications synovial signal intensity. ical deficits. One of them showed in Group I and none in Group II. Results: The MRI characteristic with severe right side PT-SSEP amplitude Outcomes: There were no clinically the greatest sensitivity was synovial reduction during surgical manipula- failed fusions at six months. space obliteration or narrowing tion, which persisted to the end of Improvements were as follows (0.93 sensitivity and 0.35 specificity). surgery. One patient with transient (Group I vs. II): Back pain decreased Several facet morphologies were highly PT-SSEP amplitude reduction had no 55 vs. 46 percent (p,0.88), ODI specific but not sensitive: lateral cup- new postoperative neurological decreased 36 vs. 28 percent (p,0.90). deficits. For SSEPs, sensitivity was 50% ping from osteophytic overgrowth Conclusions: There were no (0.90), and synovial mottling (0.90). and specificity 97%. EMG bursts were recorded in 36 patients (82%). detectably significant differences Facet asymmetry and enlargement between Groups I and II in fusion rate, correlated poorly (sensitivity & speci- Spontaneous bursts of EMG activity before surgical manipulation occurred back pain relief or ODI improvements. ficity = 0.50), suggesting that joint in 8 patients (18%). Patients with OR Time, blood loss and hospital stay hypertrophy may be protective and postoperative worsening showed EMG time were extremely favorable for represent a more advanced stage in activity in the myotomes where their Group II. We conclude that single side natural history of joint degeneration. new deficits presented. C-EMG had a pedicle screw and rod construct is Conclusions: Abnormal synovial pat- sensitivity of 100% and a specificity of sufficient for many single level PLIF’s terns were the best predictors of “hot” 19%. Evoked EMG consistently identi- which require a posterior construct. facets. This study suggests that specific fied functioning neural elements. abnormalities in the bony, cartilagi- Conclusions: The combination of the nous, and synovial architecture may highly specific SSEPs, the highly sensi- give future insight into the pathophys- tive C-EMG and the E-EMG, provides a iology of facetogenic pain syndromes potentially useful adjunct to complex and the natural history of facet degen- microsurgery for ATCS. In our series, eration from synovial degeneration to microsurgical decision making was par- facet enlargement. ticularly influenced by the combined use of C-EMG and E-EMG recording.

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208. Development of an 209. Minimally Invasive Lateral Mass 210. Posteromedian Extracavitary Animal Model of Post-Traumatic Screw Fixation in the Cervical Spine: Approach to the Thoracolumbar Syringomyelia Associated with Initial Clinical Experience with Long- Spine: A Single Incision Approach Adhesive Arachnoiditis: Implications Term Follow-up for Circumferential Decompression, for an Enhanced Understanding Michael Y. Wang, MD, Los Angeles, Reconstruction, and Arthrodesis of the Pathobiology and for the CA; Allan D.O. Levi, MD, PhD, Miami, Nicholas B. Levine, MD, Cincinnati, Development of Novel Therapeutic FL; Bryan C. Oh, MD, Los Angeles, CA OH; Charles Kuntz, MD, Cincinnati, Approaches Introduction: Lateral mass fixation of OH; Robert J. Bohinski, MD, PhD, Toshitaka Seki, MD, PhD, Toronto, the cervical spine has been a major Cincinnati, OH ON, Canada; Michael G. Fehlings, advancement for spinal surgeons. This Introduction: Thoracolumbar spine MD, PhD, FRCS, Toronto, ON, Canada technique provides three-dimensional approaches can be divided into three Introduction: We have sought to fixation from C3 to C7. However, general categories: posterior, postero- develop a animal model of post- exposure of the dorsal spinal muscula- lateral, and anterolateral. These traumatic syringomyelia (PTS) to facili- ture can produce postoperative neck approaches prohibit 360-degree access tate the understanding of this disorder pain. A minimal access approach using to the vertebral column and spinal so that improved therapeutic tubular dilators can potentially over- cord. In this retrospective clinical approaches can be developed. come the drawbacks associated with study, we describe an amalgamated Methods: Injured Wistar rats received the extensive muscle stripping needed approach, posteromedian extracavitary, 35g clip injury was applied to the for traditional exposures. which allows for circumferential expo- spinal cord to simulate a moderate Methods: A retrospective analysis sure of the spine through a posterior spinal cord injury (SCI) at T6 was performed on the first eighteen midline incision. level.(1)Rat PTS model (n=48); The patients treated with minimally Methods: 18 patients underwent a animals were divided into 4 groups. invasive lateral mass screws. All posteromedian extracavitary approach G1 was animals received SCI only, G2 patients, except two who were lost for complex circumferential lesions was received SCI and injected kaolin to follow-up, had a minimum of two secondary to infection, trauma, and into the subarachnoid space (SAS), years’ clinical follow-up. All patients tumors of the thoracolumbar spine. G3 was injected kaolin into the SAS had a CT scan in the immediate An extended posterior midline incision only, and G4 was sham group. post-operative period to check the was made. After removal of the The survival time was 1, 2, and 6 positioning of hardware. Operative posterior elements and associated weeks. (2)Neuroprotective drugs time, blood loss, and complications proximal ribs heads, an extracavitary (n=4-5/treatment); Experimental rats were ascertained. Fusion was assessed dissection was performed to expose were randomly divided into 1 of 5 radiographically with dynamic radi- the lateral portions of each vertebral treatment groups. Beginning 1h after ographs and CT scans. body. The circumferential view of the injury, the animals were given either Results: Sixteen of the eighteen vertebra and thecal sac permitted total an intraperitoneal injection of saline, patients underwent successful screw corpectomy. Three-column reconstruc- vehicle, MPSS, minocycline, or riluzole placement. Two patients had the tion was achieved with pedicle screw for 6 days after SCI. All treatment rats minimal access procedure converted fixation and an expandable vertebral were examined by using the BBB for 4 to an open surgery because radi- body replacement cage. weeks. Quantitative histological and ographic visualization was not Results: Postoperatively, all patients immunohistochemical assessments adequate in the lower cervical spine. had improvement in visual analog scale were undertaken using fluorescence Six cases involved unilateral instru- (VAS) pain scores and stable or microscopy and image analysis. mentation and ten had bilateral improved Frankel classification scores. Results: (1) Both groups G3 and G4 screws. A total of 39 levels were Two patients continued to decline due did not develop syringomyelia. PTS instrumented. There were no intra- to pre-existing radiation myelitis. One was observed in both groups G1 and operative complications, and patient died within 30 days of surgery G2 at 6 weeks. Especially, G2 was follow-up CT scans demonstrated no secondary to unrelated malignant pleu- observed larger syrinx compared with bony violations except in cases where ral effusion complications. Anatomic G1.(2) Gradual improvement in hind bicortical purchase was achieved. alignment was restored and remains limb function was observed for each All patients achieved bony fusion. stable in all patients and no one has group in BBB, although the statistical Conclusions: A minimally invasive required a chest tube. analysis revealed no significant approach can be a safe and effective Conclusions: The posteromedian extra- difference. However the lesion was means for placing lateral mass screws cavitary approach provides a uniform significantly decreased in the neuro- in the subaxial cervical spine. Up to approach to the thoracolumbar spine protective drug groups compared two levels can be treated in this (T2-L2) for complex destructive lesions with control groups. manner, preserving the muscles and requiring simultaneous decompression Conclusions: Both compressive injury ligaments that maintain the posterior and manipulation of all three vertebral and adhesive arachnoiditis are required tension band of the cervical spine. columns. Circumferential exposure, to develop extensive PTS. By under- decompression, reconstruction, and standing the molecular pathogenesis of arthrodesis via a posterior approach PTS, improved treatment approaches provide an alternative to staged anteri- may be developed. or and posterior approaches.

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 50 ORAL POINT ABSTRACTS

211. CGRP and GAP43 Increase 212. Neodisc – Design, Testing 213. Spinal Deformity Following and Colocalize in Allodynic Rats and Early Clinical Results of a Selective Dorsal Rhizotomy for Following SCI and Stem Cell Textile/Elastomeric Cervical Disc Spasticity Transplantation Replacement Jeff D. Golan, MD, Montreal, PQ, Melissa Y. Macias, MD, PhD, Alan McLeod, PhD, Taunton, United Canada; Jeffery A. Hall, MD, FRCS(C), Milwaukee, WI; Mara C. Bacon, BS, Kingdom; Chris Reah, PhD, Taunton, Montreal, PQ, Canada; Jean-Pierre Milwaukee, WI; Shekar N. Kurpad, MD, United Kingdom; Andre Jackowski, Farmer, MD, FRCS(C), Montreal, PQ, PhD, Milwaukee, WI MD, Birmingham, United Kingdom Canada Introduction: Although transplanta- Introduction: The Neodisc is a Introduction: Selective dorsal rhizotomy tion of neural stem cells (NSC) in motion-preserving implant comprised (SDR) has been shown to provide the injured spinal cord may improve of an elastomeric core encapsulated considerable benefit to children with functional outcome, we have consis- by a polyester textile jacket. The spastic cerebral palsy. The goal of this tently observed forelimb allodynia, device is designed to replace the study was to examine the incidence the mechanism of which remains nucleus, annulus, and the ALL, while of spinal deformities in these patients poorly understood. In the present leaving the vertebral endplates intact. and to determine risk factors more study, alterations of primary afferent The encapsulating fabric is intended to likely to be associated with deformities. pathways rostral to injury and encourage tissue ingrowth, as has Methods: All patients who underwent tranplantation are investigated with been demonstrated in an ovine model. SDR at the McGill University Health GAP-43, which identifies sprouting Pre-clinical testing of the device has Center between 1991 and 2001 were neurites, and CGRP, a well-character- included biomechanical, biocompati- identified. Their hospital charts, preop- ized nocioceptive neuron marker. bility and fatigue testing. The implant erative and the latest postoperative Methods: Reproducible, moderate is CT- and MRI-compatible and easily spinal radiographs were systematically spinal cord injuries (10g from 25 mm) revisable. Implantation is straightfor- reviewed. were produced in 25 Sprague-Dawley ward: simple discectomy without endplate preparation, device insertion, Results: The study group consisted rats using the NYU Impactor model. of 98 patients with a mean age at At post-injury day 8, animals were and fixation to the anterior column with screws. surgery of 5.1 years (3.0 to 11.0 years) randomly selected to receive either and a mean radiographic follow-up of C17.2 NSC, (9); GDNF transfected Methods: Nine single-level (C3-C7) 5.8 years (1.1-11.5). Thirty-nine (44.8 C17.2 NSC, (13); or normal saline Neodiscs have been implanted %) out of 87 patients with postopera- (NS), (3). BBB scoring assessed loco- since July 2004 in a prospective tive weight-bearing AP radiographs motor function/recovery and hot-plate non-randomized multi-center had scoliosis (Cobb angle at least 10 testing measured sensory responses. European clinical trial. All patients degrees), while 17 (32.1 %) patients Animals survived 42 days post injury. presented with single-level DDD with with postoperative standing radi- C6-T1 spinal cords were processed for neural symptoms and ranged in age ographs had hyperlordosis (at least CGRP/GAP43 immunohistochemistry. from 31-54. Follow-up is to 6-months 54 degrees). Ambulatory children Density of immunoreactivity (IR) was in all 9 patients and 12-months in 4. requiring assistive devices had more measured and characterized. VAS pain scores, SF-36, NDI and significant coronal misalignment than Results: Locomotor function was not European myelopathy scores were independent ambulators (p 0.013). significantly improved in NSC treated collected at 1-month, 3-month, Patients that had surgery at 5 years of animals at any time period, p greater 6-month, and 12-month follow-up. age or later had more significant than 0.05. Significant forelimb thermal Radiographic measurements include hyperlordosis (p 0.007). There were allodynia was observed following disc height, segmental motion, and no significant changes in thoracic or transplantation with both NSC sagittal alignment. thoracolumbar kyphosis. Overall, 18 populations, p less than 0.05. GDNF Results: Surgical time ranged from (19.1%) patients had postoperative transfection failed to show a signifi- 55-104 minutes. Blood loss averaged L5-S1 anterolisthesis and 11 (11.7%) cant motor or sensory effect when less than 15cc. All patients have good patients had L5 spondylolysis. Despite compared to native C17.2 NSC. clinical results: VAS scores improved these radiological findings, none of Marked bilateral axonal sprouting was pre-op to 6-months from 6.6 to 2.0 these patients had clinically significant demonstrated by increased GAP-43-IR (arm) and 4.1 to 0.4 (neck), SF-36 deficits requiring bracing or surgical in NSC but not NS treated cords. scores increased from 41 to 80. correction. Similarly, CGRP increased and colocal- Average flexion/extension ROM is Conclusions: Ambulatory children ized with GAP-43-IR further suggesting 6.7º. There have been no device requiring assistive devices preopera- sprouting of nocioceptive primary displacements. Thin-section CT scans tively and those who had their afferent fibers. have demonstrated no evidence of surgery at 5 years of age or later had Conclusions: Nocioceptive afferent heterotopic bone formation. a significantly higher incidence of sprouting may represent aberrant Conclusions: The Neodisc is a nucleus- spinal deformities at follow-up. changes in pain pathways that suggest like disc replacement, representing a mechanism for allodynic pain follow- the first of a new type of motion- ing NSC treatment of the injured preserving device for the cervical spinal cord. spine.

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES ORAL POINT ABSTRACTS 51

214. Comparison of Outcomes After 215. Effects of Age on Perioperative 216. A Key Role for FAS Mediated Lumbar Artificial Disc Replacement and Intermediate-Term Clinical Apoptosis in the Pathobiology of Surgery in Worker’s Compensation Outcomes and Fusion Rates After Cervical Spondylotic Myelopathy: Versus Non-Compensation Patients Multilevel 360-degree Lumbar Evidence from Human Tissue and a Hyun W. Bae, MD, Santa Monica, CA; Fusion Mutant Mouse Model Ben B. Pradhan, MD, MSc, Santa Frank L. Acosta, Jr., MD, San Francisco, Wenru Yu, MD, Toronto Western Monica, CA; Michael A. Kropf, MD, CA; Henry E. Aryan, MD, San Hospital Research Institute, ON, Santa Monica, CA; Linda E.A. Kanim, Francisco, CA; Christopher P. Ames, Canada; Tianyi Liu, Toronto Western MA, Santa Monica, CA; Rick B. MD, San Francisco, CA Hospital Research Institute, ON, Delamarter, MD, Santa Monica, CA Introduction: Combined (anterior Canada; Darryl C Baptiste, PhD, Introduction: Results of lumbar spinal plus posterior, or 360-degree) lumbar Toronto Western Hospital Research fusion for disabling back pain can fusion across multiple (2 or more) Institute, ON, Canada; Michael G. be less than ideal in the workman’s levels is thought to be associated with Fehlings, MD, PhD, Toronto Western compensation (WC) population. increased perioperative morbidity Hospital Research Institute, ON, Motion-preserving alternatives to and worse clinical outcomes when Canada fusion surgeries are being developed performed in elderly patients. We Introduction: Although human cervical for improved effectiveness, reduced evaluated our experience with multi- spondylotic myelopathy (CSM) is a morbidity, and recovery time. However, level 360-degree lumbar fusion for common etiology of chronic spinal how WC status affects outcomes in degenerative disc disease (DDD) in cord dysfunction, little is known regard- such newly-developed spinal tech- elderly versus younger patients. ing the molecular mechanisms for the niques has not been well-studied. Methods: Retrospective review of the progressive neural degeneration and Methods: Patients randomized to 1-2 medical, surgical, and radiological demyelination. We hypothesized that level disc replacement (DR) or fusions records of 73 patients who underwent Fas-mediated apoptosis plays a key role were evaluated based on WC status. multilevel anterior lumbar interbody in the loss of neurons and oligodendro- This was part of a randomized fusion (ALIF) with posterolateral cytes in CSM. prospective controlled trial in a lumbar fusion with instrumentation Methods: Molecular analyses of post- FDA-regulated study. Preoperatively (360-degree fusion) for symptomatic mortem human CSM were undertaken. and at 6 weeks, 3, 6, 12, and 24 lumbar DDD. We compared the This work was complemented by stud- months, patients completed standard- perioperative events, clinical out- ies in twy/twy mice, which harbor an ized ODI and VAS questionnaires. comes, and fusion rates for patients abnormality in the Npps gene. We Return to work was also evaluated. at least 65 years old versus patients used histological and MRI approaches Results: 56 WC patients had at least 2 younger than 65 who underwent to determine morphological changes in years of follow-up. 47 underwent TDR these procedures. twy/twy mice. Apoptosis was assessed and 9 underwent fusion. VAS and ODI Results: Average follow-up was 18 by TUNEL technique and expression of scores improved significantly (p-values months. Thirty patients were at least caspase-3 and caspase-9 by Western < 0.0001) for both WC and non-WC 65 years old and 43 patients were blotting analysis. The expression of Fas patients. No significant difference was younger. There were no significant was assessed using immunohisto- found in outcome scores between differences in the number of levels chemistry and Western blotting analysis. WC and non-WC patients at any time fused, operative time, or perioperative Results: TUNEL and caspase-3 positive interval. There was no significant complications rates in either group. neurons and oligodendrocytes, which difference in patient-satisfaction Although the postoperative hospital co-expressed FAS, were observed in between the two groups at final stay was slightly longer in the elderly cervical spinal cord of CSM patients follow-up (both at 90%). There was group (9 plus or minus 1.5 days) and of twy/twy mice. Ectopic ossifica- earlier return to work for patients after compared to the younger group (7 tion at C1-C2 was confirmed histologi- DR versus fusion in both WC and plus or minus 2 days), this was not cally and by MRI in twy/twy mice. These NWC groups. statistically significant. Similarly, there mice developed spasticity and quantita- Conclusions: WC and non-WC patients were no statistically significant differ- tive neurobehavioral abnormalities on had equal clinical improvements at ences in the improvement in back footprint analysis which correlated with 2-years of follow-up after DR. Return pain or in the rates of fusion between progressive loss of neurons and oligo- to work rates may be higher and the groups at last follow-up. dendrocytes, Wallarian degeneration, earlier after DR versus fusion. This Conclusions: Perioperative events, demyelination and astrogliosis. Using implies that WC patients may derive intermediate-term clinical outcomes, immunoprecipitation and Western blot- as much benefit from this motion and fusion rates after multilevel 360- ting techniques we observed that the preserving technology as non-WC degree lumbar fusion in the elderly spinal cord tissue of twy/twy mice had patients, and should be offered this are comparable to those of younger promising surgical alternative. patients. Age should not be a factor continued in deciding to perform multilevel 360-degree lumbar fusion for patients with symptomatic lumbar DDD.

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activation of the Fas pathway with Conclusions: Single-stage cervical Results: The average period between increased interactions between Fas, pedicle reconstruction after pediculec- onset of symptoms and surgery was FasL and pro-caspase-8 and down- tomy can be achieved using traditional 2.3 months (range 1-3 months). stream activation of caspase 3. cervical lateral mass screws to serve as Tumors extended across an average of Conclusions: Our data not only show artificial cervical pedicles, allowing 3.3 levels from C1-T3. There were no an important Fas-mediated apoptotic simultaneous three-column stabiliza- intraoperative changes in neuromoni- mechanism in CSM, but also provide tion after radical posterior column toring parameters during any proce- evidence that down-regulation of Fas resection of the cervical spine for neo- dure. All patients reported stable or mediated apoptotic pathway is a plastic disease. APS can be used in improved neurological symptoms potentially attractive neuroprotective degenerative cervical disease for: 1. when present and demonstrated approach in CSM which could provide Fractured lateral mass at top or bot- radiographic evidence of fusion at a complementary treatment to surgi- tom of the construct, with the pedicle last follow-up. cal decompression. being too small to instrument; 2. Conclusions: The extreme posterolat- Deformity correction by engaging the eral transpedicular approach with anterior column in cases in which the partial dorsal corpectomy is useful for 217. Artificial Cervical Pedicle pedicles are too small to instrument. treating multilevel ventral IEST from Screw Reconstruction for C1 to the upper thoracic spine with- Degenerative and Neoplastic 218. Results of a Modified out spinal cord manipulation. Modern Disease: Intermediate-term spinal reconstruction techniques allow Clinical and Radiographic Results Paramedian Transpedicular Approach with Radical Bone for radical bone resection to minimize Frank L. Acosta, Jr. MD, San Francisco, Resection for Intradural, neural element retraction - a principle CA; Henry E. Aryan, MD, San Extramedullary Tumors of the traditionally used in skull base surgery. Francisco, CA; Christopher P. Ames, Ventral Cervicothoracic Spine Our technique has resulted in less MD, San Francisco, CA neurological morbidity than more tra- Frank L. Acosta, Jr., MD, San Francisco, ditional anterior or posterior Introduction: Three-column stabiliza- CA; John Chi, MD, MPH, San Francisco, approaches without evidence of late tion has not traditionally been possible CA; Henry E. Aryan, MD, San Francisco, instability. across levels at which a pediculectomy CA; Andrew T. Parsa, MD, San has been performed in the cervical Francisco, CA; Christopher P. Ames, spine. We describe posterior column MD, San Francisco, CA 219. Evaluation of Correction of reconstruction of the cervical spine in Sagittal Plane Cervical Spine which traditional lateral mass screws Introduction: Changes in intraopera- tive recordings of spinal cord function Deformities with Anterior ACDF are used to reconstruct the pedicle with Dynamic Plating and allow for 3-column stabilization in during surgery for intradural, a posterior construct. We report our extramedullary spinal tumors (IEST) Daniel R. Fassett, MD, Salt Lake City, experience in 10 patients. often occur after irreversible neurologi- UT; Kyle Judd, BS, Salt Lake City, UT; cal damage has already occurred. We Randy Clark, BS, Salt Lake City, UT; Methods: Retrospective chart review therefore developed an aggressive Ronald Apfelbaum, MD, Salt Lake of 10 patients who underwent exten- surgical technique with radical spinal City, UT sive posterior cervical decompression deconstruction to eliminate any retrac- Introduction: With advanced cervical with pediculectomy of at least one tion of the spinal cord and minimize level. ‘Artificial pedicle screws’ (APS) spondylosis, loss of cervical lordosis is neurological damage. We reviewed often significant. We describe an ACDF were placed directly into the cervical the results of patients with ventral IEST vertebral body at all levels where a distraction and interbody grafting of the cervicothoracic spine treated technique to restore cervical lordosis, pediculectomy was been performed. using this technique. We evaluated the clinical and radi- and review initial post-operative cor- ographic outcomes in these patients. Methods: Twelve patients (5M:7F, rection and long-term maintenance average age 35 years) with multilevel of sagittal plane balance with this Results: We used this technique in a IEST of the anterior cervical or cervi- technique. total of 10 patients with an average cothoracic spine were included. follow-up of 12 months. Six patients Methods: We identified 387 patients Average follow-up was 20 months. having ACDF with 6 months of follow- underwent surgery for tumors of the All patients presented with pain cervical spine and 4 for degenerative up. Preoperative, postoperative, and and/or radiculomyelopathy. The follow-up radiographs were reviewed disease. There were no intraoperative surgical procedure consisted of a complications. All patients demon- for patients with less than 5.0 degrees paramedian cervical transpedicular, of lordosis preoperatively. Lordosis was strated evidence of fusion without thoracic parascapular approach with evidence of hardware loosening at last measured over the entire cervical spine partial dorsal corpectomy, wide and over the instrumented levels. follow-up. No patients experienced eccentric dural opening without spinal new or worsening symptoms. cord retraction, and posterior spinal Results: Sixteen patients underwent reconstruction. 1-level ACDF. Overall cervical lordosis did not change significantly. Mean

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AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES ORAL POINT ABSTRACTS 53 lordosis at instrumented levels 2003 and with a minimally invasive devices were analyzed. Sagittal and improved from -7.4 preoperatively access tube (Endius atavi system) axial T2-weighted images were scored to +3.1 postoperatively and +0.6 at from October 2003 to June 2005 (31 using the Jarvik 4 point scale from 6-month follow-up. patients). Both groups recieved identi- 8 blinded surgeons and statistically Nineteen patients had 2-level ACDF. cal pain management orders and a analysed. Intraobserver and inter- Cervical lordosis improved with means patient controlled option for same day observer were assessed with ICC. of -9.1, -0.5, and +2.9 degrees preop- discharge. A P value <0.05 was regarded as eratively, postoperatively, and follow- Results: Both groups showed no sig- significant. up. The instrumented level had means nificant differences in age or gender. Results: Good intraobserver and of -8.9, +4.7 and +2.3 preoperatively, Blood loss and surgical times were not intraobserver variability was noted postoperatively, and follow-up. statistically different. Significantly less at both time intervals. Preoperative Nineteen patients had 3-level or dosages of narcotics medications were images of patients in all implant greater ACDF. Mean cervical lordosis given in hospital to minimal access groups had high quality images at improved from -8.0 preoperatively patients (p equals .03) and overall operative and adjacent levels. The to +14.0 postoperatively. After 6 number of pain medications taken in Bryan® and Prestige® devices allowed months, mean lordosis was 1.8 hospital were also less in the minimal satisfactory visualization of the canal, degrees. Instrumented level lordosis access group (p equals .01). Average exit foramina, cord and adjacent improved 23 degrees with surgery hospitalization times were significantly levels after arthroplasty, grade 1 to 2. (preoperative mean=-11.7, postopera- less in the minimal access group (1052 Visualization was significantly impaired tive mean=+11.2). Almost half of minutes versus 1494 minutes, p equals in all PCM® and Prodisc-C® cases at the lordosis correction at the instrumented .001) More (45 percent versus 6 per operated level in both the spinal canal levels was lost by 6 months (mean=1.6). cent) minimal access patients were and neuroforamina, grade 3-4. At Conclusions: Our ACDF technique can discharged within 12 hours (p equals the adjacent levels images quality was ® improve lordosis of the cervical spine, .001). No wound or neurologic com- statistically poorer in the PCM and ® ® especially with multi-level surgeries. plications occurred in either group. Prodisc-C than those of Prestige ® Despite this correction in lordosis, Conclusions: The use of minimally and Bryan . almost 50% of the correction may be invasive techniques (Endius atavi Conclusions: Postoperative visualiza- lost within 6 months of surgery. Even System) to lumbar microdiscectomy tion of neural structures and adjacent with the loss of correction, these resulted in less pain and shorter hospi- levels after cervical arthroplasty is patients, on average, maintained a tal stays compared to open proce- variable among current available lordotic posture as compared to their dures. No increase in morbidity was devices. Devices containing non- mean preoperative kyphotic sagittal encountered with use of this tech- titanium metals (Co-Cr-Mb alloys in alignment. nique. the PCM® and Prodisc-C®) make post- operative imaging almost unreadable whereas devices with titanium with 220. Minimally Invasive Lumbar 221. MR Imaging Clarity of the or without polyethylene still allow for ® ® ® Microdiscectomy Versus Open Bryan , Prodisc-C , Prestige LP and satisfactory monitoring of adjacent ® Microdiscectomy; Comparison PCM Cervical Arthroplasty Devices levels and the operated level (Bryan® of Surgical Time Length of Stay, James J. Lynch, MD, FRCS, Reno, NV; disc or Prestige LP®). Narcotic Usage and Complications Lali Sekhon, MD, PhD, FRCS, Reno, in Consecutive Cohorts NV; Paul A. Anderson, MD, Madison, James F. Harrington, Jr., MD, WI; Neil Duggal, MD, FRCS(C), Providence, RI; Michael Park, II, MD, London, ON; Regis W. Haid, MD, Providence, RI; Patrice Shea, RN, Atlanta, GA; John Heller, MD, Atlanta, Providence, RI; Amy Porro, MS, GA; Dan Riew, MD, St.Louis, MO; Plainville, MA Kevin Seex, MBBS, FRACS, Sydney, Introduction: Lumbar microdiscec- Australia tomy using muscle retractors is well Introduction: The purpose of this established. We wondered whether study is to compare postoperative minimally invasive access methods imaging characteristics of the four could significantly reduce surgical pain currently available cervical arthroplasty and length of stay compared to open devices at the level of implantation approaches. and at adjacent levels. Methods: A single surgeon performed Methods: Preoperative and postopera- consecutive single level lumbar tive MRI of 20 patients who had microdiscectomies at a single institu- cervical arthroplasty were assessed for tion using an open technique (35 quality. Five cases each of the Bryan®, patients) from July 2002 to October Prodisc-C®, Prestige LP® and PCM®

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222. Correction of Cervical 223. Mortality, Neurological 224. Inosine Versus Oscillating Field Kyphotic Deformity via 360 Fusion: Outcome and Axonal Survival Stimulation Plus Inosine in Treating Long Term Follow Up with a Following Spinal Cord Injury in a Experimental Chronic Spinal Cord Standardized Analysis Geriatric Population Injury Praveen V. Mummaneni, MD, Atlanta, Julio C. Furlan, MD, PhD, MBA, Scott A. Shapiro, MD, Indianapolis, IN; GA; Sanjay Dhall, MD, Atlanta, GA; Toronto, ON, Canada; Michael G. Scott Purvines, MD, Indianapolis, IN; Gerald E. Rodts, MD, Atlanta, GA; Fehlings, MD, FRCS(C), Toronto, ON, Richard Borgens, PhD, Indianapolis, IN Regis W. Haid, MD, Atlanta, GA Canada Introduction: Oscillating field Introduction: We examined standard- Introduction: The incidence of spinal stimulation (OFS) improves recovery ized outcomes and fusion rates of cord injury (SCI) is rising in the elderly. from acute spinal cord injury (SCI) patients undergoing 360 reconstruc- This study examines the potential age- in animals/humans but not chronic. tion for cervical kyphosis. related differences on outcome and Inosine is a neurotrophin that is Methods: 21 patients underwent axonal preservation following SCI. synergistic with OFS in acute SCI. 360 fusion surgery from 2002 to 2005 Methods: A cohort retrospective study We tested in a chronic SCI model for cervical kyphosis. Anterior proce- was carried out including all consecu- inosine plus OFS versus inosine. dures included discectomies and tive cases of acute traumatic cervical Methods: Guinea pigs underwent a corpectomies (one or more levels) SCI admitted to a university-teaching T10 hemisection with disappearance as the pathology dictated. Posterior hospital from 1998-2000. Younger of their unilateral cutaneous trunchi operations included lateral mass fusion individuals (age < 65 years) were muscle reflex (CTM). On day 91 post with decompression and osteotomy compared to elderly. Additionally, hemisection, 15 animals (Group 1) when indicated for neural compromise. an immunohistochemical examination had a pump placed that delivered Typically, autograft was utilized for of postmortem spinal cord tissue was inosine (10mM) at 0.25 microliters/ arthrodesis though Bone Morphogenetic performed in individuals with severe hour for 14 days. 15 animals (Group Protein was used in a limited number cervical SCI and controls. Using NF200 2) had both an OFS and inosine pump of cases. Preoperative and postopera- immunostaining, the number of axons placed. A control group of 15 animals tive Nurick grades were assigned as within the corticospinal tracts (CST), were treated with a sham stimulator well as Odom’s outcome measures. dorsal column (DC), and descending and pump. All animals underwent Fusion was assessed via dynamic vasomotor pathways (DVPs) were measurement of the (CTM) at 60 radiographs. quantitated. days and then had their cord exposed Results: Three patients were lost to Results: In the cohort, there were 23 and injected with a 20 microliter follow-up. Of the 18 remaining, 3 died elderly (10F, 13M; age 65-89 years) fluroesently labeled dextran (fluouro postoperatively. For the remainder and 28 younger individuals (4F, 24M; emerald) rostral and (fluoro ruby) follow-up ranged from 6 months to 4 age 18-64 years). The latter showed a caudal to the hemisection for axon years (Mean 18 months). Preoperative significantly higher frequency of SCI labelling to analyze for regenerating Nurick grades ranged from 0-5 (Mean (p=0.031). Both groups were similar in axons histologically. 2.5). Postoperative grades ranged 0-5 regard to the severity of SCI (p=0.116) Results: The controls recovered no (Mean 1.4). Mean improvement in the or survival in the acute care facility CTM. Group 1 recovered 23.5% of patients was one full Nurick grade. (p=0.515). There were no significant their preinjury CTM area (p0.001) . Odom’s scores were: Excellent 12.5%, differences between the groups Group 2 recovered 27.1% of their Good 50%, Fair 25%, Poor 12.5%. regarding neurological recovery preinjury reflex area (p0.01). The dif- All patients with follow up were assessed by ASIA grade (p=0.356). ference between groups 1 & 2 was a radiographically fused at 3 months The immunohistology included 7 SCI p0.14. Axon labelling demonstrated postoperatively. Ishihara's criteria was individuals (2F, 5M; ages 31-82 years) more regeneration in the ascending used to measure the degree of and 5 controls (2F, 3M; ages 30-73 fibers in group 2 as compared to correction. years) with comparable age/gender. In group 1 (p0.03) and both groups Conclusions: The treatment of cervical controls, the number of axons within regenerated more than controls kyphosis is challenging. Fusion rates CST, DVPs, and DC were not signifi- (p0.0001). Descending regeneration and standardized outcomes are rarely cantly correlated with age/gender. was significantly better in Group 2 cited in prior studies. We have demon- There were no significant differences versus 1 (p0.02) and again both were strated (with long term follow up) between both groups for extent of better than controls (p0.0004). that aggressive correction with decom- degeneration or for number of pre- Conclusions: Inosine plus OFS signifi- pression and stabilization via a 360 served axons within the DC, DVPs and cantly improved recovery and regener- approach can achieve high fusion rates CST post-SCI. ation in a chronic SCI model and is as well as provide measurable improve- Conclusions: Our results suggest that the most robust chronic injury treat- ments in Nurick grades. Most of our (1) mortality, (2) neurological out- ment seen in our lab to date. patients had good/excellent Odom’s come, and (2) axonal survival within outcomes, but this extensive correction selected spinal cord tracts was unaf- does carry potential morbidity. fected by age after cervical SCI.

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES ORAL POINT ABSTRACTS 55

225. Clinical Outcome in Patients 226. Spinal Cord Uptake and 227. Initial Experience in C1/2 Undergoing Anterior Cervical Targeted Motor Neuron Delivery Arthrodesis Using BMP-2 and Discectomy and Fusion using using the Crushed Sciatic Nerve Allograft Chips Anterior Plating System Model John K. Houten, MD, Bronx, NY Alan T. Villavicencio, MD, Boulder, CO; Thais Federici, Cleveland, OH; James K. Introduction: C1-2 arthrodesis is Sigita Burneikiene, MD, Boulder, CO; Liu, Cleveland, OH; Qingshan Teng, traditionally performed using iliac crest Evan Pushchak, BA, Boulder, CO; Cleveland, OH; Mary Garrity-Moses, autograft. Recombinant BMP-2 has Jeffrey J. Thramann, MD, Boulder, CO Cleveland, OH; Jun Yang, Cleveland, been used successfully as an alterna- Introduction: The majority of pub- OH; Nicholas M. Boulis, Cleveland, OH; tive to autograft in the lumbar spine, lished papers on Anterior Cervical Introduction: With support provided but has not been studied in C1-2 Discectomy and Fusion (ACDF) clinical by a Kline Research Award, we have arthrodesis. outcome did not use validated out- demonstrated the spinal cord uptake Methods: Patients undergoing C1-2 come measurement instruments or and specific neuronal binding of a fusion were prospectively identified, focused on physiological outcomes. synthetic peptide that mimics tetanus excluding those undergoing fusion to The purpose of this study was to toxin C fragment. Peripheral nerve the occiput or subaxial spine. C1-2 evaluate the clinical outcome for injury results in demyelination and screws were placed using the Harms patients undergoing ACDF surgery axonal degeneration. Nerve cell bodies technique. The C2 nerve root was with anterior cervical plating using are important in initiating and control- routinely coagulated and sectioned. Visual Analog Pain scale (VAS), SF-36 ling axonal regeneration. Based on its A medium-size INFUSE Bone Graft kit Questionnaire, Neck Disability Index, efficient uptake, this synthetic peptide (1.5 mg/ml rhBMP-2 applied to an Patient Satisfaction and return to work might be useful for therapeutic pur- absorbable collagen sponge for a total criteria. poses of nerve regeneration. volume of 5.6ml) and cancellous Methods: A total of 110 patients were Methods: The crushed sciatic nerve is allograft chips were packed lateral to enrolled into a prospective clinical a well-established model for the study the dural tube and between the study and underwent ACDF procedure of peripheral nerve injury. Using a lamina if no laminectomy was present. with anterior cervical plate instrumen- fluorescein-conjugated peptide with Fusion was assessed using flexion- tation. Diagnoses included: 34 (30.9 the binding characteristics of tetanus extension x-rays or CT scans a mini- %) patients with cervical spinal toxin, we surveyed its uptake and mum 6 months post-surgery. stenosis, 26 patients (23.6%) had retrograde transport after injection Results: Seven patients (3M, 4F) a intervertebral disc pathology with into the crushed sciatic nerve of rats. mean age 47 years (7-81), were fol- myelopathy, 39 patients (35.5%) We next characterized the time-course lowed a mean 16 months (6-24). with herniated disc and 11 patients of this remote delivery. Finally, to con- Indications for surgery were synovial (10.0%) had cervical spondylosis. firm the retrograde transport involve- cyst C1/2, chronic type II dens frac- Results: All patients were followed for ment, colchicine sciatic pretreatment ture, traumatic atlantoaxial subluxa- a minimum of 12 months after the was performed. tion, and atlantoaxial subluxation from surgery. Neck pain (VAS) decreased by Results: Fluorescent microscopy rheumatoid arthritis. All patients com- 54% and 57% at 6 and 12 months, revealed fluorescein-positive motor plained of neck pain, and six had respectively. Arm pain (VAS) decreased neurons in the ventral horn of the motor and sensory deficits on neuro- by 65% at 6 months and 47% at 12 lumbar spinal cord. Fluorescence was logic examination. All patients achieved months follow-up. A statistically signif- detected as early as 6 hours after injec- a solid fusion with improvement in the icant improvement was noted on tion and increased with time. Intra- neurologic exam and neck pain. No SF-36 scale, where physical component neural colchicine pretreatment was able ectopic bone formation occurred with- summary scores increased by 19% at to partially block fluorescence detection in the spinal canal. No patient com- 6 months and 25% at 12 months. in the spinal cord, revealing a retro- plained of C2 dysthesias or pain. Neck Disability Index decreased by grade axonal transport mechanism. Conclusions: This small series found 46% at 6 months and 57% at 12 Conclusions: We have demonstrated that recombinant BMP-2 with allograft months. Patient Satisfaction was at neuronal specific labeling and retro- chips successfully achieved C1-2 78% and 68% at 6 and 12 months, grade axonal transport of the synthetic arthrodesis without autograft. If these respectively. The mean time to return peptide following peripheral adminis- findings are borne out in larger stud- to work was 32.2 days. The total tration. Because axonal regeneration ies, BMP-2 would appear preferable to complication rate was 5.0%. can be facilitated by treatment with iliac crest harvest, given the low but Conclusions: ACDF with anterior neurotrophic agents, this peptide well-characterized incidence of graft plate instrumentation is an effective might be attractive to deliver thera- complications. procedure with a statistically signifi- peutic proteins. This strategy for cant improvement in all measured targeted delivery to motor neurons parameters. might be equally applicable to devel- op gene therapy strategies for the treatment of spasticity, pain and motor neuron diseases.

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E-POSTER ABSTRACT 300. Open Versus MAST Lumbar 301. Targeted Microinjection of PRESENTATIONS Interbody Fusion Cells into the Ventral Horn Utilizing Sean D. Christie, MD FRCS(C), Halifax, a Novel Delivery System in Pigs To assist you in finding specific NS, Canada; John K. Song, MD, John B. Butler, MD, Cleveland, OH; posters that you may be interested Chicago, IL; Edward Abraham, MD Nicholas Boulis, MD, PhD, Cleveland, in viewing, e-posters are located in FRCS(C), Saint John, NB, Canada; OH; Dileep Nair, MD, Cleveland, OH; the back of the exhibit hall via five Melody Hrubes, Chicago, IL; Richard Baker Ken, PhD, Cleveland, OH; computer terminals. E-Posters are G. Fessler, MD, Chicago, IL Clive Svendson, PhD, Madison, WI; located behind Booth 422, to the Shearwood McClelland, III, MD, right of the demo theater. Introduction: Minimal access surgical techniques (MAST) continue to evolve Cleveland, OH in the surgical management of spinal Introduction: Motor neuron diseases disorders. It is felt that these approaches such as ALS and SMA, spinal cord minimize tissue damage and allow for injury, demyelinating diseases such as a swifter and smoother recovery. To MS all represent devastating diseases date there has been no published of the spinal cord which at this time comparison of open versus MAST are treated supportively. Research is approaches for lumbar interbody fusion. focusing on biologic therapies such as Methods: A non-randomized compari- in vivo and ex vivo gene therapies, son of two similar cohorts of patients cellular transplants, and viral vectors undergoing lumbar interbody fusion for engineered protein delivery. was performed. The open group Standard strategies for accurate and received their interbody graft via a safe delivery of these therapies do not posterior (PLIF) approach. The MAST exist. We have developed a delivery group underwent a transforaminal system utilizing a novel platform and approach (TLIF). Both groups had injector to functionally map and deliver supplemental pedicle screw implants, a biologic payload to a targeted region percutaneous in the MAST group. of the spinal cord. Immediate surgical outcomes and Methods: 2-level laminectomies were 2-year functional outcomes were performed on ten pigs for exposure of compared between groups (VAS and the lumbar enlargement. We utilized a Oswestry). novel delivery platform to rigidly fix a Results: There were 31 patients in the microdrive and microinjection system PLIF group compared to 22 in the TLIF over the spinal cord. Utilizing group. The mean ages were 42 (PLIF) microrecording, evoked potentials versus 52 (TLIF); p=0.004. The PLIF and EMG we located the spinal gray group contained 55% males com- matter and ventral horn. After map- pared to 41% in the TLIF group. The ping, varied concentrations and L4-5 level was the most common level volumes of neuroblastoma cells were operated followed by L5-S1 in both pumped into the ventral horn at a con- groups. Grade I spondylolisthesis was trolled rate. Post-operatively the pigs equally common in both groups were examined, sacrificed, and their (38.7% versus 40.9%, PLIF versus TLIF, spinal cords harvested for histology. respectively). Blood loss was greater in Results: No neurologic deficit was the PLIF group (553 ± 407 cc versus detected post-operatively. Histologic 208 ± 109 cc; p=0.00007). After two exam of the spinal cords revealed years of follow-up both groups dis- accurate delivery of cells to the ventral played a statistically equivalent horn of the spinal cord with no improvement in functional scores damage to surrounding neurons or (p>0.09). fiber tracts. Conclusions: MAST TLIF can be Conclusions: Electrophysiological performed successfully on the same properties of the spinal cord can be patient population as traditional open used to confirm and guide targeting fusion procedures. Although the clini- for the delivery of biological therapeu- cal outcomes at two years are the tics. Rigid fixation of the cannula same, MAST TLIF had less blood loss. system and controlled pump delivery can be accomplished without detectable neurological deficits.

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES POSTER ABSTRACTS 57

302. Operative Failure of 303. Objective Clinical Outcome 304. Bioabsorbable Cervical Spacers Percutaneous Endoscopic Lumbar Following Microendoscopic in the Treatment of Multilevel Discectomy: A Radiological Analysis Discectomy (MED) for Lumbar Degenerative Disc Disease of 55 Cases Herniated Intervertebral Disks Using Kaveh Khajavi, MD, FACS, Decatur, GA; SF-36, Visual Analog Scale, and Sang-Ho Lee, MD PhD, Seoul, Republic Erin G. Mihelic, PA-C, Decatur, GA; Oswestry Disability Index of Korea; Byeng Uk Kang, MD, Seoul, James Malcolm, MD, FACS, Marietta, Republic of Korea; Yong Ahn, MD, Dae-Hyun Kim, MD, Chicago, IL; Kurt GA PhD, Seoul, Republic of Korea; Gun M. Eichholz, MD, Chicago, IL; John Introduction: Fusion rates vary Choi, MD, PhD, Seoul, Republic of Song, MD, Chicago, IL; Sean Christie, substantially in multilevel ACDF’s. Korea; Young-Geun Choi, MD, Seoul, MD, PhD, Chicago, IL; Melody Theoretical advantages of bioab- Republic of Korea; Kwang Up Ahn, Hrubes, BS, Chicago, IL; John E. sorbable implants (BIs) include their MD, Seoul, Republic of Korea O’Toole, MD, Chicago, IL; Richard G. radiolucency, a modulus of elasticity Fessler, MD PhD, Chicago, IL Introduction: Although several similar to bone, and a strength and authors have reported the outcomes Introduction: In recent years, the degradation profile allowing for grad- of percutaneous endoscopic lumbar success rate for minimally invasive ual transfer of stresses to the bone discectomy (PELD), the current techni- techniques such as microendoscopic graft as the implant degrades. To date, cal limitation of the procedure has not discectomy (MED) for treatment of little clinical data exists on the use of been fully documented. The aim of lumbar herniated intervertebral disks BIs in the cervical spine. this study was to elucidate the range has approached that of standard of lumbar disc herniation that can be microscopic discectomy. However, few Methods: We reviewed the charts of addressed effectively from the analysis studies have quantified recurrence rate 20 consecutive patients who under- of failed PELD. or outcome objectively using Visual went multilevel ACDF and plate Analog Scale (VAS), Oswestry Disability fixation, using Cornerstone-HSR Methods: The inclusion was an intra- bioabsorbable implants (70:30 poly canal herniation in which subsequent Index (ODI), or Short Form-36 (SF-36) (l-lactide-co-D, L-lactide)). BIs were surgery was performed due to the questionnaires. The purpose of this packed with either morselized iliac presence of remnant fragments. All study is to determine whether objec- crest (obtained using a twist drill) in 1586 cases including 55 failed cases tive outcome after MED is comparable 11 patients (25 treated levels), or with were classified as follows. The non- to standard microdiscectomy. rhBMP-2 in 9 patients (30 levels). migrated herniations were classified as Methods: Between September 2002 either low or high-grade based on a and February 2005, 114 patients with Results: A total of 55 disc spaces were 50% canal cross sectional area com- classic lumbar radiculopathy underwent treated in 20 patients (13 F/ 7 M). promise. The axial locations of these MED for lumbar disk herniations. Data Arm and neck pain was reduced from herniations were divided into central was collected prospectively. 87 patients an average score of 8.1 and 7.8 to 0.2 or paramedian. The migrated hernia- were available for followup. A standard and 1.1 respectively (mean f/u 12 tions were classified according to the MED was performed, and most proce- months). No patient exhibited evi- extent of the migration. A high degree dures were performed on an outpatient dence of hardware failure or move- of migration larger than the measured basis using general anesthesia. Out- ment on flexion extension x-rays height of the posterior marginal disc comes were measured using VAS, ODI during the f/u period. Of the 18 space placed the herniation in the and SF-36 preoperatively, at 6 weeks, patients with greater than 3 months high-grade migration group. 4.5 months, 10.5 months, and 18 of radiographic f/u, 48 of 49 levels Results: In the non-migrated hernia- months postoperatively. (98%) showed bridging trabecular tions, the central located high-canal Results: No procedures were converted bone and were considered to have a compromised herniations showed the to open discectomy. Average operative solid fusion. Immediate postoperative highest rate of failure (15%), signifi- time was 109 minutes, mean blood loss lordosis was largely maintained cantly different from the low and was 38 mL, approximate hospital stay throughout the f/u period, there were high-canal compromise group (1.9% was 10.2 hours. Average follow-up was no serious complications, and patient and 11.1%, respectively, P<0.001). 16.5 months, (range 6-35 months). satisfaction was high. There was no significant difference in Improvement was seen in VAS (LBP 3.9 Conclusions: Bioabsorbable implants the rate of failure between the non- pre-op, 2,1 at followup, RL 3.2 pre-op, appear to be safe and efficacious in migrated herniations and the low- 1.2 at followup, LL 3.4 pre-op, 2.2 at multilevel ACDFs. Clinical and radi- grade migration group (2.7% and followup). ODI (40.5 pre-op vs. 19.1 at ographic outcomes were excellent, 3.7%, respectively). However, the followup), and SF-36 scales (physical fusion rate was high, and immediate high-grade migration group showed a function subscale 37.1 pre-op vs. 66.1 at postoperative lordosis was largely significantly high-incidence of failure followup, role-physical functioning 11.9 maintained throughout the follow-up (15.7%, P<0.001). pre-op vs. 52.5 at followup, bodily pain period. Further clinical trials are war- Conclusions: Based on these results, 22.3 pre-op vs. 60.2 at followup.) ranted. open surgery is more advisable for Conclusions: MED for lumbar disk herniations with high-canal compro- herniations can be performed safely mise and high-grade migration. and effectively. Outcomes for MED are On the other hand, PELD can be comparable to those associated with considered as a surgical option in the standard microdiscectomy. remaining intracanal disc herniations.

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 58 POSTER ABSTRACTS

305. Corpectomy Followed by 306. Modified Pedicle Subtraction 307. Bryan® Cervical Disc Prosthesis Instrumentation with Titanium Osteotomy to Correct Thoracic Implantation Causes Kyphotic Cages and rhBMP for Vertebral Kyphotic Deformity: A Cadaveric Deformity: A Myth? Decreased Pain Osteomyelitis Study and Improved Functioning Seen Henry E. Aryan, MD, San Francisco, Peter M. Grossi, MD, Durham, NC; Without Kyphosis in Patients CA; Frank L. Acosta, Jr., MD, San Shahid M. Nimjee, PhD, Durham, NC; Treated for Spondylotic Francisco, CA; Christopher P. Ames, Louis N. Radden, DO, Durham, NC; Radiculopathy San Francisco, CA Ashtoush A. Pradhan, MD, Durham, Neil J. Cochrane, Southport, Australia Introduction: Treatment of vertebral NC; Robert E. Isaacs, MD, Durham, NC Introduction: The Bryan® uncon- osteomyelitis includes antibiotics Introduction: Posterior surgical cor- strained artificial cervical prosthesis with/without surgical intervention. rection of fixed thoracic kyphotic maintains cervical motion with relief of The decision to place instrumentation deformity with standard pedicle neck and arm pain from spondylotic into an infected spinal column remains subtraction osteotomy (PSO) shortens radiculopathy. Literature regarding controversial. We review our experi- the spine, which can buckle the spinal satisfaction with this device is scarce ence with corpectomy followed by cord– a significant concern in the as are long term trials defining bene- instrumentation with titanium cages thoracic spine. Our modified PSO fits over discectomy and fusion. for patients with instability and/or involves collapsing an osteotomy Concerns of secondary kyphotic neurological compromise from active centered around a disc space over an deformity have been raised. This study vertebral osteomyelitis. interbody cage in an attempt to quantified the degree of disability Methods: Sixteen patients treated preserve column height. Herein we and functional limitation in patients ® from 2001-2005 were included in this compare two PSO techniques in a selected for Bryan disc replacement analysis. Ten patients presented with cadaveric model. pre- and post-operatively, whilst pain and 6 with radiculomyelopathy. Methods: Nine PSOs were performed observing kyphotic deformity. Nine had associated epidural abscess. in fresh human cadavers: Modified Methods: Oswestry Disability Index Cervical spine was affected in 5 PSOs on six and standard PSOs on (ODI) and SF36 Index were used, patients, thoracic spine in 7, and three. All PSOs were performed at T6 being robust / reproducible tools. lumbar spine in 4. All patients were (standard) or around the T5-6 disc Patients completed questionnaires treated with corpectomy of the space (modified). All of the wedge pre- and from 3 months post-opera- involved vertebral bodies followed by osteotomies had a posterior height of tively, each having 1 to 3 Bryan® disc titanium cage/plate reconstruction 22mm. Intraspinous distance was prostheses implanted. These scores with autograft/allograft. Eleven measured before and after correction; were compared for 45 patients in one patients underwent supplemental pre- and post- correction regional practice (97% response, 69 implants). posterolateral screw/rod fixation. Cobb angles were measured inde- Results: Patients reported decreased Results: A 1-level corpectomy was pendently. Loss of height and degree disability and increased functioning perfomed in 1 patient, 2-level corpec- of correction were compared. after Bryan® disc implantation. The tomy in 14, and 3-level corpectomy in Results: Modified PSO resulted in a mean ODI improved from 43.65% 1. Titanium cage with allograft was loss of height of 10.6 ± 7.8 mm com- (95% confidence interval 37.9 - 49.4) used in 5 patients and autograft in 11 pared to 16.7 ± 3.1 mm with standard to 19.4% (14.0 - 24.9) post-operatively. patients. The most common pathogen PSO. Modified PSO allowed for 24.0°± The mean SF36 improved from 42.7% was staphylococcus aureus. All patients 4.9° of regional correction, standard (36.7 - 48.6) to 64.9% (57.7 - 72.0). were treated with IV antibiotics for at PSO resulted in 17.7° ± 0.6°of correc- All results were significant (p < 0.01). least 6 weeks postoperatively and life- tion. While relatively consistent results Kyphosis was not increased compared long antibiotics were used in 3 patients were noted with standard PSO, the to conventional fusion techniques. In with coccidiomycoses, candida, and degree of correction obtained using fact pre-existing kyphotic deformity tuberculosis osteomyelitis, respectively. this modification was more variable. was correctable by implantation. There were no recurrent infections. All Nevertheless, using this technique, it Conclusions: After Bryan® cervical patients demonstrated radiographic was possible to obtain up to 30° of disc replacement, there is significant evidence of fusion at last follow-up. correction– a 70% greater improve- decrease in disability and pain as well Average follow-up was 15 months. ment than with the standard PSO– as improvement in functional ability Conclusions: Corpectomy followed by with less shortening of the spine. when compared to pre-operative titanium cage/plate reconstruction is a Conclusions: Our modified PSO state. It is proposed that if undertaking safe and effective surgical treatment for attains similar kyphosis correction, cervical discectomy, maintenance of patients with vertebral osteomyelitis and potentially far greater correction, normal cervical motion is associated and does not lead to recurrent hard- than can be safely obtained with the with higher satisfaction when com- ware infections. Antibiotic therapy standard PSO technique in the tho- pared to fusion. Kyphotic deformity is tailored to the specific organism racic spine. largely a result of surgical technique should be continued for at least 6 and can be avoided (and corrected) weeks after surgery, and life-long by Bryan® prosthetic implantation. therapy is required for fungal or tuber- culosis infections.

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES POSTER ABSTRACTS 59

308. In Vitro Study of Traumatic 309. Return to Work Analysis of 310. Clinical and Radiographic Loading After Implanting the Bryan® Patients Treated with an Artificial Outcomes of Thoracic and Lumbar Cervical Disc Prosthesis. Cervical Disc or an Arthrodesis Pedicle Subtraction Osteotomy for Fixed Sagittal Imbalance Neil Duggal, MD, FRCS(C), London, Vincent Traynelis, MD, Iowa City, IA; ON, Canada; Neil Crawford, PhD, Paul Anderson, MD, Madison, WI; Benson P. Yang, MD, Chicago, IL; Barrow Neurological Institute, AZ; Newton H. Metcalf, BS, Memphis, TN Stephen L. Ondra, MD, Chicago, IL; Larry A. Chen, BS, Chicago, IL; HeeSoo Robert Chamberlain, MS, Barrow Introduction: Return to work data Jung, BA, Chicago, IL; Tyler R. Koski, Neurological Institute, AZ; Seungwon provides valuable information con- MD, Chicago, IL; Sean A. Salehi, MD, Baek, Barrow Neurological Institute, AZ cerning the efficacy of a treatment Chicago, IL Introduction: Insertion of the Bryan® from a medical and economical per- cervical disc prosthesis requires spective. We assessed return to work Introduction: Few reports for compli- resection of the stabilizing disc and data for patients enrolled in both the cations and outcomes after pedicle ligaments. Initial stability is achieved Bryan® and Prestige® Cervical Disc IDE subtraction osteotomy (PSO) exist in by precision milling of the vertebral studies. the literature. There are no reports pertaining to thoracic PSOs specifically. end plates, creating concavities that Methods: Patients from the Bryan® hold the biconvex design of the We evaluate the radiographic and and Prestige IDE studies were exam- functional outcomes of pedicle sub- prosthesis. Before bony ingrowth has ined separately to maintain statistical occurred, patients may be at theoreti- traction osteotomy (PSO) in general. integrity. Both IDE studies prospectively Furthermore, we compare and con- cal risk in the setting of trauma. To followed patients with single-level explore this potential susceptibility to trast these measures between thoracic symptomatic cervical spinal disease and lumbar PSO subgroups. injury, we studied load to failure in who were randomly assigned to human cadaveric specimens implanted receive either an instrumented ACDF Methods: Thirty-five consecutive ® with Bryan disc prostheses. or a cervical disc replacement. The patients with sagittal imbalance treat- ed with PSO by a single surgeon with Methods: Fifteen cervical spine seg- return to work data was analyzed for minimum 2-year follow-up were ana- ments (C3-T1) were implanted with both treatment groups. ® lyzed. Perioperative course and com- appropriately sized Bryan disc pros- ® Results: The Bryan data included 240 plications were noted. Measurements theses at C5-6. Using pure moments, ® patients Bryan discs and 222 patients of standing long-film radiographs of 5 specimens were loaded to failure in with an arthrodesis. The median the spine were taken preoperatively, flexion, 5 in extension, and 5 in axial ® returns to work (days) for the Bryan immediately postoperatively, and at rotation at a constant cable uptake patients were 50 and for the controls most recent follow-up. The Modified rate corresponding to approximately it was 74. There was no statistical Prolo and SRS-22 outcomes instru- 0.5 degrees per second. difference in the demographics or ments were administered. Results: Specimens failed at loads of preoperative status between the treat- Results: Early complications after 9.4 ± 3.2 Nm (mean ± standard ment groups, however the difference PSO included neurologic injury, deviation) in flexion, 6.2 ± 1.3 Nm in in median return to work time was wound-related problems, and ® extension, and 11.0 ± 1.7 Nm in axial statistically significant. The Prestige nosocomial infections. Late complica- rotation. The load required for failure data consisted of 250 patients who tions were limited to pseudoarthrosis ® during axial rotation was statistically received a Prestige disc and 260 indi- and attendant instrumentation failure. significantly greater than the load viduals who were treated with an Lumbar PSOs were associated with required for failure during extension arthrodesis. There was no statistical improvements in local, segmental, and (p=0.04, Kruskal-Wallis one-way difference in the demographics or global measures of sagittal balance analysis of variance on ranks followed preoperative status between treatment while thoracic PSOs were only associ- by Dunn’s method). Other pairwise groups. Patients receiving the Prestige® ated with local improvement. Most comparisons were not significant. device had an overall median return to patients rated their functional status as Conclusions: In all three loading work of 46 days which was significant- ‘fair’ to ‘good’ according to the modes, the magnitude of loading to ly different than the median return to Modified Prolo scale and reported that induce failure exceeded the ranges work time for patients receiving an they were satisfied with the overall commonly considered physiological, arthrodesis which was 63 days. management of their back condition implying that implantation of the Conclusions: Patients treated with an according the SRS-22 questionnaire. Bryan® disc does not render the spine artificial cervical disc return to work Conclusions: The ability to perform a unstable. No case of device expulsion more rapidly than those treated with PSO at both lumbar and thoracic lev- occurred. an arthrodesis and the difference els is a powerful asset for the spinal between the two is statistically deformity surgeon. Radiographic and significant. clinical outcomes were superior with lumbar PSOs secondary to several anatomical and technical obstacles hindering the thoracic procedure. Nevertheless, the thoracic PSO proves to be a useful addition for regional improvement in sagittal balance for patients with a fixed thoracic kyphosis.

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 60 POSTER ABSTRACTS

311. Porous Coated Motion 312. Intervertebral RhBMP-2 for 313. Comparison of Sagittal and Cervical (PCM) Disk Replacement in Transforaminal Lumbar Interbody Coronal Alignment of the Cervical Adjacent Segment Disease-Clinical Fusion Spine After One to Three-Level Follow up of 40 Cases Alan T. Villavicencio, MD, Boulder, CO; Artificial Disc Replacements Paul McAfee, MD, Sparks, MD; Luiz Sigita Burneikiene, MD, Boulder, CO; (Prodisc-C) Versus Fusion Pimenta, MD, PhD, Sao Paulo, Brazil; E. Lee Nelson, MD, Boulder, CO; Ben B. Pradhan, MD, MSc, Santa Matthew Scott-Young, Queensland, Ketan R. Bulsara, MD, Columbia, MO; Monica, CA; Hyun W. Bae, MD, Santa Australia; Andy Cappuccino, Buffalo, NY Jeffrey J. Thramann, MD, Boulder, CO Monica, CA; Michael A. Kropf, MD, Introduction: Adjacent segment dis- Introduction: The purpose of this Santa Monica, CA; Linda E.A. Kanim, ease with radiculopathy and neurolog- study was to evaluate the safety of MA, Santa Monica, CA; Rick B. ic deficit adjacent to a non mobile recombinant human bone morpho- Delamarter, MD, Santa Monica, CA; spinal segment is the ideal application genetic protein (rhBMP-2) on Introduction: Large-scale clinical trials for cervical arthroplasty. Not only are absorbable collagen sponges (ACS) in have shown the efficacy of lumbar disc the stresses and loads increased but conjunction with allograft for the TLIF replacement (DR). DR represents unfortunately the previously fused surgical approach with respect to mobile reconstruction of the spinal segment is further compromised by fusion rates, complications, clinical column, and as such is unproven in being fixed in a kyphotic position. outcome as patient’s perceived global spinal deformity, or in preservation Methods: This is a prospective study effect and satisfaction. of spinal alignment when used for of 40 PCM prostheses inserted in thirty Methods: Seventy-four consecutive multiple levels. A recent report demon- patients with 50 adjacent segments patients undergoing TLIF for degener- strated the early loss of local lordosis ® previously fused or rendered immobile. ative disc disease were divided into with DR with the Bryan prosthesis. This is an analysis of segmental as well Results: The mean improvement of five groups depending on whether the patient underwent a minimally inva- as overall sagittal and coronal cervical cervical lordosis was 9.4 degrees alignment with one to three-level DR. (range (-15 to 23). EBL = 0 to 100 cc sive or open surgical approach and with no patients requiring blood trans- the number of spinal levels operated Methods: This is a prospective ran- fusions, Length of surgery = mean 104 on. Operative data, fusion, complica- domized controlled study comparing minutes (60 to 150) and the length of tions and clinical outcome (Macnab’s single-level cervical DR to ACDF. Two hospital stay = mean 1.17 days (0 to 3 criteria and patient satisfaction rates) and three-level DR were performed in days). The clinical follow up ranged were evaluated. Average follow-up eligible patients after receiving permis- from 6 to 32 months with a mean of time was 20.6 months (range, 14 to sion from the FDA for compassionate 25 months. All patients were neuro- 28 months). use. Preoperative and postoperative logically intact at follow up with a Results: Radiographic fusion rate was radiographic cobb angle measure- mean improvement of NDI = 50 % 100% at 12 and/or 24 months after ments were performed. and mean improvement in VAS = 58.3 the surgery. The mean time to achieve Results: 41 patients were included in %. The range of flexion and extension fusion was 4.1 months (range, 2 - 10 the study, consisting of 26 DR and 15 motion at the level of the prosthesis months). There was no ectopic bone ACDF patients. There were 18 1-level was a mean of 8.9 degrees (range 4 to formation or other complications DRs and 15 1-level ACDFs. Follow-up 20 degrees). related to the BMP use identified. ranged from 1 to 2 (mean 1.5) years. Conclusions: Naturally, the adjacent Clinical outcome, as patients’ per- There were also 6 3-level and 2 2-level segment application of a cervical disk ceived global effect was excellent/ DRs. Segmental lordosis increased replacement is a challenging clinical good in 81.3% in the one-level mini- immediately postoperatively in both environment for cervical arthroplasty– mally invasive group and 75.0% in the DR and ACDF patients, and this was by definition every case had prior two-level minimally invasive group, maintained in both groups. Overall surgery–seventeen of the 50 previously compared to 72.7% and 60.0% in cervical lordosis was maintained by fused levels had prior cervical instru- the open approach patients groups both DR and ACDF. Coronal alignment mentation. Despite the complicated (P - 0.1). Patient satisfaction rates were was also maintained by both DR and nature of the presenting pathology, higher in the one-level and ACDF, not changing from neutral the Porous Coated Motion Cervical two-level minimally invasive groups pre-op to follow-up. prosthesis successfully restored some (P - 0.01). Conclusions: Single and multi-level element of cervical lordosis and Conclusions: Our results demonstrate cervical DR with the ProDisc-C pros- restored stability to the cervical that TLIF surgical procedure with bone thesis was able to preserve coronal segments. morphogenetic protein application is a and sagittal cervical alignment, both feasible and safe method of spinal segmental and overall, at up to two lumbar fusion. There were no signifi- years after surgery. Our results show cant differences in clinical outcome that the ability of these devices to between the open versus minimally maintain mobility does not compro- invasive cases. However, patient mise preservation of spinal alignment. satisfaction rates were higher in the minimally invasive patients group.

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314. Total Disc Replacement Versus 315. Biomechanical Evaluation of a 316. In Vitro Biomechanics of Multi- Fusion as a Salvage Treatment for Novel Anterior Cervical Plate System level Cervical Disc Arthroplasty Failed Back Surgery Syndrome Darrel S. Brodke, MD, Salt Lake City, Kevin T. Foley, MD, Memphis, TN; Rick B. Delamarter, MD, Santa Monica, UT; Randy Clark, BS, Salt Lake City, UT; Denis J. DiAngelo, PhD, Memphis, TN; CA; Hyun W. Bae, MD, Santa Monica, Kent N. Bachus, PhD, Salt Lake City, UT John S. Schwab, MS, Memphis, TN; CA; Michael A. Kropf, MD, Santa Introduction: Benefits of cervical plate John German, MD, Albany, NY; Kelly Monica, CA; Linda E.A. Kanim, MA, fixation include immobilization during Scrantz, MD, Memphis, TN Santa Monica, CA; Ben B. Pradhan, fusion and possibly increased fusion Introduction: The purpose of this MD, Santa Monica, CA rates. Concerns relate to implant size study was to determine the ability Introduction: Spinal fusion is an and bulk, retraction required to place of the PRODISC-C disc prosthesis to accepted salvage for failed prior the implants, and added costs. A restore cervical spine motion and procedures such as discectomies, unique cervical plate, utilizing a single compare this motion to that of laminectomies, nucleoplasties, or screw in each vertebra, has been harvested and two-level fusion IDET annuloplasty – failed back developed to address some of these conditions. surgery syndrome (FBSS). The semi- issues. Methods: Six human cadaveric cervi- constrained ProDisc-L prosthesis is Methods: Two plate designs were cal spines (C2-T1) were tested in designed to be inherently more stable evaluated; the UNIPLATE system flexion, extension, lateral bending, than a non-constrained disc (eg. (one-screw/vertebra) and the SLIM- and axial rotation under displacement Charité-III), has porous-coated LOC system (two-screws/vertebra). control. Three different conditions endplates, fixation keels, and has Kinematic testing was performed on were evaluated: the harvested spine, undergone trials for multi-level disc 12 fresh-frozen human cervical spines spine with C5-C6 and C6-C7 disc replacement (DR). This study examines (C3-7) using a custom seven-axis spine replacements using the PRODISC-C, the outcomes of single and multi-level simulator applying independent flex- and two-level (C5-C7) fusion. Fusion semi-constrained DR as salvage for ion/extension, lateral bending, and was simulated by attaching custom failed back syndrome. axial rotation moments with a 50N designed screws and clamps to the Methods: 120 patients were included compressive axial follower-load. ROM C5, C6, and C7 spinal bodies. The in the study. 66 patients with data were collected for the intact spines were tested to a target moment intractable low back or leg pain after state, ACDF with plating of C4-5, of 3Nm. Measurements included indi- prior surgery underwent DR or fusion and an additional ACDF at C5-6 with vidual vertebral motions, total spine as part of a prospective randomized plating of C4-6. Stiffnesses were calcu- rotation, and applied loads. trial. Outcomes of DR (N=44) were lated from the moment-rotation data. Results: There were no significant compared to fusion controls (N=22) Results: One-level construct: both plate differences in the normalized motion and DR without prior surgery (N=54). systems significantly increased the data between the PRODISC-C spines Outcome measures included the stiffness nearly 4x in flexion/extension, and the harvested (H) spines in all Oswestry Disability Index (ODI), Visual 4.5x in lateral bending, and 1.6x in loading modes, except for flexion Analog Scale (VAS), and radiographs axial rotation, compared to the intact (113% of H), right (124% of H) and (24 months). state with no significant difference. left (122% of H) axial rotation. For the Results: Patients with FBSS described The UNIPLATE system reduced ROM fused condition, significant differences more preoperative pain and disability. 67%, and the SLIM-LOC system occurred in flexion plus extension After DR, FBSS patients had signifi- reduced the ROM 33%, compared to between Fusion versus Harvested (5% cantly reduced pain and disability by the intact state, respectively. Two-level of H) and Fusion versus PRODISC-C the ODI and VAS scores (both by over construct: both plate systems signifi- (5% vs. 110%). Similar differences 60%). The results were comparable cantly increased the stiffness at least occurred in lateral bending between with DR patients with no prior surgery. 6.8x in flexion/extension, 6.9x in lateral Fusion versus Harvested (33% of H) In the early to intermediate postopera- bending, and 1.6x in axial rotation, and Fusion versus PRODISC-C (33% tive period, both groups did better compared to the intact state with no vs. 114%) and in axial rotation than fusion patients (VAS from 7 to significant difference. Both systems between Fusion versus Harvested 3.75, ODI from 30 to 22). Patient reduced the two-level ROM 67% of (21% of H) and Fusion versus satisfaction in both arthroplasty the intact state. PRODISC-C (21% vs. 136%). groups (90%) far exceeded the fusion Conclusions: The kinematic stability Conclusions: Use of multi-level group (55%). of the one-screw/vertebra construct PRODISC-C prostheses did not limit Conclusions: Patients with FBSS are (UNIPLATE) is statistically equivalent to the overall biomechanical integrity also candidates for DR if other inclu- the two-screw/vertebra construct of the operated spine. In contrast, sion and exclusion criteria are met. (SLIM-LOC) in both the one-level and fusion caused significant reduction in Having had tissue-removing but non- two-level ACDF construct models. motion at the operated levels with destabilizing prior spinal procedures compensatory increased motion at does not appear to compromise the adjacent segments. results of DR with single or multi-level ProDisc-L.

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 62 POSTER ABSTRACTS

317. Initial Clinical and Radiographic 318. Clinical Experience with the 319. Overexpression of Protease Results of a Minimally Invasive Absorbable Anterior Cervical Plate Nexin I Provides Neuroprotection Presacral Approach for L5-S1 for Single Level ACDF and Blocks Neuroinflammation After Interbody Fusion Justin F. Fraser, MD, New York, NY; Spinal Cord Injury in Mice Frank L. Acosta, Jr., MD, San Francisco, Nicole Sorrentino, PA, New York, NY; Paul M. Arnold, MD, FACS, University CA; Henry E. Aryan, MD, San Roger Hartl, MD, New York, NY of Kansas Medical Center, KS; M. Francisco, CA; Christopher P. Ames, Introduction: Anterior cervical discec- Farooque, MD, Veterans Administration MD, San Francisco, CA tomy with allograft and plate instru- Medical Center, MO; M. Bilgen, MD, Introduction: Anterior access to the mentation has become a standard of Veterans Administration Medical L5-S1 disc space for interbody fusion care for treatment of single level cervi- Center, MO; B. Citron, MD, Veteran’s can be difficult and often requires the cal radiculopathy and/or myelopathy. Administration Medical Center, MO; assistance of a vascular surgeon for Use of metal plates can lead to com- B. Festoff, MD, Veteran's adequate exposure. We reviewed our plications including dislodgement Administration Medical Center, MO experience with a novel minimally- and dysphagia, and is not desirable Introduction: Thrombin is both a invasive technique for L5-S1 interbody because of persistant foreign material proinflammatory mediator and a fusion that requires no retraction of implantation. Absorbable cervical neurotoxic factor within the adult the great vessels and no dissection of plates have recently become available spinal cord. Prothrombin mRNA and the sympathetic plexus. but information on fusion rates and the most common thrombin receptor, Methods: Eight patients (5F:3M, outcome for ACDF is limited. PAR1, are rapidly upregulated after average age 55 years) were included Methods: Patients presenting with contusion injury in rats (Citron et al., in this analysis. Average follow-up was one-level cervical radiculopathy and/or J Neurotrauma 17:1191[[Unsupported 5.5 months. Back pain was due to myelopathy and without mechanical Character - Codename ­]]0S, lumbar degenerative disc disease instability who had failed non- 2000). Antithrombin (ATIII) is the most (DDD) in 5 patients, degenerative operative treatment underwent single potent thrombin inhibitor in blood lumbar scoliosis in 2 patients and lytic level ACDF using allograft interbody while a related serpin, protease nexin spondylolisthesis in one. All patients spacers and instrumentation using a I (PNI) serves that function in tissue, had evidence of L5-S1 degeneration resorbable MacroPore 70/30 PLA including CNS. ATIII has potent anti- on imaging studies and underwent (Mystique, Medtronic) plate. Visual- inflammatory as well as anticoagulant percutaneous, presacral fluoroscopically- Analog scale, Neck Disability Index actions. PNI provides neuroprotection guided interbody fusion (AxiaLIF) with scores, flexion/extension scores, and may also be anti-inflammatory. cage and BMP/mastergraft at this percent fused, and time to fusion Methods: We generated transgenic level, with or without interbody fusion were assessed up to one year mice genomically overexpressing at adjacent levels. post–operatively. Patients did not human PNI (TghPNI) and performed Results: Mean operative time for the wear a hard-collar postoperatively. moderate compression spinal cord L5-S1 AxiaLIF procedure was 43 min- Results: 10 patients have been included injury (SCI) in TghPNI and wild type utes. Four patients underwent AxiaLIF to date. The majority of patients pre- (wt) as described (Farooque, Acta followed by percutaneous L5-S1 pedi- sented with radiculopathy. One Neuropath 100:13-22,2000). cle screw-rod fixation. Two patients patient had a transient Horner’s syn- Locomotor rating scores and actome- underwent AxiaLIF followed by percu- drome after surgery. One screw-head ter testing was performed while evolu- taneous L4-L5 extreme lateral inter- broke intraoperatively, and a rescue tion of SCI was monitored over time body fusion. Unfavorable anatomy screw was placed with good results. using a special surface coil on an MRI precluded access to the L5-S1 disc Immediate postoperative imaging scanner with 9.4 Tesla field strength space during open lumbar interbody studies revealed good alignment of and 1mm slice thickness. fusion in 2 patients who subsequently plate and graft in all patients. Settling Results: At day 1 in wt mice, grey underwent AxiaLIF at this level. All of the graft was observed in 2 patients matter tissue damage was already patients had radiographic evidence of 6 weeks after surgery. There was no obvious but became gradually stable L5-S1 interbody cage placement failure due to dislodgement of graft extensive at days 7 and 14 after SCI, at last follow-up. or plate; no patient required further extending caudal from the injury Conclusions: The percutaneous pre- surgery. VAS and NDI improved signifi- epicenter. Damage was much reduced sacral route provides safe and mini- cantly at 6 months after surgery. in transgenic TghPNI mice, and motor mally-invasive access to the L5-S1 Conclusions: Based on these prelimi- scores confirmed MRI data. Damage disc space. It can be used alone or in nary results, the absorbable anterior was much reduced in TghPNI mice, combination with minimally-invasive cervical instrumentation is safe and and motor scores confirmed MRI data. or traditional open fusion procedures effective as an alternative to metallic Conclusions: Histologic sections and can be performed in patients in plates in single level ACDF with the supported both anti-inflammatory whom adequate access to the L5-S1 advantage of avoiding permanent and neuroprotective effects of the disc space is unachievable from an implantation of foreign body. overexpression of PNI on recovery open lateral approach. following compression SCI in mice.

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES POSTER ABSTRACTS 63

320. XLIF: One Surgeon’s Interbody 321. Charité Lumbar Artificial Disc 322. Multimodality Evoked Potential Fusion Technique of Choice Retrieval by Minimally Invasive Monitoring for Intradural Spinal William Smith, MD, Las Vegas, NV Lateral Approach (XLIF): Case Cord Lesions of the Cervical and Report Thoracic Spine: Prospective Long- Introduction: The XLIF procedure term Clinical Evaluation of 22 Cases allows for superior disc-space prepara- Luiz Pimenta, MD, PhD, Sao Paulo, tion and stabilization with minimal Brazil; Roberto Díaz, MD, Sao Paulo, Frederick Vincent, MD, Toronto, surgical time or patient morbidity. Brazil ON, Canada Previous reports have presented the Introduction: Most lumbar TDR Introduction: We hypothesized that technique as an alternative to ALIF for devices require an anterior abdominal changes in intraoperative motor and DDD. The current report highlights approach, which can be technically somatosensory evoked potential its use in one practice as the preferred demanding at L4-5. Converting a responses during surgery for intradural interbody fusion technique for a failed TDR to an anterior interbody cervical and thoracic spinal lesions cor- variety of indications. fusion is especially difficult due to scar relate with postoperative neurological Methods: 72 XLIF cases were per- formation and risk of vascular injury, changes and influence intraoperative formed by one surgeon from June and so posterior fixation is alternative- surgical decision making. 2004 - May 2005. Indications included ly recommended. Still, some circum- Methods: Twenty-two patients under- failed-laminotomy syndrome, adja- stances may necessitate removal of the going resection of cervical and tho- cent-level syndrome, internal disc TDR. We used a lateral approach to racic spinal lesions over a 48-month disruption, stenosis, spondylolisthesis, more safely access the disc space. period were monitored with motor and degenerative scoliosis, among Methods: A Charité TDR device (MEP) and somatosensory evoked others. Posterior microdecompression (DePuy Spine, Raynham, Massachusetts) potential (SSEP) monitoring. We was adjunctively performed in 26/72 was implanted in a 39 year-old prospectively examined the relation- cases (36%). Operative and immedi- woman with L4-L5 DDD. Her back ship among intraoperative monitoring ate-postoperative details were ana- pain reappeared 15 days post-op and findings and pre- and post-operative lyzed to evaluate the efficacy and x-rays showed instability caused by an neurological examinations. minimally-disruptive benefits of the unrecognized isthmic pars defect frac- Results: Twenty-two patients (7 technique. ture at the implanted level. An instru- intramedullary lesions, 12 Results: A total of 99 levels were treat- mented posterolateral fusion was per- extramedullary lesions,1 syringomyelia ed: 52/72 cases were single-level, formed, subsequently became infect- and 1 transdural cord herniation) were 16/72 2-level, 2/72 3-level, and 1 ed, and was again revised. Her back included in the study and followed each 4-level and 5-level; 39/99 proce- pain persisted 18 months later and x- postoperatively for 12 months. The dures were at L4-5, 32/99 at L3-4, rays revealed rod failure. TDR removal correlation between MEP/SSEP 23/99 at L2-3, 3/99 at L1-2, and 2/99 was performed via XLIF through a 2- changes and motor grade loss on at T12-L1. 19% were stand-alone, inch lateral incision using a MaXcess preoperative and post-operative 22% were supplemented with unilat- retractor and EMG guidance assessments revealed 3 true positive eral pedicle screws, and 59% with bilat- (NuVasive, San Diego, California). and 19 true negative MEPs and 1 true eral pedicle screws. XLIF OR time and Results: The polyethylene TDR core positive and 19 true negative SSEPs. EBL averaged 66 minutes and 15cc, was exposed and removed quite easily Specificity was 100% for both respectively. No lasting complications after annular discectomy. The endplate MEPs\SSEPs and sensitivity was 100% occurred. All patients ambulated within fixation was separated with a flat chis- and 33% for MEPs and SSEPs respec- 8 hours. 51% were discharged within el without significant force. Standard tively. Positive predictive value (PPV) 48 hours; the remainder mainly elderly intradiscal instruments were used for and negative predictive value (NPV) with significant comorbidities. disc-space preparation and a PEEK were 100% and 100% for MEPs, and Conclusions: XLIF is a safe and repro- interbody implant filled with iliac crest were 100% and 90% for SSEPs. The ducible procedure that can be done autograft was inserted across the accuracy of MEP and SSEP were 100% quickly, affords an exceptional inter- peripheral apophyseal ring. A posterior and 90% respectively. body grafting area, and results in revision was also performed with Conclusions: These results demon- minimal morbidity. It can be used with re-position of the rod. The TDR was strate good sensitivity, specificity, PPV adjunctive procedures for a variety of successfully revised to an interbody and NPV for MEPs. MEP monitoring back and leg symptoms. It has become fusion in 100 minutes, with 50cc accurately predicts postoperative my preferred technique for treating blood loss. The patient was discharged decreases in neurological motor func- lumbar degenerative conditions, in 24 hours. tion and provides additive information especially in an elderly population that Conclusions: An anteriorly placed to SSEPs. previously had few treatment options. Charité TDR device can be successfully and more safely revised using an XLIF approach.

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323. Total Cervical Artificial Disc 324. A Novel Biomechanically 325. In Vivo Image Based 3-D Finite Replacement with the PCM (Porous Superior Means of Minimally Element Analysis of L5-S1 Charité Coated Motion) Disk. Prospective Invasive Transfacet Non-Screw-Rod Artificial Disc Implant 3 Years Follow Up Clinical and Based Fixation: Early Clinical Robert Nicholson, BA, Ann Arbor, MI; Radiological Study, 230 Discs Performed. Experience and Biomechanical Data Chia-Ying Lin, PhD, Ann Arbor, MI; Luiz Pimenta, MD, PhD, Sao Paulo, Larry T. Khoo, MD, Los Angeles, CA; Barunashish Brahma, MD, Ann Arbor, Brazil; Paul McAfee, MD, Roberto Diaz, Andrew Cappuccino, Lockport, NY; MI; Scott Hollister, PhD, Ann Arbor, MI; MD, Sao Paulo, Brazil; Andy Capuccino, Bryan Cunningham, MSc, Baltimore, Frank La Marca, MD, Ann Arbor, MI MD, Buffalo Spine Center, NY; Claudio MD; Adebukola Onibokun, MD, Los Introduction: Since FDA approval, Tatsui, MD, Sao Paulo, Brazil; Luis E. Angeles, CA clinical and biomechancial research Guerrero, MD, Sao Paulo, Brazil; Bryan Introduction: We describe a novel continues into the complications of Cunningham, MSc, Union Memorial means of minimally-invasive transfacet Charité artificial disc replacement Hospital, MD; Alan Crockard, MD, PhD, London, United Kingdom fixation using a novel rivet system that (ADR), which may include posterior is not dependent on traditional lateral facet joint arthrosis and device subsi- Introduction: Many surgical options mass screw-rod fixation. dence. The objective of this project is are available to treat the cervical spine to employ an image based 3D finite disease. Traditional treatment of cervi- Methods: A biomechanical cadaveric study in a C5 corpectomy model element model to determine changes cal spondylosis and cervical herniated in stresses following ADR in the spine disc disease with neurological com- comparing the ROM on rotation, flex-extension, and lateral bending segment that may relate to these two pression is ACDF. Total disc replace- potential complications. ment has been reported to restore after the following: Mesh Cage alone, motion in the cervical spine. The pur- Cage+ Ant Plate, Cage +Ant Plate+ Methods: Image based 3-D models pose of this prospective study was to lateral mass plates, Cage+Ant were constructed from pre-operative evaluate pain relief and radiographics Plate+transfacet rivets. Using the and post-operative fine cut lum- outcomes of the cervical disc replace- transfacet rivets clinically, supplemen- bosacral spine CT scans of patients ment utilizing the PCM disc. tation of single and multi-level anterior scheduled to undergo L5-S1 Charité constructs were acomplished. Eight artificial disc implant. As a control, a Methods: Report of 3 years follow-up cases were completed and followed normal healthy disc model was used. total disc replacement study in a over a 2-6 month period with use of Finite element analysis was then per- consecutive series of 138 patients radiographic and clinical outcomes formed using VOXELCON 5.0 software underwent a total of 230 PCM disc assessment. on the all models. Two loading condi- for treatment of cervical degenerative tions, representing compression and disease with radiculopathy and/or Results: The cage alone group flexion loads were used. Displacement, myelopathy. Radiographic and clinical demonstrated the most motion in outcomes were collected preoperatively, all modalities except lateral bending shear, and stress were analyzed in all at 1 week, at 1, 3, 6, 9, 12, 15, 18, 24, where there was no difference. three spatial dimensions. 30 and 36 months postoperatively. The Comparing the last three groups, Results: All of the models show signifi- NDI, VAS, ODOM and TIGT question- there was no statistically significant cant stress at the L5-S1 facet joints naires were used to assess pain and differences between the plate, without significant differences. High functional outcomes. plate+lateral mass screws, and stress was found at the inferior L5 and Results: There were no deaths, no plate+transfacet rivets in flexion- superior S1 endplates only of the infections, and no instances of iatro- extension or lateral bending. The Charité ADR models. Only minimal genic neurologic progression. PCM groups with lateral mass screws or stress was found in the discs of the maintains phisiologic ROM. 94% of transfacet rivets performed equally normal and degenerative models. patients discharged < 24 hours. There well in axial rotation and were superi- Conclusions: The stress found at the were four re-operations for replace- or to the group with anterior plates facet joints may be due to the lordotic ment of a low-profile component with only (p less than 0.05). In the eight curve of the L5-S1 spine segment in a PCM arthroplasty device. 87% of clinical patients, there were no gross relation to the loading force vectorin working patients were able to return complications of transfacet fivet fixa- our models. This is different than what to their baseline level of employment. tion with low blood loss, no operative has been reported with geometric The clinical success based on Odom’s complications, and good early out- linear finite element analysis studies. criteria was 95% or more. The mean comes. The increased stress at the L5-S1 end- VAS and NDI improves at the final of Conclusions: Posterior transfacet fixa- plates seen in the Charité ADR models the follow-up. tion is a novel means of subaxial cervi- could play a role in the incidence of Conclusions: Following cervical cal spine stabilization that can be device subsidence. arthroplasty with the PCM disc, applied in a minimally-invasive percu- radiographic and clinical outcome taneous fashion to supplement an measures were encouraging when anterior construct or for stand-alone compared to historical data of one facet arthrodesis. Biomechanically, it level ACDF; is a good treatment appears to provide equal rigidity to option for degenerative disc disease traditional dorsal lateral mass fixation and a viable alternative to fusion. techniques.

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326. Laminectomy for Cervical 327. How to Predict Best Results 328. Restoration and Maintenance Spondylotic Myelopathy in from the Bypass Coaptation for of Coronal and Sagittal Lumbar Elderly Patients Cervical Root Avulsion Spinal Alignment with a Semi- Mark G. Burnett, MD, Phoenix, AZ; Shokei Yamada, MD, PhD, Loma Constrained Multi-level Lumbar Thomas S. Metkus, BS, Philadelphia, PA; Linda, CA; Gordon W. Peterson, MD, Total Disc Arthroplasty (ProDisc-L) Sherman C. Stein, MD, Philadelphia, PA Loma Linda, CA; Bruce A. Everett, MD, Ben B. Pradhan, MD, MSc, Santa Introduction: As the population ages, FACS, Fontana, CA; Daniel J. Won, MD, Monica, CA; Hyun W. Bae, MD, Santa medical professionals must increasing- FACS, Fontana, CA; Javed Siddiqi, MD, Monica, CA; Michael A. Kropf, MD, ly take age into account during surgi- PhD, FRCS, Colton, CA Santa Monica, CA; Linda E.A. Kanim, cal decisionmaking. Unfortunately, Introduction: The prognosis of cervi- MA, Santa Monica, CA; Rick B. significant attention has not been cal root avulsion is considered unfa- Delamarter, MD, Santa Monica, CA given to studying the effects of age vorable for functional recovery. Based Introduction: The first prosthetic disc on outcome for many neurosurgical on bypass coaptation procedures, the in the US was approved by the FDA procedures. In the present study we authors retrospectively formulate the for single-level disease. Unfortunately examine the functional outcome of effective factors for restoring function DDD frequently occurs in more than cervical laminectomy in the elderly of denervated muscles. one level. The ProDisc-L artificial disc patient population. Methods: Twenty patients with cervi- recently completed clinical trials for Methods: We retrospectively reviewed cal root avulsion accumulated over 22 single and two-level DDD. Some the charts of patients over the age of years were divided into three groups: patients have undergone disc replace- 65 with cervical spondylotic myelopa- C5 and C6 roots avulsion (N=14); C8 ments (DR) at 3 or more levels under thy who underwent surgical decom- and T1 avulsion (N=2 infants); and C5 “compassionate use” for multi-level pression at our institution between through T1 avulsion (N= 4). In the first DDD. Local asymmetric disc collapse 1997 and 2003. A total of 36 patients group, coaptation consisted of C3 and and spinal deformity is common with (17 male, 19 female) over the age of C4 anterior rami to the upper trunk of multi-level DDD. There have been no 65yrs (mean age=81yrs) underwent the brachial plexus (added by spinal reports on the effect of multi-level DR laminectomy for cervical spondylotic accessory nerve in 3 patients); C3 or on spinal alignment. myelopathy. Information from charts C4 ramus to the lower trunk in the Methods: This is a review of 80 and follow-up telephone interviews second group; and C3 and C4 to the patients with DDD who underwent 2 was used to determine functional state upper trunk and intercostal nerves to to 3-level DR with a semi-constrained at 6 months following surgery. the median and ulnar nerves in the prosthesis. Radiographic evaluation Functional outcome was measured third group. was performed to assess the restora- using the Japanese Orthopaedic Results: 1) The first group had the tion and/or maintenance of sagittal Association (JOA) scale, Cooper scale, best results to restore shoulder girdle and coronal alignment. Patients with and Nurick scale. Differences between muscles and biceps (4+/5 within 2.5 local spinal deformity due to signifi- pre-operative and post-operative years). In a 17-years-old patient, cant asymmetric disc collapse were function were compared and statistical same motor recovery occurred in 10 also evaluated separately. significance determined using the months. 2) The second group Results: Multi-level DR with a semi- two-tailed t-test for paired samples. regained some finger movement but constrained prosthetic disc was Results: Mean JOA scale scores needs further follow-up. 3) The third successful in correcting local spinal improved significantly from 10.14 group regained less motor recovery deformity and maintaining alignment before surgery to 11.53 after laminec- in the shoulder girdle muscles than at up to 36 months of follow-up. tomy (P=0.015). Similar improvements the first group and only one infant Average preoperative lumbar lordosis were seen in the Cooper (3.72 to restored significant finger movement. on average was 40 degrees, and was 1.47; P=0.004), and Nurick (2.61 to Pain relief was noted over 3-4 months measured at 42 degrees immediately 2.30; P=0.13) scores. There were no after surgery. postoperatively, 41 degrees at 24 serious complications and no surgical Conclusions: The combination of months. Preoperative coronal asym- deaths. abnormal EMG findings and normal metric disc collapse causing local Conclusions: Laminectomy for cervical sensory conduction confirms root deformity up to 15 degrees was also myelopathy is a safe and effective avulsion proximal to the sensory successfully corrected and maintained. procedure for elderly patients. ganglion. CT myelogram or MRI is for Conclusions: Disc prostheses are screening test. Bypass capitations are dynamic devices that allow motion. useful for motor restoration. Younger However, with local deformity, semi- ages suggest good outcome. constrained DR successfully corrected asymmetry, implying that physiologic stabilizers in the back (muscles, liga- ments, etc) can benefit from DR in maintaining alignment. Multi-level DR has shown the ability to maintain coronal and sagittal spinal alignment at up to 3 years of follow-up.

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 66 POSTER ABSTRACTS

329. Motion-Preserving Dynamic 330. Is Excessive Bone Formation 331. PEEK Interbody Spacers Filled Posterior Stabilization of the Associated with the Use of rhBMP2 with Allograft Chips in Anterior Lumbar Spine: Early Results from in Minimal Access PLIF/TLIF? Cervical Discectomy and Fusion the US Clinical Trial with the Vivek Joseph, MBBS, FRCS, Toronto, Aubrey S. Okpaku, MD, Bronx, NY; Dynesys System ON, Canada; Y Raja Rampersaud, MD, John K. Houten, MD, Bronx, NY Hyun W. Bae, MD, Santa Monica, CA; FRCS(C), Toronto, ON, Canada Introduction: Polyetheretherketone Ben B. Pradhan, MD, MSc, Santa Introduction: The use of rhBMP2 for (PEEK) is a radiolucent, nonresorbable Monica, CA; Linda E.A. Kanim, MA, interbody fusion is associated with polymer successfully used as an inter- Santa Monica, CA; Rick B. Delamarter, excellent fusion rates. For posterior body spacer for anterior cervical fusion MD, Santa Monica, CA approaches, concerns regarding the when filled with iliac crest autograft Introduction: Lumbar fusion has long formation of bone within the epidural and with recombinant BMP-2. The been the mainstay of surgical treat- space have been raised. The objective fusion rate with PEEK spacers has not ment for instability of the lumbar of this study was to assess the inci- been established when the device is spine. Recently, a new concept of dence and clinical sequelae of epidural filled with allograft chips. dynamic stabilization has been advo- bone formation after the use of Methods: We prospectively collected cated to preserve motion and avoid rhBMP2 in minimal access interbody data on the surgeries using the PEEK the morbidity of spinal fusion. This is (PLIF and TLIF) fusions. spacer in 25 levels in 22 consecutive one of the first intermediate-term Methods: This study compared 2 patients undergoing anterior cervical reports on the US FDA clinical trials groups (A - with BMP [n=23] / B - discetomy and fusion for cervical for the Dynesys device. without BMP [n=10]) of patients who spondylotic myelopathy or radiculopa- Methods: 30 patients aged 49-77 had undergone instrumented minimal thy. All patients had supplemental (mean 65) with degenerative lumbar access PLIF (n=10) or TLIF (n=23 [n= anterior instrumentation with semi- spondylosis at 1-2 levels were entered 4-bilateral]) with a minimum 6 month constrained plates. Patients with a his- into the prospective randomized con- postoperative CT. In all cases local tory of diabetes or smoking within 6 trolled US-IDE study of the Dynesys autograft and/or allograft was used. months of surgery were instructed to device. 23 patients completed at least Clinical chart review and CT assess- use an external bone growth stimula- 12 months of follow-up. ment for bone formation (intradiscal, tor for 3 months. Serial x-rays were Results: Patients treated either with annular/ALL/PLL, epidural [canal / obtained in the course of routine dynamic-stabilization or fusion had foramen] and beyond the spine) was office visits. Fusion was assessed using reduced pain and disability as meas- independently performed. either flexion-extension x-rays or CT ured by Oswestry and VAS scores. Results: Average clinical and CT follow scans at a minimum of 6 months after There was no significant difference up was 13.0 and 7.9 months respec- surgery. between the two groups. Motion at tively. From 33 patients, 36 levels (3 Results: The mean patient age was the treated segment was slightly patients had 2 level procedures) were 56.3 years (42-78). Smokers were decreased for dynamic-stabilization assessed. Bridging bone was seen in all 9% while 32% had diabetes. Clinical patients while it was significantly but one level. Bone formation within follow up was obtained at a mean 14 decreased for fusion patients. Sagittal the disc, to the outer rim of the annu- months (9-31). Imaging assessment and coronal alignment were main- lus, canal, foramen, and beyond the for fusion was performed at a mean tained by the Dynesys device. There spine was seen in 100%, 44.4% (n=10 12 months after surgery (6-22). Fusion were two instances where radiographs group A, n=6 group B), 5.6% (n=1 occurred in all patients. No graft- revealed mild radiolucent halos around group A, n=1 group B), 11% (n= 4 related complications were noted. One Dynesys screws, both asymptomatic. group A), and 0% of levels respective- patient underwent additional cervical Conclusions: Both dynamic-stabiliza- ly. Foraminal bone formation was only spine surgery for adjacent segment tion and fusion-treated patients seen in the BMP-TLIF group. No disease 7 months after the initial sur- reported decreased disability and pain. clinical sequelae were associated with gery. Fusion was appreciated in all Dynamic-stabilization decreases back epidural bone formation. patients with bone growth consistent- and leg pain while avoiding the mor- Conclusions: Although, the use of ly seen both within the device center bidity of fusion, maintaining sagittal rhBMP2 is associated with a higher and periphery. alignment of the lumbar spine, and incidence of epidural bone formation, Conclusions: If confirmed by larger without eliminating motion. The there were no associated clinical studies, PEEK interbody spacers filled short-term results from this study sequelae. with allograft appear to be a suitable suggest that this may be a viable substitute for structural allograft or alternative to fusion. autograft in anterior cervical fusion procedures.

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332. A Long-Term Clinical Outcome 333. Real-time CT-guided Conclusions: PTDD with LASE under Analysis of Minimally Invasive Percutaneous Thoracic Disc CT fluoroscopy guidance is an accurate, Cervical Foraminotomy Decompression with Laser Assisted safe, and effective minimal invasive Larry T. Khoo, MD, Los Angeles, CA; Spinal Endoscopy for Symptomatic procedure for symptomatic thoracic Murat Cosar, MD, Los Angeles, CA; Thoracic Disc Herniation disc herniation in selected patients. Adebukola Onibokun, MD, Los Ho-Yeong Kang, MD, Seoul, Republic Angeles, CA of Korea; Sang-Hyeop Jeon, MD, 334. Percutaneous Endoscopic Introduction: This study examines the Seoul, Republic of Korea; Sang-Ho Lee, Lumbar Discectomy for Upper 4-year long-term clinical outcomes of MD, PhD, Seoul, Republic of Korea; Lumbar Disc Herniation Ho Yeon Lee, MD, PhD, Seoul, MICF over time to determine the inci- Yong Ahn, MD, PhD, Seoul, Republic dence of recurrent symptoms and the Republic of Korea; Won-Chul Choi, MD, Seoul, Republic of Korea of Korea; Sang-Ho Lee, MD, PhD, percentage of patients requiring addi- Seoul, Republic of Korea; Soo Taek tional cervical spinal surgery. Introduction: Computed tomography Lim, MD, PhD, Seoul, Republic of Methods: We conducted a multi- (CT) fluoroscopy, one of the most Korea; Sang-Hyun Keem, MD, Seoul, center retrospective chart review of recent developments in interventional Republic of Korea; Dong-Yeob Lee, 73 patients who had a MICF. Patient radiology, provides accurate spatial MD, Seoul, Republic of Korea information and real-time information. histories and evaluations were Introduction: There have been few reviewed and scored specifically for The purpose of this study is to present percutaneous thoracic disc decom- published studies on the outcomes symptoms of neck pain, radiculopathy. of percutaneous endoscopic lumbar In addition to these, findings of abnor- pression (PTDD) with Laser Assisted Spinal Endoscopy (LASE) under CT discectomy (PELD) for upper lumbar mal reflexes, decreased sensation, and disc herniation. The purpose of this decreased strength were also record- fluoroscopy guidance for symptomatic thoracic disc herniation. study was to evaluate the efficacy of ed. Static and dynamic plain cervical PELD for upper lumbar herniation. We spine radiographs, MRI, and/or com- Methods: Between March to further describe the predictive factors puted-tomographic myelogram (CTM) November 2003, eight consecutive and technical pitfalls unique for upper were obtained pre- and post-opera- patients, who have suffered from lumbar level. tively. intractable thoracic axial and/or radicular pain due to soft disc hernia- Methods: We reviewed the clinical Results: Whereas patients selected for data of 47 consecutive patients treat- MICF had minimal preop neck pain, tion, underwent real-time CT-guided PTDD with LASE. By showing a live ed with PELD at L1-2 or L2-3 level significant neck pain was subsequently from Jan 2001 to Mar 2003 at our seen in 8 patients with symptoms in image, the ipsilateral or central portion of protruded disc is decompressed via hospital and compared the clinical 2% at 1 year, 5% at 2 years, 9% at 3 outcomes with those of patients years, and 11% at 40 months. Overall, the posterolateral approach using an automated nucleotome and micro- treated with PELD at L3-4 level. 15 patients (20%) of these 23 sympto- Patients with soft disc herniation matic patients underwent an addition- forceps through a small cannula. Then, disc tissue was more potentially without segmental instability were al cervical surgery after MICF. 4% of included in our study. patients underwent a repeat MICF at shrunk and annuloplasty was per- the same level as before at an average formed using a Ho:YAG laser under Results: The mean follow-up period of 12 months postop with a positive endoscopic view. All patients were was 38.8 months and the mean age response in all 3 cases. An additional discharged from the hospital in less was 54.9 years. The success rate of 2 patients had MICF at a different than 24 hours. L1-2 + L2-3 group was 74.5%, where- level. 7 patients had an ACDF at the Results: The mean follow-up period as that of L3-4 group was 88.1% (P < same level. An additional 2 patients was 23.8 months (range 20-28 0.05). The cases required further sur- were determined to have pain at a months). According to the modified geries were more in L1-2 + L2-3 group different level from preop and under- Macnab criteria, excellent was obtained than in L3-4 group (14.9% vs. 5.2%; P went ACDF at a different level with in 6 patients (75.0%), good in 1 < 0.06). The clinical predictive factors both having positive outcomes. (12.5%), and fair in 1 (12.5%). for favorable outcome were younger Compared with preoperative values, age (less than 50 years; P < 0.05) and Conclusions: MICF continues to be shorter symptom duration (less than 6 our procedure of choice for properly there was a significant decrease in Visual Analog Scales (6.5 to 1.6; months; P < 0.05), while the radiologi- selected patients with cervical radicu- cal predictive factors were lateral disc lopathy. p=0.11) and Oswestry Disability Index (55.0 to 17.5; p=0.11) at the 3-month herniation (subarticular or foraminal; P follow-up, and the improvements were < 0.05) and low grade disc degenera- well maintained throughout the follow- tion (grade 3 or less; P < 0.05). up period. There were no postoperative Conclusions: The surgical outcomes complications and no case required of PELD for L1-2 and L2-3 herniation conversion to an open surgery. were less favorable than those for lower lumbar herniation. Therefore, more strict patient selection and specialized technical considerations are required.

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335. Evaluation of the Misonix 336. The Utility of MR Neurography 337. Spontaneous Resolution of Ultrasound Osteotome Device in in Brachial Plexus Imaging Syringomyelia Associated with Sheep Laminectomies Aaron G. Filler, MD, PhD, Santa Chiari Type 1 Malformation William C. Welch, MD, FACS, Monica, CA Motoo Kubota, MD, PhD, Chiba, Pittsburgh, PA; Wendy Fellows-Mayle, Introduction: Magnetic Resonance Japan; Ado Tamiya, Chiba, Japan; PhD, Pittsburgh, PA; Micheal Sharts, Neurography has shown promise for Naokatsu Saeki, Chiba, Japan; Akira MD, Pittsburgh, PA; Patricia the image evaluation of the brachial Yamaura, Chiba, Japan; Toshio L. Karausky, BSN, RN, Pittsburgh, PA; plexus relative to routing MR imaging. Fukutake, Chiba, Japan Introduction: Bone removal has However there has been no compre- Introduction: Syringomyelia with traditionally been performed by hensive assessment of initial progress Chiari malformation has been thought hand instruments or cutting burrs. in this field and no update of method- to rarely shrink spontaneously. To our Ultrasonic osteotome devices offer the ology. In the past artifacts and variable knowledge, only several cases have potential advantage of more con- image quality have limited utility. been reported in English literature. trolled bone resection and reduced Methods: An updated standardized We reported here additional nine likelihood of soft-tissue injury. This MR Neurography protocol was applied pediatric cases whose syringomyelia study was designed to evaluate the for the collection of brachial plexus shrank spontaneously, and assessed safety and efficiency of bone removal image data in 500 patients and these their neurological and neuroradio- in a sheep laminectomy model using were compared with image data on logical features. the Misonix ultrasonic osteotome 200 patients imaged using an older Methods: From 1988 to 2003, we versus traditional use of high-speed MR Neurography brachial plexus conducted prospective MRI studies in drill and Kerrison punches. protocol. pediatric patients with scoliosis and Methods: The study was IACUC Results: The use of unilateral imaging positive neurological signs or symp- approved using twelve sheep under- with nerve perpendicular views and toms. Sixty-two scoliotic children going complete 3 level, bilateral patient positioning to straighten the showed syringomyelia associated with laminectomy. Eight surgeries were normal plexus resulted in significant Chiari malformation, and nine of them performed using the ultrasonic increase in image reliability and clinical revealed spontaneous resolution of osteotome. Four control sheep surgeries utility. This methodology equalized the syringomyelia following improvement used traditional means. Pre and post- efficacy for proximal and distal pathol- of tonsillar ectopia. op MRI’s were done on one sheep ogy including tumors, trauma and Results: All nine patients showed from each group to evaluate for entrapment syndromes and greatly only mild neurological deficits. Their hematoma and/or inflammation. reduced the occurrence of image scoliosis remained stable during fol- Somatosensory evoked potentials intensity artifacts. low-up periods. They were diagnosed (SSEP) were done pre and post op on as having syringomyelia at the age of all sheep. Weekly clinical neurological Conclusions: Modification of brachial plexus MR Neurography protocols to 7.2 years, and the syringes disap- and behavioral examinations evaluated peared or remarkably diminished in gait, reflex, bowel/bladder function correct problems observed with earlier protocols has greatly improved the size at the age of 12.1 years. Basal and pain withdrawal. After sacrifice, angles have become narrower and histological analyses assessing integrity efficacy, reliability, and clinical utility of this diagnostic technique. clivo-axial angles wider during this of dura, nerve roots and bone was period. Improvement of tonsillar completed. displacement seems to be attributed Results: Of the experimental and to increased growth of the calvaria control group there were no relative to the central nervous system, weaknesses attributed directly to followed by spontaneous resolution of the surgery. Acquired post-op MRI’s syringomyelia. revealed no significant damage. All Conclusions: Spontaneous resolution sheep remained healthy neurologically of syringomyelia is not rare in growing and behaviorally. Laminectomy times children. using the device averaged 7 minutes while time for the controls was 12.5 minutes. Conclusions: The ultrasonic osteotome made a precise cut over a small distance in a controlled fashion, reduced surgery time in this model and was safe.

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES POSTER ABSTRACTS 69

338. CT-SPECT Fusion Imaging for 339. Does Minimally Invasive 340. Treatment of Cervical Diagnosing Painful Lumbar Facet Technique Limit The Ability to Degenerative Disease: Joint Arthropathy Prepare a Disc Space for Interbody A Comparison of Arthrodesis Matthew McDonald, MBBS, FRACS, Fusion? Versus Laminoplasty Adelaide, Australia; Robert Cooper, Peter M. Grossi, MD, Durham, NC; Masaki Mizuno, MD, PhD, Hisai Mie, MD, Adelaide, Australia; Michael Y. Ashtoush A. Pradhan, MD, Durham, Japan; Yoshichika Kubo, MD, PhD, Wang, MD, Los Angeles, CA NC; Shahid M. Nimjee, PhD, Durham, Hisai Mie, Japan; Shigehiko Niwa, MD, Introduction: Facet disease is believed NC; Roger E. McLendon, MD, PhD, Hisai Mie, Japan; Keita Kuraishi, to play a role in axial back pain. Durham, NC; Robert E. Isaacs, MD, MD, Hisai Mie, Japan; Shiro Waga, However, the lack of good diagnostic Durham, NC MD, PhD, Hisai Mie, Japan and imaging methods for diagnosing Introduction: The main determinant Introduction: Cervical myelopathy this condition have made this entity for obtaining arthrodesis with inter- due to spondylosis, disc herniation more obscure than discogenic pain. body fusion is adequate disc removal and OPLL may be treated by anterior SPECT imaging is a highly sensitive and endplate preparation. Controversy cervical decompression and fusion and specific test, but the images have still exists as to whether this can be (ACDF), cervical laminoplasty and poor resolution. CT provides excellent performed utilizing minimally invasive laminectomy with fusion. We selected resolution but lacks specificity. surgical (MIS) techniques. Herein, we the operative approach according to a Methods: Thirty-six patients with compare discectomies obtained utliz- number of affected cervical levels. If suspected back pain from facet disease ing two different approaches (Open the patient had lesions more than two underwent SPECT-CT fusion imaging and MIS) to the lumbar spine in a without kyphosis and instability, we of the lumbar spine. SPECT images human cadaveric model. chose the laminoplasty. For one or were obtained using a dual head Methods: Standard Open and MIS two levels lesion, we selected the gamma camera equipped with VXGP Transforaminal Lumbar Interbody ACDF. A retrospective review of high-resolution collimators using a Fusions (TLIF) were performed in ACDF and laminoplasty patients was 20% energy window centered at alternating segments of twelve performed to compare preoperative/ 140keV and a 360-degree rotation lumbar disc spaces in four fresh postoperative neurological scores and totaling 128 projections at 16 seconds human cadavers from L3-4 to L5-S1 outcomes. each. Transaxial CT images were trans- (6 MIS, 6 open). Identical TLIF tech- Methods: One hundred sixty-three ferred in DICOM to provide proper nique and instruments were utilized patients with cervical degenerative image overlay in the axial, sagittal, regardless of the approach taken. In disease were followed. Eighty-two and coronal planes. Scanning for both each case, a unilateral facetectomy patients underwent ACDF with cylin- modalities was performed with stan- was followed by a radical discectomy; drical cage and 81 patients underwent dard patient positioning. Patients the only exception was that in the MIS mid-sagittal splitting laminoplasty. with concordant images and symp- levels, a fixed 22mm portal was used. Patients were aged 20-79, (mean age toms then underwent joint injection Following discetomy in situ, the spines 56 Cage fusion, 63 laminoplasty). Pre and/or rhizotomy by an independent were removed from the body. The and postoperative neurological status physician. segments were then cut through the were assessed using the Neurosurgical Results: Successful image fusion was disc space and analyzed grossly and Cervical Spine Scale (NCSS, full score performed on all patients, and image histologically by pathologists blinded 14 points). quality allowed definitive localization to the approach, to quantify the Results: Mean follow-up was 15 of the “hot” lesion in all cases, in con- extent of disc removal and bony end months for the ACDF group and 55 trast to conventional high-resolution plate exposure. months for the laminoplasty group. SPECT imaging which often led to Results: No clinically significant NCSS score of ACDF were pre-op problems differentiating L4/5 and advantage was noted with either open 10.0 and post-op 12.8. NCSS score L5/S1. In patients with solitary lesions, or minimally invasive approaches. In of laminoplasty were 7.7 and 10.4. injection led to definitive pain resolu- both cases, the contralateral dorsal Recovery rates were 74.3% and 45.0% tion, even if temporary, in all cases corner was the most consistently and recovery points were 2.8 and 2.7. with anesthetic blockade. difficult region to reach. Quantative Complications included 4 in Cage Conclusions: CT-SPECT fusion analysis showed that an adequate fusion (Transient motor weakness, CSF combines the virtues of functional and discectomy and disc space preparation leakage and 2 Donor site problem) anatomic imaging, aiding the clinician could be obtained with both tech- and 5 in laminoplasty (3 Transient C5 in diagnosing painful facet arthropa- niques. palsy, 2 intractable neck pain). There thy. In addition, the excellent anatomic Conclusions: For single level interbody were no instrument failure and no detail allows for precisely targeted fusion, with respect to disc space required reoperation case. treatment of the offending joint, preparation for fusion, an open Conclusions: Both procedures allowed particularly in patients with abnormal approach offers no significant advan- for improvement in NCSS scores. lumbar segmentation. tage compared with an identical MIS Complications were comparable. technique. With either technique, an Overall, ACDF using cage and lamino- adequate disc space preparation can plasty provide similar results for the be obtained. treatment of cervical disorders.

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341. 360 Degrees Minimal Invasive 342. Safety and Feasibility of 343. MR and CT Characteristics of Axial Percutaneous L5-S1 Fusion Percutaneous Lumbar Spine Pedicle Materials Used for Artificial Cervical (Axialif). 2 Years Clinical and Screw Fixation as an Outpatient Disc Replacements Radiological Follow-Up Procedure James J. Lynch, MD, FRCS FI, Reno, Luiz Pimenta, MD, PhD Sao Paulo, John Pollina, Jr., MD, Buffalo, NY; P. NV; Jun-Young Yang, MD, St. Louis, Brazil; Roberto C. Diaz, MD, Sao Jeffrey Lewis, MD, FACS, Buffalo, NY; MO; Ty Bae, MD, St. Louis, MO; Fang Paulo, Brazil; Claudio Tatsui, MD, Sao Jennifer Weaver, RPA-C, Buffalo, NY Zhu, MD, St. Louis, MO; Bret Taylor, Paulo, Brazil; Luis E. Guerrero, MD, Introduction: The standard technique MD, St. Louis, MO; Paul Young, MD, Sao Paulo, Brazil; Andrew Cragg, MD, for pedicle screw fixation usually St. Louis, MO; Greg Marik, MSME, Minneapolis, MN involves extensive dissection for Memphis, TN; K. Dan Riew, MD, Introduction: The common approaches exposure of the spine. Percutaneous St. Louis, MO of the lumbosacral spine require pedicle screw fixation (Sextant, Introduction: This study compares muscular and ligament dissection, Medtronic, Memphis, TN) is minimally the MR and CT characteristics of five retraction of the neural and vascular invasive producing less tissue damage different materials commonly used for structures when involve direct visuali- and blood loss. Overall recovery, cervical artificial disc replacements. zation to either the anterior or the therefore, is expected to be quicker. Methods: We obtained MR and CT posterior elements. A new minimally Methods: A prospective analysis of scans of 2 cadaveric spines with 5 invasive presacral approach allowing 119 consecutive patients who under- different cylindrical implants approxi- longitudinal vertical spinal access for went, on an outpatient basis, percuta- mating artificial cervical discs. We disc and vertebral body treatment was neous lumbar pedicle screw fixation. randomly placed the following: developed. The technique preserves polyethylene (PE), titanium ceramic the integrity of muscles, ligaments Results: 52.9 percent (63/119) of patients were smokers. 43.7 percent composite, (TiC), titanium alloy (Ti and annulus of the disc and provides 6Al 4V), cobalt chrome (Co Cr), and biomechanical and physiological (52/119) were Workers Compensation cases and 22.7 percent (27/119) were 316 stainless steel (SS). These were advantages. The purpose of this analyzed by a radiologist and a spine prospective study was to determine No Fault cases. Preoperative symp- toms were low back and leg pain in surgeon independently and blindly. feasibility, safety and outcomes of the Each implant was graded for the percutaneous axial interbody fusion. 71.4 percent (85/119), low back pain only in 28.6 percent (34/119). 90.8 amount of artifact, sharpness of the Methods: 27 patients with radiculo- percent (108/119) procedures were edge, ability to read the rest of the pathy resulting from non-sequestered staged following an anterior lumbar disc space, and the ability to read the simple disc herniation localized to interbody fusion after an average of adjacent disc space, and based on the L5-S1, low back pain due to 12 days from initial procedure. 9.2 these, ranked from best to worst. pseudoarthrosis, spondylo grade I and percent (11/119) had previous stand- Results: For both CT and MR scans, II. The surgery was performed using alone posterior lumbar interbody the order was identical, and from best the AxiaLIF technique consisted of fusion with psuedoarthtrosis. 61.3 to worst was: PE, TiC, Ti 6Al 4V, CoCr, radial discectomy, disk packing with percent (73/119) were one level fixa- then SS. With CT, even the worst osteogenic material and stabilization tions, 38.7 percent (46/119) were two metal (SS) had minimal effect on read- by insertion of an axial interbody level fixations. The average blood loss ability. In contrast, the implants had a fusion rod. This construct was supple- was 15.9cc (10-300cc). The average more profound effect on the MR mented with posterior fixation. operating time was 40.4 minutes (25- scans. While PE had minimal to no Radiographic and clinical outcomes 200 minutes). 94.1 percent (112/119) effect, even the best metals, TiC, and were collected preoperatively, at 8 were discharged to home the same Ti 6Al 4V imparted some artifact. SS weeks, 3, 6, 9, 12,18 and 24 months day of the procedure. 6 percent made it impossible to see anything postoperatively. ODI, VAS, Prolo and (7/119) were admitted and discharged even at the adjacent disc space. Sf-36 were used. All adverse outcomes within 1-4 days. There were two post- Conclusions: Our results indicate that related to the index procedure were operative wound infections, and one noted. PE imparts little to no artifact on MR patient required revision of a previous- or CT scans. In contrast to CT scans, Results: No intra-operative complica- ly placed pedicle screw. MRs were profoundly affected. TiC tions. Blood loss was less them 50 cc. Conclusions: Blood loss, operative and Ti 6Al 4V were judged to be Mean surgical time 122 minutes. All time, and complications for percuta- nearly equal and the most readable patients recovered uneventfully. neous pedicle screw placement in this and SS was felt to be the worst. Patients were discharged in the next study were the same or better than 2 days.VAS, SF-36, ODI and Prolo that reported in the literature for the scores improved. 86% rate of fusion standard open procedure. Nearly all after 1 year. patients were safely discharged the Conclusions: The current study day of the procedure. Percutaneous demonstrates that AxiaLIF was feasible, pedicle screw placement on an there are numerous potential applica- outpatient basis is safe and effective. tions for this new approach and may be a new therapeutic option for minimally invasive spinal surgeons.

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344. Fusion Rates in the Cervical 345. Vertebral Artery Injury 346. Use of Continous Spine Diagnosed with Computed Intraoperative Electromyographic Justin Fraser, MD, New York, NY; Tomographic Angiography in Potential Nerve Root Monitoring Roger Hartl, MD, New York, NY Patients Harboring Blunt Cervical During Decompression of Patients Spine Trauma with Symptomatic Lumbar Introduction: Spine surgeons utilize Radiculopathy anterior cervical discectomy (ACD), Vassilios G. Dimopoulos, MD, Macon, ACD with fusion (ADCF), ACDF with GA; Kostas N. Fountas, MD, PhD, Larry T. Khoo, MD, Los Angeles, CA; anterior plating (ACDFp), corpectomy Macon, GA; Theofilos G. Machinis, Murat Cosar, MD, Los Angeles, CA; (CORP), and corpectomy with plating MD, Macon, GA; Carlos H. Feltes, MD, Adebukola Onibokun, MD, Los (CORPp) to fuse the cervical spine. Macon, GA; Joe S. Robinson, MD, Angeles, CA; Murisiku Raifu, MD, Surgeons should understand their FACS, Macon, GA; Arthur A. Grigorian, Los Angeles, CA respective fusion rates to discuss treat- MD, Macon, GA Introduction: This study examines ment options for cervical spondylosis. Introduction: Vertebral artery injury the utility of continous intraoperative Methods: Of 49 papers published is a well-documented complication of monitoring of EMG nerve root poten- since 1990 on anterior cervical fusion, blunt cervical spine trauma. Its clinically tials during decompression of lumbar 21 provided data on at least 25 silent and often delayed presentation radiculopathy using a proprietary patients, follow-up for more than may lead to under-diagnosis of this neurophysiological EMG monitoring 12 months, radiographic evidence of severe clinical entity. In our current system. fusion, and delineation by number of communication, we report on our Methods: Of the 43 patients, 8 had levels fused. Chi-squared and Fisher experience with the use of computed spondylolisthesis, 13 had classical exact tests were used for group and tomographic angiography (CTA) in the lumbar central and recess stenosis pairwise comparisons. early evaluation of vertebral artery with minimal disc herniation, 6 had affection in patients sustaining blunt purely recess or foraminal stenosis Results: Mean age was 46.7 years, cervical spine trauma. 46.6% were female, and mean follow- without herniation, and 16 had up was 39.6 months. 2682 patients Methods: This is a prospective clinical recess/foraminal stenosis with signifi- were included with an overall fusion study including 27 consecutive cant disc herniation. Neurological rate of 89.5%. For single-disc level, patients (18 male, 9 female) who strength examination; EMG ampli- fusion rates were 84.9 (ACD), 92.1 presented to our institution with a tudes, VAS scores for radiculopathy (ACDF) and 97.1% (ACDFp) (p0.002). diagnosis of blunt cervical injury and were recorded (pre and post op). For two-disc level disease, fusion rates associated subluxation or fracture of Results: Only 39 of the 43 patients for ACDF, ACDFp, CORP, and CORPp the posterior cervical elements. The demonstrated measurable asymmetric were 79.9 (ACDF), 94.6 (ACDFp), mean age of the patients was 39.2 EMG amplitudes. 30 patients had 95.9 (CORP), and 92.9% (CORPp) years (range 17-85). Imaging studies clinical strength improvements. (p0.0001). For three-disc level disease, including C-spine x-rays, computed Intraoperative EMG improvements fusion rates were 65.0 (ACDF), 82.5 tomography (CT) and CTA were were seen in 21 of these 30 patients. (ACDFp), 89.8 (CORP), and 96.2% performed in all patients. Of the 9 patients who did not improve (CORPp) (p0.0001). Utilizing anterior Results: Traumatic vertebral artery in strength after decompression, 8 plates significantly improved fusion for occlusion was evident on CTA in 2/27 demonstrated worsening on EMG. In 1-level (p0.0001), 2-level (p0.0001), patients (7.4%). In one case, both the early recovery group, EMG was and 3-level (p0.05) ACDF. There was vertebral arteries were affected in a 88% sensitive as compared to 50% no significant difference in fusion rates patient with complete C2-C3 disloca- sensitive for late improvements in for 2-level ACDF and CORPp. By one- tion. The other patient sustained strength after 3 months postop. tailed Fisher exact testing, CORPp had occlusion of the proximal right Overall, EMG nerve root monitoring a significantly higher fusion rate than vertebral artery associated with locked had a positive predictive value of ACDFp for 3-level disease (p0.03). facets at the level of C5-C6. 95.5% and a negative predictive value Conclusions: Anterior approaches to Conclusions: Injury of the vertebral of 47.1% with regards strength cervical disc disease and spondylosis artery secondary to blunt cervical improvement. There were 3 cases with can achieve high fusion rates. spine trauma can be safely and worsened transient postop weakness Utilization of an anterior plating accurately detected by CTA. Large resolved within 3 months. In detecting system significantly improves fusion multi-institutional prospective clinical such motor injury, EMG was 100% rates. For two-level disease, ACDF trials should be conducted in order to sensitive, 97% specific with a positive and corpectomy are comparable evaluate the role and cost to risk ratio predictive value of 75% and a nega- procedures in achieving postoperative of CTA as a screening modality in tive predictive value of 98%. fusion. patients harboring blunt cervical Conclusions: Use of intraoperative spine injury. EMG nerve root surveillance may pro- vide an useful adjunct in determining the adequacy of decompression during surgical treatment of compressive lum- bar radiculopathy and may help to pre- dict the degree of motor improvement to be expected after surgery.

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347. Potential for Radiation Dose 348. Comparison of Motion at 349. Stand-alone PLIF with Ray TFC Reduction by Performing Treated and Untreated Adjacent in 103 Cases: Perioperative Percutaneous Kyphoplasty Under Segments After Single to Three- Complications and 5-Year Follow-up Intraoperative Fluoro-based CT Level Disc Replacement Versus Kosuke Kuribayashi, MD, Osaka, Japan Guidance Fusion in the Cervical Spine Introduction: Cylindrical titanium Sigita Burneikiene, MD, Boulder, CO; Ben B. Pradhan, MD, MSc, Santa cages have been extensively used as Alan T. Villavicencio, MD, Boulder, CO; Monica, CA; Hyun W. Bae, MD, Santa a device in posterior lumbar interbody Ketan R. Bulsara, MD, Columbia, MO; Monica, CA; Michael A. Kropf, MD, fusion (PLIF). However, many compli- Jeffrey J. Thramann, MD, Boulder, CO Santa Monica, CA; Linda EA Kanim, cation cases were reported when Introduction: Fluoroscopic guidance MA, Santa Monica, CA; Rick B. using cages without supplemental has contributed to the safety of Delamarter, MD, Santa Monica, CA posterior fixation. I report periopera- various spine surgery procedures, at Introduction: Large-scale clinical trials tive complications and 5-year the same time the concern is raised have shown the ability of lumbar disc follow-up outcome in those who on increased radiation exposure. replacement (DR) to restoring and underwent PLIF in which a Ray TFC Percutaneous kyphoplasty is usually maintain range of motion (ROM). was implanted. performed under biplanar fluoroscopic However, detailed comparison of ROM Methods: A total of 125 patients image guidance. The purpose of this across disc replacements (individual underwent PLIF with Ray TFC without study was to compare radiation time segments in multi-level arthroplasty) supplemental fixation (stand-alone when using isocentric (Iso-C) fluo- and untreated adjacent levels, versus PLIF) between September 1997 and roscopy-based navigation vs. biplanar fusion, has not been reported. July 2000. Seven died of other dis- fluoroscopy for the pedicle cannula- Methods: This is a prospective ran- eases, seven were under medical tion during kyphoplasty procedure. domized controlled study comparing treatment for other disease, six were Methods: A prospective clinical study single-level cervical DR to ACDF. Two lost and two needed additional PLIF was performed. Total operative time and three-level DR were performed in with pedicle screws for migration of and intraoperative fluoroscopy time in eligible patients after receiving special cages before five years have passed. the Iso-C fluoroscopy patients group permission from the FDA. Preoperative A total of 103 patients remained in a was compared to a historical cohort of and postoperative radiographic ROM stand-alone PLIF group at 5-year patients that underwent the procedure measurements were performed across follow-up. These patients included under biplanar fluoroscopy guidance. treated and adjacent untreated levels, 59 males and 44 females with mean There were 35 patients in the Iso-C and compared between single and age of 52.8 yrs (17-81 yrs). Fifty-two fluoroscopy assisted group and 12 multi-level DR, and ACDF. patients were implanted at 1-level, patients in the retrospectively analyzed Results: 41 patients were included in 44 at 2-level, and 7 at 3-level. Pre- biplanar fluoroscopy assisted patients the study, consisting of 26 DR and 15 and post-operative functions were group. ACDF patients. There were 18 1-level evaluated by the Japanese Orthopedic Results: The mean duration of the DRs and 15 1-level ACDFs. Follow-up Association (JOA) score. Normal score surgery was shorter in the isocentric ranged from 1 to 2 (mean 1.5) years. is 29 points. fluoroscopy guidance patients group There were also 6 3-level and 2 2-level Results: Perioperative complications compared with the biplanar fluo- DRs. DR increased segmental motion. occurred in 10 cases (8%). However, roscopy-assisted procedures, 58.6 min In multi-level DR, at each individual device-related complications needed (range 36 - 89 min) versus 69.2 min DR segment, the ROM was maintained additional operation or suffered from (range 44 - 113 min) for single-level and approximated that of physiologic permanent symptom occurred only in cases, respectively. This difference was ROM (as measured at unaffected 3 cases (2.4%). The JOA Score not statistically significant (P - 0.3). segments). Adjacent segment motion improved from 9.7 before operation The mean fluoroscopy exposure time above a fusion was increased signifi- to 28.3 points at 5-year follow-up. was 57.4 sec (range, 20 - 83 sec) for cantly compared to DR. Adjacent Conclusions: A larger cage should the isocentric fluoroscopy assisted segment motion below the treated be used to avoid retropulsion and cases with additional 40 seconds level was also significantly different migration of cages. Exact after treat- fluoroscopy time utilized for the 3-D between fusion and DR. ment with a hard corset is required fluoroscopy “spin”, compared to Conclusions: Cervical DR not only for 3 to 6 months after surgery. Under 266.6 sec (range, 144 - 400 sec) for retains mobility, but is able to do so these conditions, stand-alone PLIF the biplanar fluoroscopy assisted cases. while imparting normal physiologic will achieve good outcome for The difference was statistically signifi- ROM, both at the treated and untreated degenerative lumbar spine disease. cant (P - 0.0001). segments; versus ACDF which imparts Conclusions: The use of intraoperative hypermobility to adjacent segments. fluoro-based CT guidance for the Moreover, multi-level cervical DR is able pedicle cannulation during percuta- to maintain physiologic range of motion neous kyphoplasty potentially increas- at each of the treated segments. es safety and significantly reduces radiation exposure for the patient and surgical staff.

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350. Prevalence of Obesity in 351. An Economic Analysis of 352. Anterior Lumbar Interbody Elective Thoracolumbar Fusions and Lumbar Total Disc Replacement vs. Fusion followed by Percutaneous Relation to Complication Incidence Fusion Pedicle Screw Fixation for the Nimesh Patel, MD, Chicago, IL; Richard D. Guyer, MD, Plano, TX; John Revision Surgery in the Lumbar Bradley Bagan, MD, Chicago, IL; Harel J. Regan, MD, Beverly Hills, CA; Scott Spine Deutsch, MD, Chicago, IL; John K. G. Tromanhauser, MD, Boston, MA; Sang-Ho Lee, MD, PhD, Seoul, Ratliff, MD, Philadelphia, PA; Richard Toselli, MD, Raynham, MA; Republic of Korea; Byeng Uk Kang, Introduction: Many patients under- Introduction: New treatments, partic- MD, Seoul, Republic of Korea; Yong going elective thoracolumbar proce- ularly those that include the use of Ahn, MD, PhD, Seoul, Republic of dures are obese, although prevalence new implants, may lead to increased Korea; Gun Choi, MD, PhD, Seoul, within this community is unclear. costs to both hospitals and payers. Republic of Korea; Young-Geun Choi, Contribution of obesity to complica- The potential costs associated with MD, Seoul, Republic of Korea; Kwang tions in spine surgery is unclear. We lumbar total disc replacement (TDR) Up Ahn, MD, Seoul, Republic of assessed the prevalence of obesity in a were examined and compared to Korea; thoracolumbar fusion cohort and fusion. Introduction: In the past decade, correlate degree of obesity with Methods: An economic model anterior lumbar interbody fusion (ALIF) operative complications. examining hospital and payer cost was a common procedure for various Methods: A retrospective review of all perspectives was developed to pathologic conditions including trau- patients treated by the senior author compare costs of TDR to three spinal ma, deformity correction, infection, was completed. 332 elective thora- fusion procedures: ALIF with ICBG; degenerative disc disease, and revision columbar cases, exempting cases of ALIF with BMP and cages, and instru- of the previous back surgeries. The trauma and tumor, were found. mented IPLIF with ICBG. Parameter aim of this study was to determine Restricting our assessment to fusion estimates for the model were collected the efficacy of ALIF augmented by cases, 97 cases were found; 91 had from the IDE trial of the Charité percutaneous pedicle screw fixation adequate follow-up. Body mass index Artificial Disc, peer-reviewed literature, (PPF) for revision surgery in the was calculated for all patients, follow- clinical expert opinion, and a multi- lumbar spine. ing the equation BMI= weight in year medical claims analysis. Methods: Radiographs and medical kilograms / (height in meters) Results: The estimated cost for the records for 32 patients who under- squared. index hospitalization for each proce- went ALIF with PPF were reviewed Results: Average BMI for the cohort dure is $15,368 for TDR, $17,407 for retrospectively. The preoperative was 29.3. Seventy two percent of ALIF with ICBG, $21,498 for ALIF with diagnosis was instability (n=11), DDD patients were overweight or obese, BMP, and $21,495 for IPLIF. The key (n=9), recurrent disc herniation (n=7), with 41% of patients having a BMI cost drivers for each of the procedures and pseudarthrosis (n=5). The patients greater than 30, and 9% greater than were medical supplies and hospital were 13 men and 19 women with a 40. Overall complication rate was 44 facility costs. Over a two-year time mean age of 59 years (range; 29 ~ complications in 32 patients, yielding horizon the cost to a payer for each 78), the mean follow-up was 25 a rate of 35%. We found 19 significant procedure is estimated at $25,329 for months (range; 13 ~ 46). An average complications in 17 patients (18.7%). TDR, $24,225 for ALIF with ICBG, of 1.5 previous procedures were A standard cohort of complications $29,508 for ALIF with BMP, and performed. The postoperative changes occurred: wound infection (n=3), CSF $32,226 for IPLIF. The key cost driver of back and leg pain were graded by leak (n=8, 1 requiring reoperation), across all procedures from the payer the visual analog scale (VAS), and the DVT (2), cardiac (4), symptomatic perspective is the cost for the index functional outcome was measured by pseudoarthrosis (1), pneumonia (3), hospitalization. Success rate for each Oswestry Disability Index (ODI). prolonged intubation (2), urologic procedure and costs of revision (when Results: The mean VAS for back and issues (10), positioning palsy (2), necessary) were also a contributors to leg pain were decreased from 8.2 and neuropathic pain (2), and other (7). overall cost. 7.9 to 3.5 and 3.1, respectively (P < Concentrating on significant complica- Conclusions: The model demonstrates 0.01). The mean ODI was improved tions, we found correlation between that the overall economic effect of from 83% to 28%. Solid fusion was weight and complication incidence. TDR procedures on hospitals and achieved for 31 of 32 patients. Positioning palsies only occurred in payers is likely to be equivalent or Complications included one case of the extremely obese. less than lumbar fusion procedures. small iliac vein tear, repaired with Conclusions: Obesity is prevalent in intraoperative suturing, and one case elective fusion cases. Extreme obesity of painful pedicle screw instrumenta- may increase perioperative complica- tion requiring removal. tions. Specific care should be taken to Conclusions: Based on these results, limit risk of perioperative positioning the ALIF with PPF is an effective palsies in obese patients. surgical option in the revision of the lumbar spine in selected cases. A prospective controlled study is required to confirm these results.

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 74 POSTER ABSTRACTS

353. Feasibility Study of 354. Incidence of the Piriformis 355. Comparison of Microsurgical Percutaneous Axial Lumbar Fusion: Syndrome in Patients with Sacroiliac Versus Minimally invasive Approaches Interim Results Dysfunction in Bilateral Decompression of Lumbar Luiz Pimenta, MD, PhD, Sao Paolo, Michael A. Amaral, MD, FACS, Atlanta, Spinal Stenosis Brazil; Larry T. Khoo, MD, Los Angeles, GA; Alan B. Lippitt, MD, Atlanta, GA; Maged L. Abu-Assal, MD, Loma Linda, CA; Murat Cosar, MD, Los Angeles, Vickie Sims, PT, Atlanta, GA CA; Samer Ghostine, MD, Loma CA; Roberto Diaz Orduz, MD, Sao Introduction: Sacroiliac dysfunction Linda, CA Paolo, Brazil; Andrew Cragg, MD, Sao accounts for about 15% of low back Introduction: Minimally invasive Paolo, Brazil; Fernando Bellera, MD, pain patients. The pain is usually procedures for decompression of Sao Paolo, Brazil posterior, in the area of the sacroiliac spondylitic spinal stenosis have been Introduction: A clinical pilot study was joint. A subset of patients also presents advocated in order to minimize conducted to presacral percutaneous with sciatica-like pain which, to date, surgical complications, and improve access to the anterior sacrum with has remained unexplained. The piri- outcome. This study compares the insertion of an axially oriented stabi- formis syndrome can be diagnosed results of the Open Microsurgical lization construct for immobilization electrophysiologically by measuring approach (OMS) for bilateral lamino- and fusion of the lumbosacral spine. the H-reflex delay when the leg is tomies and partial facetectomies with Methods: 18 patients needing L5-S1 placed in a flexed-adducted-internally that of Minimally Invasive Surgery fusion resulting from degenerative disc rotated position. (MIS). We hypothesized that since MIS disease were examined and evaluated Methods: A series of patients with requires less surgical manipulation and with radiographic tools, VAS, SF-36 sacroiliac dysfunction diagnosed by retraction of the soft tissues, as well as and Oswetry scores preoperatively. a fluoroscopically controlled sacroiliac better preservation of the spinous Fixation of the lumbosacral junction block were also assessed for piriformis ligaments, it should carry less surgical was performed through a 14 mm syndrome using the H-reflex delay risk than OMS. Patient functional access cannula using an axial presacral method. outcome and satisfaction should be higher with MIS than OMS. approach. Treatment of the patients Results: The presence of piriformis was facilitated by means of insertion syndrome was noted in about one Methods: A retrospective chart review of an axial interbody fusion construct third of patients diagnosed with of 100 surgical cases performed by a for stabilization of the lumbosacral sacroiliac dysfunction (detailed single surgeon was undertaken. 50 junction coupled with osteogenic numbers to be presented). consecutive cases utilizing the OMS material and posterior pedicle screw approach were compared to 50 instrumentation. Conclusions: The piriformis syndrome consecutive MIS. Both types of is frequenltly associated with sacroiliac procedures were performed through Results: There was minimal post- dysfunction, explaining the presence operative pain. There were no cases a unilateral inicion. We compared of sciatica like symptoms in a subset of immediate, 3- month, and greater of bowel, vascular or nerve damage. patients. One postoperative complication was than 1 year outcomes. noted (Septicemia 2-weeks post- Results: Surgical complications and operative due to an infection of the postoperative complications rates were bone graft harvest site. Patient has decreased in the MIS as compared to since recovered). Improvements were the OMS group. Immediate, short- observed in VAS, Oswestry and SF-36 term (3 month) and long-term values. Radiographic analysis concluded (greater than 1 year) outcomes of there is no evidence of implant back- functional capacity and patient satis- out, loosening or damage, bone faction were also better in the MIS resorption, fractures, or sacral abnor- than in the OMS group. Delayed malities. To date the patients clinical spinal instability was not encountered progress is acceptable and no addi- during the study period. tional intervention has been required. Conclusions: This study answers our Four patients have passed the 12- hypothesis affirmatively. Decreasing month data point. CT demonstration surgical trauma and limiting decom- of fusion at 12 months has been pression to the regions essential for observed. nerve decompression decrease the Conclusions: The clinical data to incidence of immediate and delayed date indicate that the subjects being complications. Postoperative recovery treated with the study device and is faster and functional capacity procedure have on average improved improved. While MIS is technically since their pre-treatment condition more complex than OMS, there is and that the fusion implant can be significantly added benefit to the safely delivered utilizing the presacral patient, well worth the effort. access technique.

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356. Cadaveric Morphometric Study 357. Radiographic Outcome 358. Pain outcome and vertebral of S2 Alar Screws Following Anterior Alone body height restoration in patients Michael Y. Wang, MD, Los Angeles, Stabilization for Thoracolumbar undergoing kyphoplasty. CA; Michael Groff, MD, Indianapolis, Burst Fractures Carlos H. Feltes, MD, Macon, GA; IN; Anthony Kim, MD, Los Angeles, CA Michael P. Steinmetz, MD, Madison, Kostas N. Fountas, MD, PhD, Macon, Introduction: Robust posterior fixation WI; Gregory Trost, MD, Madison, WI; GA; Theofilos G. Machinis, MD, to the sacrum can be a challenging Daniel Resnick, MD, Madison, WI Macon, GA; Vassilios G. Dimopoulos, task. In the presence of osteoporotic Introduction: The surgical manage- MD, Macon, GA; Mozaffar A. Kassam, bone, long segment fusions, and high- ment of thoracolumbar burst fractures MD, Macon, GA; Kim W. Johnston, grade spondylolistheses, standard S1 may be via an anterior, posterior, or a MD, FACS, Macon, GA; Joe S. pedicle screws may be predisposed to combined approach. The fear of doing Robinson, MD, FACS, Macon, GA failure. However, the routine applica- an anterior alone stabilization is con- Introduction: Osteoporotic vertebral tion of iliac fixation carries excessive tinued progression of deformity with compression fractures (VCFs) are a morbidity. S2 alar screws give the the possibility of chronic pain and/or significant cause of disability for the spinal surgeon an intermediate option neurologic deficit. elderly. In the last few years, kypho- for supplementing sacral fixation Methods: We reviewed our last 11 plasty, a minimally invasive technique, without the need to fuse across the cases of anterior alone stabilization of has been developed in order to sacroiliac joint. thoracolumbar burst fractures to provide immediate pain relief and Methods: This cadaveric study determine the stability of the construct return patients to premorbid level of was undertaken using 80 adult non- over time. A minimum follow-up of activity. diseased human sacral specimens. 6 months was required. The pre- Methods: We retrospectively reviewed Cadaveric linear measurements were operative, postoperative, and latest 24 patients (16 female, 8 male) treated performed directly on the specimens follow-up radiographs were reviewed with balloon kyphoplasty for osteo- using electronic calipers to ascertain for sagittal alignment (one level above porotic VCFs. The average age of the morphometric data most useful for and below), fusion status, and hard- patients was 72.6 years (range 48-87 optimal screw placement starting ware failure. The patients neurologic years). A total of 37 vertebral levels superior to the S2 foramen and directed status, comorbidities, and smoking (25 thoracic and 12 lumbar) were superiorly and laterally towards the status were also recorded. intervened upon. Kyphoplasty was sacroiliac joint. Results: All patients underwent anterior performed in all cases within 9 weeks Results: The mean sagittal distance alone decompression and stabilization from the onset of pain. VAS scores between the S1 and S2 foramina was of L1, L2 or T12 burst fractures with were documented in the immediate 14.7 + 2.7 mm; the mean sagittal allograft femur and anterolateral plate pre- and post-operative period, as distance between the sacral ala and stabilization. Seven were at L1, three well as 4, 12, and 72 weeks after the the S2 foramina was 28.8 + 4.4 mm. at L2, and one at T12, all but two procedure. Vertebral body height The average lateral offset between the were neurologically intact before restoration was assessed on post- midline and the medial S2 pedicle wall surgery. The average preop sag angle operative x-rays. was 14.2 + 1.4 mm. The shortest bi- was 18º (sd 7.1, range 9-30º). Results: Mean pre-operative VAS score cortical screw trajectory (parallel to Postoperatively the sag angle averaged was 9.3 and improved to 5.4 in the the S2 pedicle) was 25.2 + 2.5 mm, 14º (sd 4.1, range 5-19) and 14º (sd immediate post-operative period. while the longest and idealized screw 4.9, range 6-22º) at latest follow-up. At 4, 12 and 72 week post-operative, trajectory was 43.3 + 3.9 mm. All patients demonstrated evidence of mean VAS scores were 5.1, 5.9, and Conclusions: The placement of fusion. Ten were neurologically intact, 6.1 respectively. All patients were S2 screws is highly dependent on with one demonstrating neurologic discharged from the hospital within intraoperative landmarks, with improvement. 24 hours and were able to return to intraoperative radiographs being of Conclusions: Anterior alone decom- their daily activities. However, no limited use. Furthermore, determining pression and stabilization is an significant restoration of vertebral screw trajectories and lengths based established treatment for unstable body height was observed. No severe on preoperative imaging can be thoracolumbar burst fractures. Some complications were associated with difficult on two-dimensional images. fear progression of deformity without the procedure. This data may assist surgeons in the a concominant dorsal fixation, espe- Conclusions: Kyphoplasty is a safe and safe placement of alar screws with the cially in the face of posterior column effective treatment modality for osteo- maximal bony purchase. injury. Our data indicate, that an porotic VCFs when undertaken early anterior alone strategy is effective after the onset of pain, even when no at correcting kyphois and more significant restoration of vertebral importantly maintaining the correction body height is achieved. in long term follow-up.

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 76 POSTER ABSTRACTS

359. Prevertebral Soft Tissue 360. Instrumented Posterior Lumbar 361. Three-Dimensional Thickness Safety Guidelines for Interbody Fusion with Mineralized Fluoro-Based CT Guidance for Discharge After Anterior Cervical Collagen Matrix and Bone Marrow Complex Spinal Surgery Discectomy Aspirate as a Bone Graft Substitute Alan T. Villavicencio, MD, Boulder, CO; Will F. Beringer, DO, Normal, IL; Lawrence M. Spetka, MD, Toledo, OH; Sigita Burneikiene, MD, Boulder, CO; Keith Kattner, DO, Bloomington, IL; Ethel Parker, BS, Toledo, OH Ketan R. Bulsara, MD, Columbia, MO; Ann Stroink, MD, Bloomington, IL Introduction: The use of iliac crest Jeffrey J. Thramann, MD, Boulder, CO Introduction: Shorter postoperative bone graft for lumbar interbody fusion Introduction: The purpose of this hospitalization for anterior cervical can lead to significant postoperative study was to prospectively evaluate discectomy (ACD) requires the early donor site pain and morbidity. A the clinical utility and accuracy of identification of postoperative commercially available Type I bovine intraoperative 3-D fluoro-based CT complications for safe discharge. collagen fibrous matrix is combined as an adjunct for the placement of a Methods: In this retrospective chart with bone marrow aspirate to create complex spinal instrumentation. and X-ray review, the postoperative an osteogenic and osteoconductive Methods: The Iso-C 3-D fluoroscopy day 1 (POD 1) prevertebral soft tissue bone graft substitute. unit (Siemens, Malvern, PA) and the thickness (PVSTT) anterior to the third Methods: A retrospective review was Stealth Treon computer volumetric cervical vertebral body (C-3) on lateral performed of 86 consecutive patients navigational system were used. A total cervical spine X-ray was scrutinized to having had one- or two-level lumbar of 322 spinal instrumentation screws find signs of increased retropharyngeal fusion. Three were lost to follow-up or transpedicular cannulations were edema and airway stenosis in ACD leaving 83 for review. There were 38 performed in 82 patients. Accuracy, patients being prepared for discharge smokers, 11 diabetics, and 64 patients operative time and the amount of on POD 1 or POD 2. Comparisons admitting to regular alcohol use. fluoroscopy utilization time were of POD 1 PVSTT between patients Forty-three (43) were working prior to assessed for TLIF and kyphoplasty cases. discharged on the planned discharge surgery, and 14 were on worker’s Results: Only 4 percutaneous day and those with prolonged compensation. All patients had PLIF transpedicular lumbar screws out of hospitalizations were made. with transpedicular fixation. No iliac 265 total (1.5 %) were malpositioned. Results: Six of the ninety ACD patients crest bone graft was used, but local Average operative time for TLIF cases reviewed had signs of increased PVSTT bone and PRP were added in some was 185 minutes (range, 114 to 311 and airway anterior-posterior diameter cases. No graft was placed in the minutes) for one-level and 292.6 less than 5 millimeters. Four of these lateral gutters. There were 68 one- minutes (range, 173 to 390 minutes) six patients had symptomatic level and 15 two-level fusions. Clinical for two-level procedures. Biplanar retropharyngeal edema requiring outcome was measured with a Visual fluoroscopy utilization time was 93 prolonged hospitalization. On Analog Scale. Plain 4-view lumbar radi- seconds (range, 27 to 280 seconds) average, these six patients had a ographs and CT scans (in 72 patients) for one-level procedures and 216 1.1 day longer length of stay (p less were performed and evaluated using a seconds (range, 80 to 388 seconds) than .001). Six other ACD patients had modified Lenke scale. for two-level procedures. Average increased length of stay for various rea- Results: Mean follow-up was 12 surgery duration for kyphoplasty sons. The mean POD 1 PVSTT among months with a range of 10-21 months. was 58.6 minutes (range, 36 to 89 all ACD patients with increased length Pain decreased 72.7% at latest minutes) for one-level procedures of stay was 11.0 millimeters while the follow-up compared to baseline. and 68.5 minutes (range, 65 to 75 mean for patients with normal dis- Postoperatively, 54 patients were minutes) for two-level cases. Biplanar charge date was 8.1 millimeters (p working and 4 were on worker’s fluoroscopy utilization time was 57.4 equals .027). compensation. Radiographically, seconds per case (range, 20 to 83 Conclusions: ACD patients with 76 (91.6%) patients were rated as seconds). POD 1 PVSTT anterior to C-3 greater “definitely solid” and 6 (7.2%) were Conclusions: Use of intraoperative than 10 millimeters on lateral cervical rated as “possibly solid” There were 3-D fluoroscopy for image guidance spine X-ray should be assessed for no graft-related complications. in minimally invasive complex spinal symptomatic airway stenosis prior to Conclusions: The combination of instrumentation procedures is feasible discharge. ACD patients with pro- mineralized collagen and bone and safe. This technique provides longed postoperative hospitalization marrow aspirate may be a viable bone excellent visualization of three- have increased PVSTT anterior to C-3 graft substitute in an interbody fusion dimensional relationships. This poten- on POD 1 lateral cervical spine X-rays. model. Further follow-up to 2 years is tially results in improved accuracy of warranted. screw positioning and the ability to detect misplaced screws prior to wound closure. This technique also potentially results in a significant reduction in radiation exposure for patients and staff.

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362. Predictive Factors for 363. Percutaneous Ventral 364. Initial Clinical Outcomes of Subsequent Vertebral Fracture Decompression for Degenerative a Minimally Invasive Lumbar After Percutaneous Vertebroplasty Lumbar Spondylolisthesis in Medically Interbody Fusion (MiLIF) Multi-Center Study Yong Ahn, MD, PhD, Seoul, Republic Compromised Geriatric Patients of Korea; Sang-Ho Lee, MD, PhD, Ho Yeon Lee, MD, PhD, Seoul, Richard E. Manos, MD, San Diego, CA; Seoul, Republic of Korea; Sang-Hyun Republic of Korea; Sang-Ho Lee, MD, Mitchell Hardenbrook, MD, Keem, MD, Seoul, Republic of Korea; PhD, Seoul, Republic of Korea; Yong Portsmouth, VA; Michael Liu, MD, Chan Shik Shim, MD, PhD, Seoul, Ahn, MD, PhD, Seoul, Republic of Salem, OR; William Sukovich, MD, Republic of Korea Korea; Dong-Yun Kim, MD, Seoul, Portsmouth, VA; Thomas Sweeney, MD, Sarasota, FL; Todd Kuether, MD, Introduction: The purpose of this Republic of Korea; Won-Chul Choi, Portland, OR study was to evaluate the predictive MD, Seoul, Republic of Korea factors for subsequent vertebral Introduction: The purpose of this Introduction: Transforaminal lumbar fracture after percutaneous vertebro- study is to present the surgical interbody fusion (TLIF) requires plasty (PVP) at the neighboring levels technique of percutaneous ventral extensive exposure and prolonged (adjacent vs. non-adjacent levels). decompression for degenerative retraction times resulting in ischemia lumbar spondylolisthesis (DLS) and and denervation of paraspinal muscu- Methods: The medical records of 508 lature. Minimally invasive lumbar consecutive patients treated with PVP, the clinical outcomes in medically compromised geriatric patients. interbody fusion (MiLIF) affords the between Jan 2000 and Dec 2002, advantages of TLIF while minimizing were retrospectively reviewed. A total Methods: Between November 2001 muscle/soft tissue dissection. of 43 patients with 49 painful subse- and February 2004, 11 consecutive quent vertebral fractures after PVP patients underwent percutaneous Methods: Patients with degenerative were identified on the basis of clinical ventral decompression without violation disc disease or spondylolisthesis were and radiological findings. New verte- of the posterior bony structure was enrolled prospectively in a multi- center study. MiLIF was performed bral fractures, occurring at any of the performed under local anesthesia. We through two one-inch paraspinal 3 consecutive vertebral bodies from decompressed the ventral portion of incisions with placement of structural the previously treated level, were thecal sac through posterolateral allograft or synthetic interbody fusion included in the study. Study groups approach using endoscopic tools. All device and local or iliac crest bone were divided into 3 groups; adjacent patients had significant limitation in graft and pedicle screws. Oswestry fracture group, non-adjacent fracture ambulatory ability because of buttock Disability Index (ODI), SF-36, Numeric group and control group composed pain, leg, and back pain. Rating Scale (pain), and Modified of 50 randomly selected patients with Results: The mean follow-up period Prolo Scale were measured. no evidence of a new fracture. The was 25.1 (range, 11-38) months. clinical factors, radiological factors Results: Forty-three patients (25 male, There were 11 patients suffered from 18 female), average age 43 years and intervention-related factors were diabetes (n=4), cardiac disease (n=5) statistically analyzed. (22-75) underwent single level MiLIF. cerebrovascular accident (n=2) or Mean blood loss was 187.1 cc, mean Results: Of the 49 new vertebral frac- malignancy (n=2). Among them operative time was 231 minutes, and tures, 35 (71.4%) were developed at two patients had both diseases mean length of hospitalization was the adjacent level. The mean time to simultaneously, and the levels of two 2.7 days. There were no intra- subsequent fracture was 7.9 months. malignancies were same on the treated operative complications or blood For the adjacent fracture, intradiscal levels. The affected levels were L3-4 in transfusions. Mean percent ODI cement leakage (P < 0.01) and low two, and L4-5 in nine patients. The decreased significantly from 45.5 body mass index (P < 0.05) were mean age of the patients was 67±9.1 pre-operatively to 35, 27.4, 22.3, the significant predictive factors. (range, 51 to 85) years. The mean and 21 at 6 weeks, 3, 6, and 12 In contrast, segmental mobility operation time was 72±16.9 (range, months respectively. Average pain (difference in range of motion) was 50 to 100) minutes. The mean score score of 6.0 improved to 4.5 at 2 related to the non-adjacent fracture of ODI improved from 72.2% pre- weeks post-op (p-value less than (P < 0.05). operatively to 27.4% at the final 0.0009). SF-36 summary scores Conclusions: According to our follow-up. All patients could walk significantly improved by 6 months. results, the mechanisms of subsequent without any difficulty after surgery. Average return to work was 39.6 days. fracture at adjacent and non-adjacent There was one complication that was Based on Modified Prolo Scale, 100 vertebrae are quite different. A direct quadriceps weakness in one patient percent had successful return to pillar effect (difference in strength but it was transient. There were no work/activity at 3 months. caused by cement augmentation) may postoperative complications and no Conclusions: MiLIF is a safe and provoke the adjacent fracture, whereas progression of spondylolisthesis during effective treatment for degenerative a dynamic hammer effect (difference the follow-up period. disc disease and spondylolisthesis in segmental mobility) may be related Conclusions: Percutaneous ventral and compares favorably to published to the non-adjacent fracture. decompression is a safe and effective retrospective open TLIF case series. minimally invasive alternative method of Prospective studies directly comparing treating DLS in medically compromised open versus minimally invasive fusion geriatric patients, especially when gen- are required to validate benefits of eral anesthesia is not recommended. minimally invasive techniques.

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 78 POSTER ABSTRACTS

365. One Year Follow-up on the 366. Management of Deep Spine 367. Lumbar Total Disc Replacement First 40 Patients Using Cortoss for Infections with Vacuum-Assisted from a Direct Lateral Approach Treating Vertebral Compression Closure; a Retrospective Study of Luiz Pimenta, MD, PhD, Sao Paulo, Fractures in Vertebroplasty and 15 Patients Brazil; Roberto Diaz, MD, Sao Paulo, Kyphoplasty John B. Butler, MD, Cleveland, OH; Brazil Hyun Bae, MD, Santa Monica, CA; Alex Jones, MD, New Orleans, LA; Introduction: Most lumbar TDR Philip Maurer, MD, Philadelphia, PA; Richard Schlenk, MD, Cleveland, OH; devices require an anterior abdominal William Beutler, MD, Harrisburg, PA; Isador Lieberman, MD, Cleveland, OH; approach, which can be technically Walter Peppelman, DO, Harrisburg, PA; Edward C. Benzel, MD, Cleveland, OH demanding at L4-5 because of the Raymond Linovitz, MD, Encinitas, CA; Introduction: Deep infections of the need for mobilization of the great Erik Westerlund, MD, Encinitas, CA; spine are a significant cause of mor- vessels. Limited anterior access can Timothy Peppers, MD, Encinitas, CA; bidity and mortality. Deep tissue result in less than ideal device Isador Lieberman, MD, Cleveland, OH; infections complicate anywhere from placement and resulting functional Choll Kim, MD, PhD, San Diego, CA; 0.7-11.9% of spinal surgeries. limitations or complications. TDR Federico Girardi, MD, New York, NY Management of spine infections placement from an anterior approach Introduction: 40 patients were includes non-surgical management also requires removal of the anterior enrolled in 2 FDA approved pilot IDE with IV antibiotics, irrigation and longitudinal ligament, which can studies using Cortoss for the treatment debridement with primary closure, result in hyperextension and possible of VCFs using vertebroplasty tech- drains, inflow/outflow irrigation sys- dislodgement of the device. Lateral nique at 3 centers (20 patients) and tems, or open- healing through sec- placement of a TDR device may allow kyphoplasty technique at 5 centers ondary intention with wound packing for easier access to the disc space and (20 patients). Treatment was limited and dressing changes. Vacuum assist- preservation of stabilizing ligamentous to one or 2 levels from T6 to L5. ed closure (VAC) is a new alternative structures. Methods: 8 males and 12 females in treating this problem. We present Methods: A lateral TDR device (mean age 72) were treated using the a retrospective review of 15 patients (NuVasive, Inc., San Diego, CA) was Vertebroplasty technique. 26 vertebrae presenting with complex spine infec- implanted at an L4-5 level via an XLIF were treated averaging 1.9cc injected tions treated with I&D and placement approach through a 2-inch lateral per vertebra. 6 males and 14 females of VAC dressings. incision using a MaXcess retractor and (mean age 79) were treated using the Methods: We reviewed the charts of EMG guidance (NuVasive). The device Kyphoplasty technique. 25 vertebrae 15 patients dating back to 2003 who has a large footprint and is positioned were treated averaging 4.1cc injected presented with deep infections of the over the bilateral periphery of the ring per vertebra. spine and who were treated with apophysis, with the axis of motion Results: Vertebroplasty patients VAS placement of VAC dressings. We positioned posteriorly. improved from 74.1 pre-op to 24.1 at reviewed operative notes, discharge Results: Implantation of the lateral 3 months, 28 at 6 months and 32 at summaries, and follow-up visits. We TDR device took approximately 50 12 months. Similarly, ODI decreased assessed outcome based on review of minutes, with minimal blood loss and from 52% pre-op to 30% at 3 months follow-up visits. no complications. Immediate post-op and 23% at 12 months. Kyphoplasty Results: Management of deep wound x-rays showed good placement of the patients VAS improved from 78 pre-op infections with VAC placement result- device, and restoration of disc height, to 22 at 3 months and 20 at 6 ed in good wound closure in 13 out foraminal volume, and sagittal bal- months. Similarly, ODI decreased of 15 patients. 1 patient has had the ance. The patient was up and walking from 60% pre-op to 33% at 3 months VAC removed but has an open wound the same day of surgery and dis- and 35% at 6 months. Leakages were with healthy granulation tissue and no charged the next day, with complete analyzed on post-op CT scans and signs of infection. 1 patient, a resolution of symptoms. found to be similar in both groups. Jehovah’s Witness, died as a result of Conclusions: A lateral TDR device can All extravasations were asymptomatic intra-op blood loss 2 days following be successfully implanted using an with no cardiac irregularities or placement of the VAC dressing. 1 XLIF approach. This approach appears pulmonary emboli. patient did experience a bleeding to be safer and less disruptive than Conclusions: The results obtained in complication related to the continuous an anterior placement approach. these 2 pilot IDE studies are consistent negative pressure of the VAC. Preliminary review of motion and with those of the European prospective Conclusion: We have had consistently symptom relief is positive. A larger study which indicate that Cortoss is good results obtaining wound patient series with longer-term safe and effective in the treatment of debridement and closure in patients evaluation is forthcoming. osteoporotic VCF. These studies suggest with complex and deep spine infec- a smaller volume of Cortoss appears tions. We believe VAC offers a good to successfully reinforce the vertebrae alternative in the management of and achieve symptomatic relief, as these infections. compared to volumes reported in the literature for PMMA.

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368. Subjective and Objective 369. Management of Atlantoaxial anterior decompression with resection Variability in Assessing Lumbar Degenerative Pannus of the Elderly of pannus followed by posterior C1-C2 Spinal Stenosis on Magnetic with Tranoral Odontoidectomy and stabilization. A large percentage of Resonance Imaging Posterior C1-C2 Fusion patients with myelopathy will have Sami I. Aleissa, MD, Calgary, AB, Michael A. Finn, MD, Salt Lake City, neurological improvement after Canada; A. Alarjani, Calgary, AB, UT; Ronald I. Apfelbaum, MD, Salt surgical intervention. Canada; R. Hu, Calgary, AB, Canada; Lake City, UT; Daniel R. Fassett, MD, Steve Casha, Calgary, AB, Canada Salt Lake City, UT

Introduction: Magnetic resonance Introduction: Degenerative pannus 370. A New Approach for image (MRI) is a frequent investigation of the eldery (atlantodental synovial Kyphoplasty and/or Vertebroplasty used in assessing lumbar spinal steno- cyst degeneration) can occur at the of Sacral Insufficiency Fractures sis. The availability of digital imaging atlantodental articulation to cause tools may allow for more objective myelopathy or cervical pain condi- Donald P. Atkins, MD, FACS, San reporting of these investigations. tions. In the setting of myelopathy, Antonio, TX; James Dix, MD, San Antonio, TX Methods: Seven spine surgeons these lesions often require anterior were asked to generate a subjective transoral decompression followed by Introduction: Thoracolumbar kypho- (normal, mild, moderate, severe posterior C1-C2 arthrodesis. plasty and vertebroplasty is a safe, impression) and objective (canal Methods: A retrospective chart review reproducible technique now widely cross-sectional area) score at L34, was performed on all patients receiving utilized for the treatment of osteo- L45 and L5S1 for six lumbar spine transoral odontoidectomy and posterior porotic compression fractures and MRIs. Each score was generated twice C1-C2 fusion to identify patients treat- osseous tumors of the spine. Its role by each observer at different sittings. ed for (non-rheumatoid) degenerative for the treatment of sacral lesions and Spearman or Pearson correlation pannus at the antlantoaxial joint. sacral insufficiency fractures is less well coefficients were determined to Patient age, sex, clinical presentation, defined. The authors describe a novel compare inter- and intra-observer operation performed, pathology find- approach to the treatment of sacral variability as well as the correlation ings, fusion status, clinical outcome, insufficiency fractures. between the two scores. and complications were retrospectively Methods: Seven patients underwent Results: The intra-observer correlation evaluated. vertebroplasty and/or kyphoplasty coefficient for the subjective score was Results: Nine patients (5 male and 4 with a new, to our knowledge, previ- 0.785 and 0.936 for the objective female; mean age 75.4, range 49-89) ously unreported technique. Sacral score. The mean inter-observer corre- with degenerative panni were treated insuffiency fractures generally occur lation for the subjective score was with transoral decompression. Seven through the sacral ala, rather than the 0.759 and 0.895 for the objective of nine patients presented with S1 pedicle, and can result in subluxa- score. The overall correlation between myelopathy, one presented with tion and angulation of the S1 or S2 the subjective and objective methods cervicalgia, and one presented with segment into the pelvic inlet. A stan- was 0.506. However, this was not uni- dysphagia. All patients were treated dard approach through the S1 pedi- form at all levels (0.524 at L34, 0.834 with transoral odontoidectomy and cle, therefore, fails to fill the majority at L45 and 0.328 at L5S1). The median resection of pannus followed by a of the fracture line. The authors took a subjective scores at these levels were C1-2 posterior fusion procedure. caudal approach with an entry site at mild, moderate and normal respectively Pathology was sent on all nine patients the S3 segment in a medial to lateral while the mean objective scores were confirming the diagnosis of non- trajectory through the fracture line 131.7, 99.4, and 170.5 mm2. rheumatoid degenerative synovial cyst. ending at the rostal cortical margin of Conclusions: Objective measurements A majority of patients had significant the sacral wing. Kyphoplasty of the of canal diameter on MR images of improvement in neurological function fracture line was performed in some the lumbar spine improved both intra- following surgery. Of the patients with patients. Filling with PMMA then was and inter-observer variability over adequate long-term follow-up, all accomplished from a cephalic to rostral often used subjective assessments. demonstrated radiographic fusion of course as the cannula was withdrawn. The correlation between the subjective the C1-C2 posterior arthrodesis. Results: The procedures were all con- and objective scores was poor, Complications were limited to two sidered technically successful without particularly in the presence of mild post-operative wound infections with major complication. Early clinical disease. This suggests that while one requiring debridement. results were promising. canal diameter is considered during Conclusions: Degenerative atlantoaxi- Conclusions: This new technique radiological assessment of spinal al pannus due to synovial cyst forma- directly addresses the pathologic stenosis, other variables greatly tion occurs most commonly in elderly fracture line bridging the gap from influence the spine surgeon’s patients and most frequently presents the sacral foramina to the sacraliliac conclusions. with myelopathy. In the setting of sig- joint. Our initial clinical results indicate nificant anterior spinal cord compres- that this is the preferred approach and sion, this condition is best treated with may offer relief to this population of patients.

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371. Asymetric Pedicle Subtraction deformities are usually well treated Conclusions: Anterior rods offer little Osteotomy with Partial with a single-stage PSO. We believe in the way of additional stability when Vertebrectomy for Correction of that our modification of the PSO pro- added to a construct of anterior cage Fixed Combined Coronal and cedure involves extensive asymmetric and posterior short segment pedicle Sagittal Imbalance: A New Twist partial vertebral body resection and screw constructs. on an Old Technique closing wedge osteotomy as a one- J. Patrick Johnson, MD, Los Angeles, stage posterior procedure is effective CA; Hooman Melamed, MD, Los in achieving simultaneous correction Angeles, CA; Leonel A. Hunt, MD, Los in both planes. 373. 360º Lumbar Fusion with Angeles, CA; Robert S. Pashman, MD, Minimally Invasive Surgical Los Angeles, CA; Neel Anand, MD, Technique: Results in 100 Cases Los Angeles, CA; W. Putnam Wolcott, Peter H. Hollis, MD, Great Neck, NY; MD, Los Angeles, CA 372. Anterior Rod Placement in Chris M. Overby, MD, Great Neck, NY; Thoracolumbar Corpectomy: Mark Eisenberg, MD, Great Neck, NY Introduction: Fixed coronal plane A Biomechanical Study deformity typically requires a 2-stage Introduction: Simultaneous stabiliza- anterior release and/or vertebral Michael W. Groff, MD, Indianapolis, IN; tion of both the anterior column and resection and posterior release with James Z. Mason, MD, Little Rock, AR; the posterior elements yields the high- instrumented fusion to correct these Scott H. Purvines, MD, St. Louis, MO; est rate of fusion in the lumbar spine. challenging problems. We present a Robert B. Sloan, MD, Indianapolis, IN; This may be done with a combination variation of the pedicle subtraction Kevin O’Neill, Indianapolis, IN of anterior lumbar interbody fusion osteotomy procedure (PSO) as a Introduction: Thoracolumbar verte- (ALIF) and posterior segmental fixation one-stage posterior procedure for the brectomy is a common treatment with (PSF), however, this involves two treatment of fixed coronal and sagittal traumatic and oncologic indications. separate surgical approaches. Another imbalance. Anterior reconstruction with a struct method allows for a single surgical Methods: We treated two patients graft and posterior placement of approach by combining posterior inter- who had multiple previous spine pedicle screws is a common treatment body fusion (PLIF) and PSF. This latter surgeries for idiopathic scoliosis. They strategy. It has been suggested that a method has been criticized for exces- presented with inability to stand erect single rod anteriorly augments stability, sive muscle dissection and neural with fatigue-related pain. Full length particularly in torson, although this retraction. Posterior lumbar decom- standing PA, lateral, and bending has not been formally explored. pression and PLIF are now readily scoliosis x-rays were obtained. Methods: Fourteen fresh frozen performed without significant Patient#1 had pre-operative curves cadavers were divided into two groups paraspinal muscle dissection through measuring 33 and 53 degrees with with similar ages and bone minearal tubular retractors via one inch 6cm of right coronal imbalance and densities (BMD). Both groups under- paraspinal incisions. PSF can be 5cm of anterior sagittal imbalance. went a standard anterolateral achieved in an essentially percutaneous Patient#2 had curves measuring 43 vertebrectomy of T12 with preserva- manner via the same incision. By com- and 59 degrees with 6.5cm of right tion of the contralateral cortex. bining these latter two techniques one coronal imbalance and 7.5cm of Reconstruction was performed with might achieve 360 degree lumbar anterior sagittal imbalance. Imaging a titanium cage and posteriorly placed fusion via two small paraspinal incisions studies revealed signs of solid fusion. pedicle screws from T11 to L1. In one with all the benefits of minimally inva- Both patients underwent single-stage group screws were placed bicortically sive surgery. Minimally invasive spine posterior lumbar asymmetric PSO accross the bodies of T11 and L1 surgery results in less blood loss, shorter with extensive transpedicular partial and connected with a single rod. hospital stay, less postoperative pain, vertebral resection. Correction was Specimens were potted at T10 and L2. and eventually shorter operative time. maintained and stabilized with pedicle Force displacement curves were gener- This study analyzes the clinical and screw fixation. ated with an MTS piston and exten- radiographic results in 100 cases of 360 siometers to measure displacement. degree lumbar fusion done with mini- Results: Patients had correction of mally invasive surgical techniques. their coronal and sagittal imbalance. Results: The anterior rod afforded Patient#1 had imbalance corrected to increased stability with respect to all Methods: Cases were analyzed retro- within 0.9 and 1.6cm respectively, and movements examined, namely flexion, spectively. Clinical outcome was meas- patient#2 corrected to within 0.7cm rotation, and lateral bending. None of ured using a modified Prolo scale and and 1.0cm, respectively. Average the differences, however, were statisti- fusion rate by plain x-ray or CT scan. blood loss was 2600cc. Average cally significant. In an analysis of Results: Good to excellent clinical surgical time was 558 minutes. covariance it was found that BMD was results were seen in 80% and radi- Conclusions: Fixed combined defor- much more closely associated with ographic fusion was noted in all patients mity presents unique challenges that stifness than construct design in the within 6-12 months. There were no are distinctly different from pure sagittal motions of torsion (p=0.0006) and neurologic complications or wound plane deformities. Fixed sagittal plane flexion (p=0.0525). infections and no construct or align- ment changes.

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Conclusions: Circumferential lumbar 375. Value of the Maximum Canal 376. Percutaneous Endoscopic fusion with PLIF/PSF can be achieved Compromise and Spinal Cord Cervical Discectomy with WSH safely and effectively with minimally Compression for Evaluation of Working Channel Scope for invasive surgery. Neurological Status and Prediction of Noncontained Cervical Disc Neurological Outcome After Acute Herniation: Minimum 2 Years Traumatic Spinal Cord Injury Follow-up 374. Comparison of FluoroNav and ISO-C 3-D Image-Guidance Julio C. Furlan, MD, PhD, MBA, Toronto, Sang-Ho Lee, MD, PhD, Seoul, Navigation for Thoracic Pedicle ON, Canada; Michael G. Fehlings, MD, Republic of Korea; Won-Chul Choi, Screw Placement FRCS(C), Toronto, ON, Canada MD, Seoul, Republic of Korea; Seungcheol Lee, MD, Seoul, Republic Graham C. Hall, Indianapolis, IN; Dean Introduction: This study examines the value of maximum canal comprise of Korea; Ho Yeon Lee, MD, PhD, G. Karahalios, MD, Chicago, IL; Eric A. Seoul, Republic of Korea; Yong Ahn, Potts, MD, Indianapolis, IN (MCC) and maximum spinal cord compression (MSCC) for assessing MD, PhD, Seoul, Republic of Korea; Introduction: Pedicle screws are neurological status and predicting of Bhanot Arun, MD, Seoul, Republic of typically the best means to stabilize neurological outcomes in individuals Korea the thoracic spine, however, their with acute spinal cord injury (SCI). Introduction: The conventional percu- placement can be challenging due to Methods: All consecutive individuals taneous endoscopic cervical discectomy the variable size, shape, and location (PECD) technique has the risk of spinal of the pedicles in this region. Image- with acute spine trauma who under- went MRI and CT scan at admission cord injury because of the relatively guided techniques for facilitating screw blind approach and straight-firing placement have been described, from 1998-2000 were included. Using ASIA score/grade, neurological status laser and the difficulty of removal of however, their accuracy and safety, remnants. The aim of this study is to especially in the thoracic region, have was assessed at admission and after discharge from outpatient clinic. Data present the surgical technique and been questioned. A retrospective series clinical outcome of PECD using a of screws placed safely with 2-D were analyzed using ANOVA and linear regression. working channel scope (WSH FluoroNav and the newer 3-D ISO-C endoscopy set, Storz, Germany) and technology is presented. Results: There were 22 individuals (6F, a side-firing laser for noncontained Methods: 37 patients had 277 thoracic 16M; ages 17-82 years; mean of 53) cervical disc herniation. pedicle screws placed. 183 (25 patients) who were surgically (50%) or conserva- tively treated. Most individuals had Methods: Between March 2002 and were placed with FluoroNav (Medtronic, September 2003, 136 patients under- Memphis, TN), and 94 (12 patients) ASIA C (n=7), D (n=8) or E (n=4), but 3 individuals had complete motor went PECD using a WSH endoscopy were placed with ISO-C 3-D (Siemens, set. Under the conscious sedation, the Malvern, PA) linked to StealthStation impairment (ASIA A1, B2) at admission. Significant correlation with baseline patient was placed in supine position (Medtronic, Memphis, TN). All patients with neck extension. After the tract was underwent post-operative CT scanning. ASIA scores was observed for the CT- MCC (p=0.044), MRI-MCC (p=0.004), dilated using a serial dilators, and the Scans were used to measure pedicle working channel scope was inserted diameter, and to quantify screw perfo- and MRI-MSCC (p=0.021). Individuals with more severe SCI had larger MRI- into disc space. Under the direct visuali- rations when present. Perforations were zation, ruptured disc fragment was described qualitatively (location), MCC (p=0.01) and there was a trend for a similar association with MRI- removed by a microforceps and vapor- and quantitatively using previously ized by a side-firing Ho:YAG laser published grading criteria. MSCC (p=0.064). There were no significant differences for CT-MCC through the working channel. Results: Screws placed with FluoroNav measurements among individuals with Results: The mean follow-up period had an unintended perforation rate different ASIA grades (p=0.392). After a was 33.3 (range, 24-42) months. of 8.7%, and a mean grade of 1.75. mean followup of 10.2 months, 10 of There were 52 males (38.2%) and Screws placed with ISO-C had a perfo- 18 individuals showed improving ASIA 84 females with a mean age of 46.1 ration rate of 5.3%, and a mean grade grade and two subjects had improving (range 24-69) years. According to of 1.40. There were no neurovascular neurological functions with no change the Macnab criteria, excellent was complications, and no revisions were in ASIA grade. Neurological outcome obtained in 73 patients (53.7%), good deemed necessary. was correlated with MRI-MCC in 46 (33.8%), fair in 5 (3.7%), and Conclusions: The rate and degree of (p=0.003) and MRI-MSCC (p=0.011), poor in 12 (8.8%). During the follow- perforation were slightly lower in the but not CT-MCC measurement up period, 12 (8.8%) patients required ISO-C group. For both groups, the (p=0.848). conversion to open surgery. perforations encountered were not Conclusions: Although all three Conclusions: PECD using a WSH clinically significant, and lower than radiologic parameters were correlated working channel scope provided a many rates of perforation previously with ASIA score at admission, only MRI- safer and effective alternative for the published for both image-guided and MCC and MRI-MSCC demonstrated treatment of noncontained cervical non-image-guided techniques. Thus, larger measurements associated with disc herniation. The WSH working both techniques were found to be use- more severe SCI. Moreover, MRI-MCC channel scope had several advantages, ful adjuncts facilitating the safe place- and MRI-MSCC measurements at such as a high quality of optics, a ment of thoracic pedicle screws. admission are potential predictors for bigger working channel, and a neurological outcomes. side-firing laser.

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377. Class II Cervical Outcomes 378. The Tops Lumbar Facet 379. The Results of Minimal Invasive Thomas B. Ducker, MD, Annapolis, Replacement System. Biomechanical Optimesh Graft Technique for MD; Stephen E. Faust, MD, Annapolis, Evaluation, Operative Data, and Stand-Alone Lumbar Interbody MD; Loretta Brady, RN, Annapolis, MD Preliminary Clinical Results Fusion in Spondylolisthesis Introduction: Prospective cohort Larry T. Khoo, MD, Los Angeles, CA; Larry T. Khoo, MD, Los Angeles, CA; outcomes were measured in our Murat Cosar, MD, Los Angeles, CA; Luiz Murat Cosar, MD, Los Angeles, CA; clinical practice (4 NS and 3 Ortho) of Pimenta, MD, PhD, Sao Paolo, Brazil; Adebukola Onibokun, MD, Los cervical spine operations 2002-2003. Roberto Diaz, MD, Sao Paolo, Brazil Angeles, CA; Sandi Lam, MD, Los 165 patients were divided by opera- Introduction: The purpose of this Angeles, CA tive procedure (7 DRG’s) and had study is to report preliminary surgical Introduction: Optimesh (Spineology, one-year follow-ups. data and clinical outcomes in patients Stillwater, Minnesota) is a novel Methods: Patients on admission had treated with the TOPS Lumbar TFR deployable interbody device used a touch-screen data entry on demo- system. here for lumbar interbody fusion in graphics and pain/disability scores. Methods: Ten patients had spinal spondylolisthesis by a minimally At 6 months an independent nurse stenosis and/or spondylolisthesis at invasive access technique. This study contacted the patients to access L4-5 due to facet arthropathy. characterizes the preliminary experience resolution of 10 different scaled Radiographs and outcome measures with Optimesh for in situ interbody results. Complete or mostly complete including Visual Analogue Scale for fusion for lumbar spondylolisthesis. resolutions of problems were consid- pain, Oswestry Disability index, SF-36 Methods: 18 patients from 33 to 76 ered good/excellent results. Cases and Zurich Claudication Questionnaire years of age (average 58 years), 10 were divided into anterior (ACDF), were prospectively recorded before female and 8 male, with spondylolis- posterior (decompression alone), surgery and at 1, 3 and 6 months thesis at L3-4, L4-5, or L5-S1 were posterior with fusion, combined postoperatively. Prior to instrumenta- treated with minimally invasive anterior-posterior – all with or without tion, a bilateral total facetectomy and decompression and interbody fusion comorbidities – complications (wCC). laminectomy and, in some cases, with Optimesh. Postoperative follow- Results: Relief of preop weakness, discectomy at the L4-L5 level was up ranged from 8 to 24 months pain, numbness ACDF 65%, ACDF accomplished through a standard (average 13 months). Data was col- (wCC) 60%, C. Lam 60%, C. Lam midline posterior approach. After lected through personal interview, (wCC) 69%, C. Lam and Fusion decompression, the TOPS screws were clinical examination, radiographic 75%,

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380. Development of a 381. Posterior Lumber Interbody 382. Stand-Alone Anterior Lumbar Thoracoscopic Implantation Fusion: Comparative Analysis of a Discectomy and Fusion (ALDF) with Technique for Spinal Reconstruction Minimally Invasive Versus an Open Plate: Initial Experience after Vertebrectomy Using the Approach Frank L. Acosta, Jr., MD, San Francisco, Synex Cage David Levy, BS, Omaha, NE; Julie CA; Henry E. Aryan, MD, San Oren N. Gottfried, MD, Salt Lake Walsh, MPAS, PA-C, Omaha, NE; Mark Francisco, CA; Christopher P. Ames, City, UT; Paul Klimo, MD, Salt Lake N. Robinson, MD, Omaha, NE; Bruce MD, San Francisco, CA; Baron, DO, Omaha, NE; Christian City, UT; Meic H. Schmidt, MD, Introduction: The stability of the Schlaepfer, MD, Omaha, NE; Stephen Salt Lake City, UT lumbar spine following anterior lumbar E. Doran, MD, Omaha, NE Introduction: The goals of anterior interbody fusion (ALIF) with lateral and middle column reconstruction of Introduction: We compared clinical plate fixation and/or posterior fixation the thoracic and lumbar spine are to and radiographic outcomes in patients has previously been investigated. correct deformity, decompress the who underwent minimally invasive However, stand-alone anterior lumbar spinal cord, and immediately stabilize versus a traditional open single level discectomy and fusion (ALDF) with and restore the weight-bearing capaci- lumbar fusion with pedicle screw plate has not. We review our initial ty of the involved vertebral segments. instrumentation and posterior inter- experience with stand alone ALDF for We report our experience with the body arthrodesis. degenerative disease of the lumbar Synex expandable interbody cage Methods: We retrospectively spine. system to achieve these goals. compared blood loss, length of Methods: Ten patients treated Methods: A prospective database has hospitalization and pre- and post- between 2004 and 2005 were included been established for patients who operative Oswestry Pain Index scores. in this analysis. All patients presented have undergone implantation of the Additionally, computed tomography with discogram positive back pain and Synex cage system. Demographic (CT) scans were obtained on all 3 with radiculopathy. All patients had data, including surgical approach, patients postoperatively to determine placement of a midline anterior plate. level of disease, etiology of instability, accuracy of screw placement and pres- Patients underwent flexion/ extension and other spinal surgeries were ence of successful interbody fusion. imaging at 6 weeks, 3 months, 6 recorded. Our primary outcome was Results: Average follow-up was 33.9 months, and 1 year post-operatively. hardware and surgical perioperative months for open patients and 13.3 Results: Seven patients underwent complications. months for minimally invasive 1-level ALDF with plate, 2 underwent Results: Since July 2002, we have patients. Blood loss during surgery 2-level ALDF with plate, and 1 under- implanted the Synex cage in 30 was significantly less for minimally went a corpectomy with placement of patients. Most patients were male invasive patients compared to open anterior graft and plate. None had (n=24) and the average age was 48. patients [299cc vs. 561cc (P=0.0058)]. supplemental posterior instrumenta- The cause of instability was predomi- Hospitalization was shorter for mini- tion. Average follow-up was 9.5 nantly neoplastic (n=15) or acute mally invasive patients (4 versus 4.7 months. All patients demonstrated trauma (n=13). Eighteen patients had days), but was not statistically signifi- radiographic evidence of fusion at last neurologic changes at admission. The cant. The open fusion group had a follow-up. None developed instability most commonly affected levels were slightly greater, but not significant, at the fusion level and none developed T10, T12, and L1. Initially, traditional improvement in Oswestry scores after hardware failure (plate back-out, screw open procedures to the thoracic and surgery. Fourteen of 28 patients (50%) lucency, etc.). Average subsidence at 6 lumbar spines were used (n=24). who underwent the minimally invasive months post-operatively was 2.2mm However, endoscopic techniques have procedure had CT proven interbody (+/- 0.4mm). been performed recently with good fusion versus 14 of 18 (78%) in the open fusion group; this difference Conclusions: Preliminary results of success. Supplemental anterior (n=12) stand-alone ALDF with plate suggest it and posterior (n=10) approaches were was not significant. In the minimally invasive group, 6/112 screws (5%) is safe and effective for the surgical used in select patients. Of the four breeched the pedicle compared with treatment of patients with degenera- complications, all were pulmonary 8/72 (11%) in the open procedure; tive disease of the lumbar spine. issues; two of these required an addi- this data was not significant. Long-term follow-up is clearly needed. tional thoracic surgery to address the Subsidence is diminished with ALDF Conclusions: Compared with tradi- complication. No hardware-related and anterior plating compared to ALIF tional open instrumented lumbar complications were observed. with posterior instrumentation. It is fusion, a minimally invasive approach Conclusions: The Synex expandable unclear at this time which subset of resulted in lower blood loss. Hospital cage is a useful tool for rebuilding the patients may ultimately require stay, interbody fusion rates and accu- vertebral body in the thoracic and posterior hardware supplementation. racy of screw placement were not sig- lumbar spines. It is safe and can be nificantly different. Both groups used as a minimally invasive thoraco- demonstrated significant improvement scopic implant. in post-operative Oswestry scores but there was no difference in functional improvement comparing open and minimally invasive techniques.

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383. Maverick Artificial Disc Removal 384. Biomechanics of Asymmetric 385. Biomechanical Benefits of Due to Metal Allergy Lumbar Pedicle Screw Combinations Nonsurgical Exogenous Crosslink Alan T. Villavicencio, MD, Boulder, CO; Zafer Yüksel, MD, Phoenix, AZ; Kemal Therapy (NEXT) Sigita Burneikiene, MD, Boulder, CO Yücesoy, MD, Phoenix, AZ; Seungwon Thomas Hedman, PhD, Los Angeles, Introduction: A common concern Baek, MS, Phoenix, AZ; Volker K.H. CA; Brendan Chuang, MD, PhD, Los involving spinal arthroplasty is the Sonntag, MD, FACS, Phoenix, AZ; Neil Angeles, CA ability for safe revision. The Maverick R. Crawford, PhD, Phoenix, AZ Introduction: Extracellular matrix (Medtronic Sofamor Danek, Memphis, Introduction: We sought to compare revitalization may have advantages TN) artificial disc has a large central the biomechanics of posterior lumbar over new tissue fabrication in the keel that allows for improved fixation fixation in treating an unstable two- biologically harsh environment of when initially implanted. However, level unilateral lesion. Using pedicle degenerated intervertebral discs. there have been concerns that this screws and rods, we compared asym- Recent investigations demonstrated would make it more difficult and metric fixation (more levels included the ability of injectable crosslink potentially dangerous if the implant ipsilateral to the lesion), short versus augmentation to improve annulus needed to be revised or removed. long fixation, and fixation with and fibrosus fatigue resistance, increase There are currently no reports describ- without connection to the involved elasticity, stabilize the joint, and ing the removal of a Maverick lumbar vertebra. improve nutritional transport. In this artificial disc. Methods: Seven human cadaveric study, multi-directional material Methods: A 43-year-old female specimens (T12-S1) were studied (1) properties of crosslinked and normal underwent Maverick artificial disc intact, (2) after simulated unilateral bovine lumbar annulus specimens replacement for intractable pain that lesion at L2-3 and L3-4, (3) L2-L4 were measured in vitro. had failed extensive conservative unilateral fixation (L3 excluded), (4) Methods: Four types of annulus management. Over 3 months follow- L2-L4 bilateral fixation (L3 included fibrosus specimens were dissected ing surgery she developed worsening contralaterally), (5) L1-L5 unilateral from bovine lumbar discs in 24 intractable lumbar pain despite good fixation (L3 excluded), (6) L1-L5 symmetrical pairs, including circumfer- positioning of the device and no evi- fixation ipsilateral (L3 excluded) and L2- ential tension (CT), radial compression dence of infection or other problems. L4 fixation contralateral (L3 included), (RC), axial tension (AT), and axial She was suspected to be developing (7) L1-L5 bilateral fixation (L3 included compression (AC). One specimen from an allergic reaction to the metal based contralaterally), (8) L1-L5 bilateral fixa- each pair was soaked in PBS for 2 days on imaging studies and an allergy skin tion (L3 excluded both sides). Testing at room temperature while the other patch test. order varied among specimens. was soaked in a 0.33% genipin solu- Results: The patient underwent Angular range of motion was recorded tion. Cross-sectional areas were meas- removal of the device with an anterior optically while loading to 6.0 Nm ured using a custom non-contact lumbar interbody fusion (ALIF) with using nonconstraining pure moments. rotating laser measurement system. PEEK (poly-ether-ether-ketone) inter- Results: Unilateral short fixation Compressive test parameters included body fusion cages and a resorbable provided significantly worse stabiliza- low stiffness region modulus, and Lactosorb® plate and screws without tion than bilateral (p less than 0.05, elastic region modulus. Tensile tests complications. Her symptoms sub- RM ANOVA). There was an average of parameters included low stiffness sided almost immediately following 50 percent reduction in range of modulus, elastic region modulus, removal of the device. motion across the lesion when adding 0.5% yield strength, ultimate tensile strength (UTS), and toughness. Conclusions: Artificial disc removal one additional level rostrally and surgery can be safely performed for at caudally. Asymmetrical long/short Results: AC modulus in the low least some devices with large midline stabilization provided similar stability stiffness region was 126% higher with keels. There were no intraoperative to symmetrical long stabilization. Very crosslink augmentation (p=0.031). complications and there was minimal little additional stability was gained by CT yield strength was 78% higher intraoperative blood loss from the including L3 in the fixation. with crosslinking (p=0.024), and UTS vertebral body. A subsequent fusion Conclusions: Unilateral fixation was increased 79% (p=0.033). CT elastic still remains another option for the inadequate for stabilizing a two-level modulus showed a 59% increase patients after an unsuccessful arthro- unilateral lesion. Bilateral fixation, with crosslinking (p=0.045) while plasty procedure. whether symmetrical or asymmetrical, toughness increased 83% (p=0.05). provides good stabilization for this AT yield strength increased 45% with injury. It is not important for stability crosslinking (p=0.008) while UTS to include the level of the lesion increased 21% (p=0.036). within the construct contralaterally. Conclusions: These results suggest some additional beneficial effects of crosslink augmentation on the mechanical properties of the annulus fibrosus: increase in strength, tough- ness, and modulus in the principle stress directions.

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386. Addition of a Cross-link alone. A trend was noted for increased 388. Comparative Analysis of to the C-1 Lateral Mass/C2 stiffness in lateral bending when cross- Lumbar Lordosis after Lumbar Pedicle Screw Fixation construct: links were added. Cross-links increase Spinal Fusion Using the Wilson A Biomechanical Study stability of the CLM/C2 thereby poten- Frame and Jackson Table John Hamilton, MD, Albany, NY; David tially increasing the fusion rate in vivo. Sung Ho Park, Seoul, Republic of Pinilla-Arias, MD, Madrid, Spain; Mary Korea Bilancini, MS, Los Angeles, CA; Hamid Object: The aim of this study was to Miraliakbar, MD, Los Angeles, CA; document changes in total lumbar Carl Lauryssen, MD, Los Angeles, CA; 387. Electrical Stimulation DC of Posterior Lumbar Interbody Fusion lordosis, unisegmental lordosis, and J. Patrick Johnson, MD, Los Angeles, CA sacral tilting between preoperation, Introduction: Atlantoaxial stabilization Michael W. Groff, MD, Indianapolis, IN intraoperation, and postoperation is required in various conditions such Introduction: DC electrical stimulation using two different spinal frames as trauma, malignancy, and inflamma- has been shown to promote bony (the Jackson table and Wilson frame). tory diseases. Screw fixation of the fusion. There is no well accepted Method: Thirty-two patients were lateral mass of C1 and the C2 pedicle method for utilizing DC electrical reviewed retrospectively, having (CLM/C2) is a viable fusion option. stimulation to augment fusion rates undergone pedicle screw fixation due The addition of a cross-link may in a PLIF construct. to lumbar spinal stenosis. The patients provide added stability and increase Methods: Over six months we offered were divided into two groups, one fusion rates. The study’s objective is patients undergoing PLIF at high risk using the Wilson frame (group 1) to assess the rigidity of CLM/C2 for pseudoarthrosis the placement of a and the other using the Jackson table pedicle screw fixation construct, with DC bone stimulator in the interspace. (group 2). In group 1, 34 patients and without a cross-link, in an odon- Five patients accepted. PLIF interspace (16 men, 18 women; age range toidectomy instability model. preparation was performed in the 45-75) were reviewed. In group 2, Methods: Seven cadaver specimens standard fashion. Free bone was place 38 patients (20 men, 18 women; age were tested in the following order: anteriorly in the interspace followed by range 42-70) were reviewed. And intact specimen, destabilized C1-C2, the bone stimulator electodes followed according to surgery levels (L4-5, instrumented CLM/C2 without a in turn by the carbon fiber cage. CT L5-S1, L4-5-S1), the two group were cross-link, instrumented CLM/C2 with scan were obtained at six months. In compared with total lumbar lordosis, cross-link. Test mode series included one case a two level fusion was per- segmental lordosis, in preoperation, flexion/extension, lateral bending, and formed with the stimulator used at intraoperation, and postoperation. torsion. Range of motion (ROM) and only one level and one level was Results: In group 1, the intraoperative stiffness were calculated for the last unstimulated as an internal control. total lumbar lordosis decreased with three cycles of each test. An analysis Results: All patients experienced compared to preoperative lordosis of variance assessed significant differ- fusion at six months as demonstrated (p < 0.05). In group 2, there was no ences in ROM and stiffness between on sagittal CT scan with bone growing marked reduction between preopera- test conditions. across the interspace. Flexion- tion and intraoperation (p < 0.05). Results: CLM/C2 alone and CLM/C2 extension xrays showed no movement But, in group 1 in patient who with cross-links exhibited significantly as well. The proximity of the travers- underwent L4-5-S1 fusion, post- increased stiffness (Nm/degree) in ing root to the stimulator leads was operative total lumbar lordosis was flexion/extension, lateral bending and not a factor due to the use of an not restored to preoperative lordotic torsion than the intact specimen and approach corridor that is further condition while in group 2, There was the destabilized C1-C2 specimen. lateral than a traditional PLIF and no marked changes between pre- Stiffness during torsion of the instru- the availability of the pedicle screw operation and intraoperation, mented CLM/C2 with cross-links construct to suture the lead to and postoperation (p < 0.05). In group 1, (2.757+/-0.52) was significantly thereby keep in very lateral in the intraoperative segmental lordosis increased (P less than .001) compared field. No patient experienced a com- decraesed with compared to preoper- to the instrumented CLM/C2 alone plication due to the insertion of the ative segment lordosis at all levels, (1.96+/-0.51). There was a trend bone stimulator into the interspace. whereas in group 2, intraoperative towards decreased ROM in CLM/C2 segmental lordosis showed no Conclusions: The use of a DC bone with cross-links when compared to change at all levels with compared stimulator is safe in a PLIF or TLIF instrumented CLM/C2 alone in preoperative segmental lordosis construct and should be considered in flexion/extension (0.32+/-0.01 vs (p < 0.05). cases at high risk for a pseudoarthrosis. 0.33+/-0.02, respectively) and lateral Conclusions: The Wilson frame bending (0.55+/-0.2 vs 0.59+/-0.17, induces iatrogenic decreased lumbar respectively). lordosis, segmental lordosis, sacral Conclusions: Cross-links statistically tilting which creates an iatrogenic significantly increased the stiffness sagittal imbalance. in the CLM/C2 in torsion when com- pared with instrumented CLM/C2

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389. Posterior Lumbar Interbody 390. Uniplate for Anterior 391. RhBMP-2 Retention in a Fusion Combined with Instrumented Cervical Discectomy and Fusion Vertebral Body Fracture Stabilization Postero-lateral Fusion- A Series of Instrumentation Device (OptiMesh) 75 Patients Chris A. Lycette, MD, Allentown, PA; Hyun W. Bae, MD, Santa Monica, CA; Kalpesh Shah, Glasgow, United Introduction: The Uniplate anterior Ben B. Pradhan, MD, MSc, Santa Kingdom; Kumar Periasamy, Glasgow, cervical plate system is a novel device Monica, CA; Li Zhao, MD, PhD, Santa United Kingdom; Eugene Wheelwright, that involves a thin titanium plate and Monica, CA; Pamela Wong, BS, Santa Glasgow, United Kingdom a single screw at each vertebral level. Monica, CA; Linda E.A. Kanim, MA, Introduction: Posterior lumbar This report describes an initial case Santa Monica, CA; Rick B. Delamarter, interbody fusion (PLIF) allows decom- series of 21 patients who underwent MD, Santa Monica, CA; pression of the spinal canal and one or two level fusions using this new Introduction: The OptiMesh interbody fusion using cages can be hardware system. The Uniplate system (Spineology, MN) is currently FDA- performed through a single posterior involves less retraction for instrumen- approved for stabilization of vertebral incision. Additional instrumented tation placement as well as the use of compression fractures. Outside the US, postero-lateral fusion (IPLF) using a fewer screws compared to traditional it is also used for interbody fusion. pedicle screw system can also be cervical plates. This is a Dacron woven-sleeve inserted achieved using the same incision. We Methods: 21 patients underwent through a cannula. For interbody wanted to assess retrospectively the either one (13 patients) or two level fusion, the sleeve is backfilled with clinical and radiological outcome of (8 patients) anterior cervical discec- allograft chips providing disc-space this technique performed in our unit tomies and fusions using the Depuy expansion and stabilization. BMP’s by the senior author. Acromed Uniplate system. All surgeries have revolutionized interbody fusion Methods: Between July 1999 and were performed by the same surgeon procedures. This study investigates April 2004, 75 patients underwent and used similar techniques. Patients rhBMP-2 retention characteristics of PLIF using cage and IPLF using pedicle undergoing surgery included degener- OptiMesh. instrumentation. Clinical outcome ative or traumatic conditions. All Methods: Eleven OptiMesh devices was measured with physical examina- patients received one month and were tested. Nine were prepared with tion in the outpatient setting and three month followup cervical xrays 500 ul of 0.032mg/ml rhBMP2, assessment of pain and function. to evaluate hardware and allograft allowed to soak for 20, 60, or 120 Radiological outcome was assessed positions. minutes (n=3 devices/soak time), and with serial radiographs/flexion- Results: There were no hardware placed in vials of 40 ml 0.9% Sodium extension radiographs/computed related complications during this Chloride solution at 37ºC water bath tomography at follow-up visits. study. There was one case of transient with 5ml of air to inflate nine balloons. Results: The mean age was 48.7 years dysphagia. All 21 patients have Two deflated devices with 1 hour (range 30-75 years). The average demonstrated no hardware failures absorb time with 500 ul of follow-up was 29.17 months (12 (plate or screw breakage) or migration 0.032mg/ml rhBMP2 were placed months to 67 months). The outcome on followup xrays. All 21 patients in saline at 37ºC water bath. Same was considered to be good or excel- demonstrate evidence of bony fusion rhBMP-2 solution was control. 150ul lent in 88% of these patients. 64% of proceeding. None of the 21 patients samples were withdrawn from each patients returned back to their original required reoperation for any reason. vial at 1, 20 minutes and 1, 6, 12, 24, work. Radiographic evidence of stable and 48 hours. ELISA was applied to fixation was seen in all but one Conclusions: This is the initial report samplings to assess the concentration patient, and radiological bony fusion of the use of the Uniplate in a series of of rhBMP-2. patients undergoing anterior cervical was seen in all the cases at the time Results: The OptiMesh (Spineology, of the most recent follow-up. One discectomy and fusion. There were no device related complications or any MN) Dacron woven sleeve device was patient had pullout of a pedicle screw, able to retain approximately 90% of and one patient had a fracture of the evidence of hardware failure over a 3 month post-operative followup period. the original concentration of rhBMP2 titanium cage (both asymptomatic). diluted in 500ul of solution and Three patients sustained a neurological This study demonstrates the feasability of the device and long-term studies expanded with a balloon to mimic complication, two of which resolved clinical expansion with a soak time of completely. will be used to evaluate fusion out- comes for further comparison in the at least 20 minutes. The longer the Conclusions: The results are com- future. preparation soak time, the less parable with similar studies published rhBMP2 in solution. in the literature. Therefore we recom- Conclusions: The Optimesh device mend the continuous use of PLIF + retained approximately 90% of the IPLF in painful lumbar degenerative original concentration of rhBMP2. spinal disease where conservative Further investigation is needed to management has failed. determine the devices’ ability to produce reliable rhBMP-2 mediated osteoinduction in-vivo.

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392. The Efficacy of Percutaneous 393. Interspinous Locker Fixation 394. Neural Prosthetic Implants in Endoscopic Interlaminar Discectomy with Ligamentoplasty for Spinal Cord: Direct Activation of (PEID) on L5-S1 Disc Herniation Lumbar Stenosis or Degenerative Muscles with Multishank Single Unit Jung Hyun Shim, MD, Suwon, Spondylolisthesis. Stimulation Electrodes Republic of Korea; Choon Keun Park, Sang-Ho Lee, MD, PhD, Seoul, Arthur L. Jenkins, III, MD, New York, MD, Suwon, Republic of Korea; Dong Republic of Korea; Byungjoo Jung, NY; Stanislaw Sobotka, PhD, New Hyun Kim, MD, Suwon, Republic of MD, Seoul, Republic of Korea; Won York, NY Korea; Jae Keon Kim, MD, Suwon, Gyu Choi, MD, PhD, Seoul, Republic Introduction: Focal pools of neurons Republic of Korea; Jang Hoe Hwang, of Korea; Ho Yeon Lee, MD, PhD, that control a single muscle (spinal MD, Suwon, Republic of Korea Seoul, Republic of Korea; Won-Chul motor units) have been characterized Introduction: Because of the high Choi, MD, Seoul, Republic of Korea and stimulated successfully with single lying iliac crest, we have encountered Introduction: Dynamic stabilization unit electrodes. We present the use difficulty in obtaining adequate access device can treat degenerative disc dis- of a multishank electrode system to when performing posterolateral trans- ease without fusion of the vertebrae, activate different muscles with stimula- foraminal endoscopic discectomies on preserving motion and flexibility. The tion of individual electrodes within the L5-S1 disc herniation. Therefore, we purpose of this study is to present system. have performed PEID as a minimally interspinous locker fixation (ILF) with Methods: We created an electrode invasive procedure in these cases. ligamentoplasty (LP) for lumbar steno- with 30 stimulating electrodes in a Methods: This is a retrospective clinical sis or degenerative spondylolisthesis. three-dimensional array, and implanted review of 17 patients who underwent Methods: Between January 2004 and these into the lumbar motor units of PEID on L5-S1 during the period of June 2005, 17 consecutive patients spinal cords of 10 Sprague-Dawly rats. February 2004 to August 2004. All underwent ILF with LP after decom- EMG and accelerometers were used procedures were performed under pression. The indications included to record the output of the muscles epidural anesthesia. Under fluoroscopic spondylolisthesis grade I with central activated. guidance, we inserted an endoscopy stenosis and bilateral foraminal steno- Results: Using stimulations of 0.0- (6mm diameter, YESS) into epidural sis. Supraspinous and interspinous 0.2mA, 0.1-0.3ms, we were able to space through interlaminar route, and ligaments were removed without reproducibly activate several different we removed the herniated disc. The violation of the spinous processes. muscles depending on which elec- wound was closed with simple skin The lower half of the upper lamina trode was stimulated. This muscle suture. The outcomes were analyzed and buckled yellow ligament were response, as graded by the rate of using a visual analog scale (VAS) and removed. After decompression, a locker movement of the joint as recorded by Modified MacNab criteria. was located between the spinous the accelerometers attached to the Results: The study involved 9 males process. Both spinous processes were limbs, was dependent on the size of and 8 females with a mean age of 32 surrounded with an artificial ligament the muscle and the stimulus intensity. as a figure-of-eight. years (range, 21 to 43). The mean Conclusions: The use of a large array hospital stay was 2.3 day. All patients Results: Mean follow-up was 11.7 of electrodes implanted in the spinal returned to work within 8 weeks (range 3-21) months. There were 12 cord of a rat can produce specific, (range, 1 to 8) after the procedure. males and 5 females with a mean age stereotypic contraction of various The mean follow-up period was 13.5 of 62.3 (range 41-81) years. There individual muscles in a way the investi- months (range, 12 to 18). VAS were 13 cases of single-level and 4 of gator can control. This has significant decreased from a preoperative mean two-levels. The operated levels were implications for the treatment of of 7.9 to 1.8 at the final follow-up. L3-4 in 7, L4-5 in 12, and L5-S1 in 2 chronic spinal cord injured patients Upon analysis using Modified MacNab patients. After surgery, lumbar lordosis with intact spinal cords below a level criteria, excellent results in 9 subjects was well preserved. The average score of of injury. (53%), good results in 7 (41.2%), a Oswestry Disability Index was improved fair result in 1 (5.8%), and poor results from 66.0 % to 31.1 %. Complications in 0 (0%) cases were obtained. There are superficial wound infection in 2 were no complications. patients and transient dysesthesia in 2. Conclusions: PEID may be an effica- There was no reoperation. cious, safe, and minimally invasive Conclusions: Interspinous locker procedure for an endoscopic discecto- fixation with ligamentoplasty has the my on L5-S1 disc herniaton. characteristics of both distraction and compression. ILF with LP seems to be the best option for soft stabilization in treating degenerative pathology. Long-term comparative studies are needed to establish the standard therapeutic role of ILF with LP.

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395. Kyphoplasty for Treatment of 396. Biomechanical Comparison of Both screw techniques limited motion Traumatic Anterior Column Isolated Occipitoatlantal Posterior better than the wired contoured rod Compression Fractures Fixation Techniques construct and were less susceptible to Dennis E. McDonnell, MD, La Crosse, Nicholas Bambakidis, MD, Phoenix, loosening by fatigue. WI; Polly A. Davenport-Fortune, NP, AZ; Iman Feiz-Erfan, MD, Phoenix, AZ; CNRN, La Crosse, WI; Melissa Lenz, Eric M. Horn, MD, Phoenix, AZ; BA, La Crosse, WI L. Fernando Gonzalez, Phoenix, AZ; 397. Value of Magnetic Resonance Introduction: Vertebroplasty and Volker K.H. Sonntag, MD, FACS, Phoenix, AZ; Seungwon Baek, MS, Imaging in Mouse Models of Spinal kyphoplasty are accepted procedures Cord Injury for correction of pathological thora- Phoenix, AZ; Zafer Yüksel, MD, columbar compression fractures Phoenix, AZ; Neil R. Crawford, PhD, Paul Arnold, MD, Kansas City, KS; caused by osteoporosis, multiple Phoenix, AZ M. Bilgen, MD, Kansas City, MO; myeloma, and hemangioma. Unstable Introduction: Transarticular screws B. Alhafez, MD, Kansas City, MO; traumatic compression fractures have can be used to immobilize C0-C1 N. Berman, MD, Kansas City, MO; traditionally been treated with open, after occipitoatlantal dislocation. B. Festoff, MD, Kansas City, MO surgical stabilization. Treatment for Alternately, rods can connect screws Introduction: The feasibility of stable vertebral compression fractures from the C1 lateral masses to keel performing high-resolution in vivo MRI conventionally focuses on the allevia- screws in the skull base. These screw on injured mouse spinal cord at 9.4 T tion of acute pain with bracing, med- techniques were compared bio- magnetic field strength was evaluated ication, and activity modification. We mechanically to a contoured wired with wild type and transgenic mice. will present the results from a series of Steinmann pin across C0-C1. Methods: The MR properties of 12 patients with stable, traumatic, Methods: Fourteen human cadaveric normal murine SC tissue were meas- thoracolumbar compression fractures, specimens (occiput-C2) were tested ured. The characteristics of the water successfully treated with kyphoplasty. (1) normal, (2) destabilized, (3) after diffusion were quantified as normative Methods: Twelve patients with screw fixation, (4) after adding a measurements. Data indicate that the painful, traumatic anterior column dorsal graft wired from occiput-C1, differences in the proton density, and thoracolumbar compression fractures (5) after fatiguing for 10,000 cycles transverse relaxation time between underwent percutaneous balloon (no graft), (6) after wiring a contoured grey and white matter dominate the kyphoplasty at our institution from rod across occiput-C1, (7) after wiring contrast seen on normal SC images at 2004 to 2005. These patients partici- a dorsal graft, (8) after fatiguing (no 9.4 T. On heavily T2-weighted images, pated in a broader study examining graft). Pure moments were applied these differences result in the reversal the safety and efficacy of kyphoplasty. to induce flexion, extension, lateral of contrast. The diffusion of water in We evaluated pain, use of pain med- bending, and axial rotation while normal mouse SC is anisotropic; the ications, function and quality of life recording 3-D angular motion. Range WM exhibits greater anisotropy and pre-procedure and three to six weeks of motion (ROM) and increase in principal diffusivity than the GM. This post-procedure. All major and minor ROM due to fatigue were compared data should establish a standard for complications were recorded. The 12 statistically using analysis of variance comparing similar measurements patient charts and radiographs were followed by Holm-Sidak test. obtained from SCs of genetically reviewed retrospectively. Results: With and without a graft, engineered mouse models of SCI. Results: All 12 patients experienced transarticular screws allowed the Results: Using established moderate prompt improvement in pain and smallest ROM, followed by the keel- compression model SCI at T12 level, were able to resume weight-bearing lateral mass screws-rods followed by we performed additional MRI and activities. There was further improve- wired contoured rod. Transarticular behavioural studies on C57BI/6 wild ment in pain, quality of life, and screws and wired contoured rod type, comparing results with human function over three to six weeks. No benefited more from a dorsal graft protease nexin I overexpressing trans- serious complications occurred, and than the keel-lateral mass screw genic male. MRI were conducted on hospitalization was generally brief. technique. Fatigue caused significantly postinjury days 1, 7 and 14 to monitor Postoperative radiographs showed greater ROM increase in the wired injury progression longitudinally and preserved alignment or improvement contoured rod construct (mean to quantify changes in lesion volume. of the kyphotic angle and no signifi- 0.83-degree increase) than in the The neurobehavioral recovery of each cant cement leakage. transarticular screw construct (mean animal was assessed using modified Conclusions: Kyphoplasty is a safe and 0.06-degree increase) or keel-lateral BBB scores on PI days 1, 3, 7, 10 and effective treatment for patients with mass screw construct (mean 0.08- 14. On PI day 14, mice were eutha- painful, traumatic compression frac- degree increase). nized for histological analysis of tures of the anterior vertebral column. Conclusion: The transarticular screw injured SCs. technique allowed less motion at C0- Conclusions: The MRI-based measure- C1 than the keel-lateral mass screw ments on the lesion volume appear to technique, especially when a wired reflect improvements in neurobehav- structural graft was present dorsally. ioral, as well as neurohistological,

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES POSTER ABSTRACTS 89 recovery patterns and may offer 399. Bone Scan Imaging for significant value in assessing similar Selective Percutaneous recoveries to establish mechanisms in Vertebroplasty in Osteoporotic genetically-manipulated mice. Vertebral fractures Harel Deutsch, MD, Chicago, IL Introduction: Percutanous poly- 398. Extrapedicular Unilateral methylmethacrylate (PMMA) Vertebroplasty vertebroplasty is an effective treatment of osteoperotic compression fractures. Harel Deutsch, MD, Chicago, IL Many patients have multiple vertebral Introduction: Vertebroplasty has body compression fractures or verte- been demonstrated to be an effective bral body wedging. Some patients treatment for osteoporotic vertebral have therefore undergone multiple compression fractures. Standard tech- level vertebroplasty. The goal of this niques involve transpedicular delivery study was to determine if a positive of methyl methacrylate bilaterally. bone scan targeted vertebroplasty Small pedicles require small 2-3-mm would eliminate the need for multi- OD needles and delivery of low level vertebroplasties. viscous cement with a possible risk Methods: Twelve patients presented of embolization. Bilateral pedicle with acute back pain and radiographs cannulation is often required to demonstrating multiple thoracic and achieve an effective vertebral body fill. lumbar compression fractures (average Methods: A modification of the stan- number of levels 2.8). No previous dard vertebroplasty technique involves films were available for comparison. placement of a larger cannula through Each patient underwent a bone scan. a lateral extrapedicular trajectory. The In ten patients, a positive bone scan trajectory allows for a medial needle test was obtained demonstrating placement and excellent vertebral increased uptake at one level. body fill through a unilateral pass. Percutaeous vertebroplasty was The larger cannula allows for more performed at the level of increased viscous cement delivery with less risk uptake only. for cement embolization. Five to 8cc Results: All ten patients had improve- of methy methacrylate was delivered. ment in their back pain. The average Biplanar fluoroscopy was used for VAS improved from 8.1 to 4.5 (p localization. <0.05). There were no procedure Results: A unilateral extrapedicular related complications. In two patients, vertebroplasty was performed in 20 a level not clearly identified as patients (average age=75.3). Pain fractured initially was noted to have improved in 16/20 (80%) of patients. increased uptake and subsequent Average VAS pain scores improved x-ray review indicated vertebral body from 8.2 to 4.0 (P<0.05). No "wedging." procedure related complications Conclusions: A bone scan is an were noted. With 6 month average effective test to predict outcome follow-up, 2 patients demonstrated with vertebroplasty and to specifically vertebral fractures at other levels. target the symptomatic vertebral Conclusions: A unilateral extrapedicu- level in patients with osteoperotic lar vertebroplasty technique allows for compression fractures. excellent vertebral body fill with a sin- gle needle placement. The larger nee- dle allows for a safer more viscous methy methacrylate delivery. Overall clinical results are similar to previously described vertebroplasty series.

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2006 MAYFIELD significantly decreased in the neuro- PSOs were associated with improve- protective drug groups compared with ments in local, segmental, and global BASIC SCIENCE AWARD control groups. measures of sagittal balance while RECIPIENT thoracic PSOs were only associated Conclusions: Both compressive injury with local improvement. Most patients 208. Development of an Animal and adhesive arachnoiditis are required rated their functional status as ‘fair’ Model of Post-Traumatic to develop extensive PTS. By under- to ‘good’ according to the Modified Syringomyelia Associated with standing the molecular pathogenesis Prolo scale and reported that they Adhesive Arachnoiditis: of PTS, improved treatment approaches were satisfied with the overall Implications for an Enhanced may be developed. Understanding of the Pathobiology management of their back condition and for the Development of Novel according the SRS-22 questionnaire. Therapeutic Approaches Conclusions: The ability to perform Toshitaka Seki, MD, PhD, Toronto, 2006 MAYFIELD a PSO at both lumbar and thoracic ON, Canada; Michael G. Fehlings, levels is a powerful asset for the spinal MD, PhD FRCS, Toronto, ON, Canada CLINICAL SCIENCE AWARD deformity surgeon. Radiographic and RECIPIENT clinical outcomes were superior with Introduction: We have sought to lumbar PSOs secondary to several develop a animal model of post- 310. Clinical and Radiographic anatomical and technical obstacles traumatic syringomyelia (PTS) to Outcomes of Thoracic and Lumbar hindering the thoracic procedure. facilitate the understanding of this Pedicle Subtraction Osteotomy for Nevertheless, the thoracic PSO proves disorder so that improved therapeutic Fixed Sagittal Imbalance to be a useful addition for regional approaches can be developed. Benson P. Yang, MD, Chicago, IL; improvement in sagittal balance for Methods: Injured Wistar rats received Stephen L. Ondra, MD, Chicago, IL; patients with a fixed thoracic kyphosis. 35g clip injury was applied to the Larry A. Chen, BS, Chicago, IL; spinal cord to simulate a moderate HeeSoo Jung, BA, Chicago, IL; spinal cord injury (SCI) at T6 level. Tyler R. Koski, MD, Chicago, IL; (1)Rat PTS model (n=48); The animals Sean A. Salehi, MD, Chicago, IL were divided into 4 groups. G1 was Introduction: Few reports for compli- animals received SCI only, G2 was cations and outcomes after pedicle received SCI and injected kaolin into subtraction osteotomy (PSO) exist in the subarachnoid space (SAS), the literature. There are no reports per- G3 was injected kaolin into the SAS taining to thoracic PSOs specifically. only, and G4 was sham group. The We evaluate the radiographic and survival time was 1, 2, and 6 weeks. functional outcomes of pedicle (2)Neuroprotective drugs (n=4- subtraction osteotomy (PSO) in 5/treatment); Experimental rats were general. Furthermore, we compare randomly divided into 1 of 5 treat- and contrast these measures between ment groups. Beginning 1h after thoracic and lumbar PSO subgroups. injury, the animals were given either an intraperitoneal injection of saline, Methods: Thirty-five consecutive vehicle, MPSS, minocycline, or riluzole patients with sagittal imbalance for 6 days after SCI. All treatment rats treated with PSO by a single surgeon were examined by using the BBB for 4 with minimum 2-year follow-up were weeks. Quantitative histological and analyzed. Perioperative course and immunohistochemical assessments complications were noted. were undertaken using fluorescence Measurements of standing long-film microscopy and image analysis. radiographs of the spine were taken preoperatively, immediately post- Results: (1)Both groups G3 and G4 operatively, and at most recent did not develop syringomyelia. PTS follow-up. The Modified Prolo and was observed in both groups G1 and SRS-22 outcomes instruments were G2 at 6 weeks. Especially, G2 was administered. observed larger syrinx compared with G1. (2)Gradual improvement in hind Results: Early complications after limb function was observed for each PSO included neurologic injury, group in BBB, although the statistical wound-related problems, and analysis revealed no significant nosocomial infections. Late difference. However the lesion was complications were limited to pseudoarthrosis and attendant instrumentation failure. Lumbar

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ADDRESS CHANGES Oran S. Aaronson, MD Carlos Acosta, MD, FACS, FI 825 Cherry Laurel Ct. Arlington Neurosurgical Assoc. Nashville, TN 37215-6165 811 W. Interstate 20, Ste. 132 To make address changes to your (615)214-0229 Arlington, TX 76017-5870 contact information as listed in (817)265-2456 this membership roster, visit Khalid Mahmud Abbed, MD www.MyAANS.org to update your Massachusetts General Hospital Mark S. Adams, MD profile. 55 Fruit St./Neurosurgery 5708 Stillwater Ln. Boston, MA 02114-2621 Midland, MI 48642-7028 (617)726-2000 (989)799-8712 Section members as of February 7, 2006. M. Samy Abdou, MD David E. Adler, MD 7790 Doug Hill Ct. 1040 N.W. 22nd Ave., Ste. 630 San Diego, CA 92127-2500 Portland, OR 97210-3049 (858)759-3488 (503)796-2743 Jafri Malin Abdullah, MD, PhD, FRCS Joseph Aferzon, MD Hospital University 114 W. Main St., Ste. 101 Sci/Neurosurgery/Neurosci New Britain, CT 06051 Jalan Hospital USM Kubang Kerian (860)832-4664 Malaysia (9) 766 4240 Cynthia Zane Africk, MD, FACS 10743 Falls Creek Ln. Chad D. Abernathey, MD Centerville, OH 45458 PO Box 668 (937)208-2088 Cedar Rapids, IA 52406-0000 (319)363-4622 Charles B. Agbi, MD Ottawa Hospital Civic Campus Adnan Adib Abla, MD 1053 Carling Ave. Rm. D711 607 Victoria Ln. Ottawa, ON K1Y-4E9 Canada Wexford, PA 15090 (613)798 5555 (412)647-3604 Jose A. Aguilar, MD Moustapha Abou-Samra, MD 706 Zumwalt Ln. 168 N. Brent St., Ste. 408 Foster City, CA 94404-3635 Ventura, CA 93003 (617)838-4925 (805)643-2179 Edward W. Akeyson, MD, PhD Daniel J. Abrams, MD New Haven Neurosurgical Assoc. 6050 E. 1st Ave. 60 Temple St. Ste. 4C Denver, CO 80220-5903 New Haven, CT 06510-2716 (303)321-9678 (203)772-4001 Alberto Abreu-Rivera, MD Faisal J. Albanna, MD, FACS PO Box 9068 Albanna Neurosurgical Ponce, PR 00732-9068 5000 Cedar Plaza Pkwy. #220 (787)840-9777 St. Louis, MO 63128-3201 (314)849-9090 Bret B. Abshire, MD UCSD/Div. of Neurological Surgery Anthony M. Alberico, MD 25150 Hancock Ave. Ste. 210 5757 N. Dixie Hwy. Murrieta, CA 92562-5982 Fort Lauderdale, FL 33334-4135 (909)461-6988 (954)776-1446 Maged Lotfy Abu-Assal, MD Tord D. Alden, MD 7811 Santa Paula ST. Children’s Mem. Hospital/Neurosurgery Highland, CA 92346 2300 Children’s Plaza (909)799-7565 Box 28 Chicago, IL 60614 Alfredo V. Abundo Jr., MD (773)880-4373 PO Box 81234 Davao City 8000 E. Francois Aldrich, MD Philippines University of Maryland Medical Center (8) 222 23 409 22 S. Greene St., Ste. S12D Baltimore, MD 21201-1544 Pablo J. Acebal, MD (410)328-0937 8940 N. Kendall Dr., Ste. 707E Miami, FL 33176-0000 (305)273-3355

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Joseph T. Alexander, MD Jim D. Anderson, MD Rex E. H. Arendall II, MD, FACS Wake Forest University Medical Center PO Box 658 1527 Sunset Rd. Dr./Neurosurgery San Carlos, CA 94070-0658 Brentwood, TN 37027-3503 Winston-Salem, NC 27157-1029 (650)299-2289 (615)327-9543 (336)716-6437 Lloyd S. Anderson, MD, FACS Perry Argires, MD, FACS Todd D. Alexander, MD 6512 E. Carondelet Dr. Lancaster Neuro-Association 1235 N. Mulford Rd., Ste. 210 Tucson, AZ 85718-0000 1671 Crooked Oak Dr. Rockford, IL 61107 (520)886-8203 Lancaster, PA 17601-4207 (815)397-0077 (717)569-5331 Mark E. Anderson, MD Maher A. Al-Hejji, MD 16300 Sand Canyon Ave., Ste. 1005 Thomas J. Arkins, MD 100 Catalina Cir. N.E. Irvine, CA 92618-3711 Connecticut Neurosurgery PC Calgary, AB T1Y-7B7 (949)753-0303 330 Orchard St. Ste. 316 Canada (403)944 8157 New Haven, CT 06511-4417 Russell J. Andrews, MD (203)781-3400 L. Willis Allen, MD 244 Mistletoe Rd. 2 Morningside Dr. Los Gatos, CA 95032-0000 Paul M. Arnold, MD, FACS Millville, NJ 08332-2839 (408)374-0401 University of Kansas Hospital (856)327-5557 Neurosurgery Jorge Angel, MD 3901 Rainbow Blvd. Eric M. Altschuler, MD. FACS 3722 Piping Rock Kansas City, KS 66160-0001 Pittsburgh Neurosurgery Assoc. Houston, TX 77027-4032 (913)588-7587 1501 Locust St. Ste. 224 (713)622-2064 Pittsburgh, PA 15219-5128 Elaine J. Arpin, MD (412)471-4772 Peter Douglas Angevine, MD S.W. Florida Neurosurgical Assoc. 10 Alden Pl., Apt. 2B 413 Del Prado Blvd. Ste. 102 Jaime A. Alvarez, MD Bronxville, NY 10708 Cape Coral, FL 33990-5703 1130 Tipton Ct. (212)305-0378 (941)772-5577 Fort Myers, FL 33901 (239)432-0774 Lee V. Ansell, MD Gustavo J. Arriola, MD 5420 W. Loop S., Ste. 1100 Ste. 2202 Antonio Alvarez-Berdecia, MD, FACS Bellaire, TX 77401-2103 36468 Emerald Coast Pkwy. PO Box 364083 (713)988-5677 Destin, FL 32541 San Juan, PR 00936-4083 (850)682-8008 (787)460-8281 Rein Anton, MD, PhD Guthrie Clinic Victor Manuel Arteaga Larios, MD James M. Alvis, MD, FACS Guthrie Square c/o Dr. Jimenez #340 Norman Neurosurgical PC Sayre, PA 18840 Interior 204 B Colonia Doctores 724 24th Ave. Ste. 220 N.W. (520)626-2164 Delegacion Cuahtemoc, DF 06720 Norman, OK 73069-6214 Mexico (405)321-6347 Ronald I. Apfelbaum, MD Dept. of Neurosurgery (555)519-6 John C. Amann, MD 30 N. 1900 E. Ste. 3B-409 Henry E. Aryan, MD Neurology & Neurosurgery Assoc. Salt Lake City, UT 84132-2303 10898 Caminito Arcada PA 50 2nd St. S.E. (801)581-6908 San Diego, CA 92131 Winter Haven, FL 33880-5052 (619)543-5540 (863)293-2107 Paul J. Apostolides, MD 6 Greenwich Office Park Richard H. Ashby, MD Michael Albert Amaral, MD, FACS Greenwich, CT 06831-5151 8919 Vista View Dr. Spine & Sacroiliac LLC (203)869-1145 Dallas, TX 75243-6350 550 Peachtree St. N.E. #1770 (214)343-2911 Atlanta, GA 30308-2263 Arthur G. Arand, MD (404)577-5455 Mayfield Clinic/Mercy Fairfield Ely Ashkenazi, MD Hlth. & Wellness Ctr. Assuta Hospital Victor T. Ambruso, MD 3050 Mack Rd. Ste. 202 62 Jabotinsty St. PO Box 233 Fairfield, OH 45014 Tel Aviv 62748 Wyoming, PA 18644-0233 (513)569-5301 Israel 3-5201467 (570)283-1400 Roberto J. Aranibar, MD Augusto G. Asinas, MD Jeremy W. Amps, MD Texas Neurosciences Institute 10 Hospital Dr. University Hospitals of Cleveland 4410 Medical Dr. Ste. 610 Holyoke, MA 01040-6603 11100 Euclid Ave. San Antonio, TX 78229-3798 (413)536-7044 Cleveland, OH 44106-1736 (210)614-2453 (216)844-5747 Donald P. Atkins, MD, FACS Carlos A. Arce, MD Bldg. 3600 James S. Anderson, MD University of Florida-Jacksonville 13518 Adobe Crossing Metrohealth MC/Neurosurgery 580 W. 8th St. Tower 1 8th Fl. San Antonio, TX 78232-5189 2500 Metrohealth Dr. H910 Jacksonville, FL 32209-6511 (210)614-2453 Cleveland, OH 44109-0000 (904)244-3950 (216)778-3140

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Anthony N. Avellanosa, MD Perry A. Ball, MD, FACS Asif Bashir, MD 4955 N. Bailey Ave. Ste. 201 Dartmouth Hitchcock Medical Center 15 Kings Ct., Apt. 6 Buffalo, NY 14226-1206 1 Medical Center Dr. Camillus, NY 13031-1755 Lebanon, NH 03756-0001 (315)484-0012 Charles Azzam, MD (603)650-5109 1916 Opitz Blvd. David S. Baskin, MD Woodbridge, VA 22191-3304 Nicholas C. Bambakidis, MD 1656 N. Boulevard (703)490-8283 2910 N. Third Ave. Houston, TX 77006 Phoenix, AZ 85013 (713)441-3800 Parviz Baghai, MD (602)406-3458 Allegheny General Hospital Francisco J. Batlle, MD 420 E. North Ave. Ste. 302 Timir Banerjee, MD 2124 Research Row, Ste. B Pittsburgh, PA 15212-4746 PO Box 22067 Dallas, TX 75235 (412)321-3033 Louisville, KY 40252-0067 (214)358-8350 (502)426-9257 Carlos A. Bagley, MD Ulrich Batzdorf, MD Johns Hopkins University Kurt D. Bangerter, MD University of California - Los Angeles Hospital/Neuros. 1014 Memorial Dr., Ste. 310 Box 956901 600 N. Wolfe St., Meyer 8-161 Denison, TX 75020 Los Angeles, CA 90095-6901 Baltimore, MD 21287 (903)416-6340 (310)825-5079 (410)955-6406 Safwan Barakat, MD, FACS Jerry Bauer, MD Roger Calingo Baisas, MD 1425 N. McLean Blvd. Ste. 550 Center of Brain & Spine Surgery WV Neurospine Stroke Ctr. Elgin, IL 60123-5723 1875 W. Dempster St., Ste. 605 PO Box 1229 (847)741-1610 Park Ridge, IL 60068-0000 Chapmanville, WV 25508-1229 (847)698-1088 (304)855-9400 Nicholas M. Barbaro, MD University of California - San Francisco Robert A. Beatty, MD Jamie L. Baisden, MD Box 0112, Neurosurgery 911 N. Elm St., Ste. 114 Dept. of Neurosurgery San Francisco, CA 94143-0112 Hinsdale, IL 60521 9200 W. Wisconsin Ave. (415)502-3744 (630)986-8290 Milwaukee, WI 53226-0099 (414)454-5400 James E. Barnes, MD Philip C. Bechtel, MD 791 Macon Alley Fort Worth Brain & Spine Inst. LLP Koang Hum Bak, MD Columbus, OH 43206-2162 1325 Pennsylvania Ave.. Ste. 890 Hanyang University Hospital (614)444-3238 Fort Worth, TX 76104-2619 249-1 Kyomundong (817)878-5327 Kuri 471701 H. Glenn Barnett II, MD, FACS South Korea Semmes Murphy Clinic David W. Beck, MD (3) 15602325 614 Skyline Dr. Forest Park Medical Bldg. Jackson, TN 38301-3923 1010 4th St. S.W., Ste. 105 Kathleen H. Baker MBA, CNRN (731)423-1267 Mason City, IA 50401 Heiden #7 (641)422-7847 857-C Rhue Haus Ln. John D. Barr, MD, MSIT Hummelstown, PA 17036 6305 Humphreys Blvd. #205 Mohamed Y. I. Beck, MD (412)623-2925 Memphis, TN 38120 1801 S. 5th St., Ste. 207 (901)226-3002 McAllen, TX 78503 Robert L. Baker, MD (956)668-9598 Ste. 1A Adib H. Barsoum, MD 1360 Old Freeport Rd. 206 Weldon St. Donald L. Behrmann, MD, PhD Pittsburgh, PA 15238-4102 Latrobe, PA 15650-1848 Orlando Neurosurgical PA (412)967-0275 (724)539-8243 1605 W. Fairbanks Ave. Winter Park, FL 32789 Roy Powell Baker, MD Henry M. Bartkowski, MD, PhD (407)975-0200 Neurological Institute of Savannah Akron Childrens Hospital 4 Jackson Blvd. 1 Perkins Square, Rm. 6411 Carl J. Belber, MD Savannah, GA 31499-3501 Akron, OH 44308-1062 2105 S. Mills Dr. (912)355-1010 (330)543-8661 Urbana, IL 61801-6741 (217)384-3030 Nevan G. Baldwin, MD, FACS Lynn Margaret Bartl, MD 3601 21st St. Neurologic Associates of Waukesha Herbert S. Bell, MD Lubbock, TX 79410 1111 Delafield St., Ste. 105 5500 Strathaven Dr. (806)785-6775 Waukesha, WI 53188-3431 Cleveland, OH 44143-1970 (262)542-9503 (440)605-0659 Gene A. Balis, MD, FACS Neurological Surgeons Associates Juan C. Bartolomei, MD Roberto B. Bellegarrigue, MD, FACS 3000 E. Fletcher Ave. Ste. 340 Spine Team Texas PA VIP-SAL 1775 Tampa, FL 33613-4645 1545 E. South Lake Blvd. #100 PO Box 025364 (813)977-3776 Southlake, TX 76092-0000 Miami, FL 33102-5364 (972)258-7417

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 94 MEMBERSHIP ROSTER

Allan J. Belzberg, MD Yashwant Bhandari, MD Maxwell Boakye, MD Johns Hopkins University Hospital 30 Wildwood Dr. Stanford University/Neurosurgery 600 N. Wolfe St., Meyer 5-109 Short Hills, NJ 07078-3026 3801 Miranda Ave, M-112 Baltimore, MD 21287-7509 (973)533-1911 Palo Alto, CA 94304 (410)955-5810 (650)493-5000 Ratan Bhardwaj, MD Vallo Benjamin, MD Hospital for Sick Children Robert J. Bohinski, MD, PhD New York University Med. Ctr. 555 University Ave. #1504 2123 Auburn Ave., Ste. 441 530 1st Ave. Ste. 7W Toronto, ON M5G-1X8 Cincinnati, OH 45219 New York, NY 10016-6402 Canada (513)569-5288 (212)263-5013 James B. Billys, MD Michael F. Boland, MD Benjamin G. Benner, MD Orthopeadic Associates 3009 N. Ballas Rd., Ste. 360C Neurosurgery Specialists 325 S. Willis St. Louis, MO 63131 6767-A S. Yale Visalia, CA 93291 (314)567-0776 Tulsa, OK 74136-3302 (559)625-0551 (918)492-7587 Eugene A. Bonaroti, MD Mark H. Bilsky, MD 618 Woodvalley Dr. Gregory J. Bennett, MD Memorial Sloan-Kettering Cancer Ctr. Pittsburgh, PA 15238-0000 8 Falconview Ct. 1275 York Ave. C705 (412)968-0375 Orchard Park, NY 14127-3755 New York, NY 10021-6007 (716)631-0001 (212)639-8526 John T. Bonner, MD 1551 W. Escalon Edward C. Benzel, MD Nancy E. Binter, MD Fresno, CA 93711 Cleveland Clinic Foundation 94 Colchester Ave. (559)440-5081 9500 Euclid Ave. S80 Burlington, VT 05401-1417 Cleveland, OH 44195-0001 (802)865-2550 Lawrence F. Borges, MD (216)445-6797 Massachusetts General Hospital Barry D. Birch, MD 55 Fruit St., White 1205 Thomas A. Bergman, MD 13400 E. Shea Blvd. Boston, MA 02114 HCMC/Surgery Dept. Scottsdale, AZ (617)726-6156 701 Park Ave. 85259-5404 Minneapolis, MN 55415-1829 Bikash Bose, MD, FACS (612)347-2810 Ronald Birkenfeld, MD Omega Professional Center Milton Hospital Office Blvd. C-79 Omega Dr. Richard Alan Berkman, MD 100 Highland St., Ste. 123 Newark, DE 19713-0000 Neurosurgical Associates Milton, MA 02186-3878 (302)738-9145 PO Box 331696 (617)698-0099 Nashville, TN 37203 Magdy I. Boulos, MD (615)986-1256 Roy W. Black, MD 1306 N. Broom St. 8609 Navidad Dr., Ste. 1 Wilmington, DE 19806-4214 Lee Berlad, MD Austin, TX 78735 (302) 571-9750 1101 Sam Perry Blvd. #321 (512)306-9925 Fredericksburg, VA 22401 Thomas R. Boulter, MD (512)452-0626 William A. Black Jr., MD PO Box 9478 1238 Gravel Pond Rd. Daytona Beach, FL 32120-9478 Robert J. Bernardi, MD Clarks Summit, PA 18411-9481 (386)257-5055 Missouri Bone & Joint Center Inc. (570)585-6981 1000 Des Peres Rd. Ste. 120 Harb Nicolas Boury, MD, FACS St. Louis, MO 63131-2062 James Blair Blankenship, MD, FACS 327 E. Gunderson Dr., Ste. C (314)205-2223 Neurosurgery Spine Center Carol Stream, IL 60188 2793 E. Millennium Dr., Ste. 1 (630)653-2599 Aldo Francisco Berti, MD, FACS Fayetteville, AR 72703-0000 8441 S.W. 114th St. (479)582-9025 Samuel R. Bowen II, MD Miami, FL 33156-4330 4224 Caldwell Mill Rd. (305)661-8288 Gary M. Bloomgarden, MD Birmingham, AL 35243-1716 Connecticut Neurosurgery PC (205)591-3472 William B. Betts, MD 330 Orchard St., Ste. 316 3502 9th St., Ste. 240 New Haven, CT 06511-4417 Hakan Bozkus, MD Lubbock, TX 79415 (203)781-3400 Senlikkoy Yenibaglar S (806)761-0720 1/5 Basak Apt Horst G. Blume, MD Istanbul 34153 William J. Beutler, MD, FACS 700 Jennings St. Turkey Pennsylvania Spine Inst. Sioux City, IA 51105-1920 (212) 311 20 00 805 Sir Thomas Ct. (712)252-4386 Harrisburg, PA 17109-4839 Arlo B. Brakel, MD (717)540-3993 Bennett Blumenkopf, MD, FACS Neuro. Assoc. of Tucson/ 515 Broad St., PMB #280 St. Marys Med. Plaza Sewickley, PA 15143-0000 1712 Anklam Rd., Ste. 102 (412)359-6200 Tucson, AZ 85745 (520)320-2150

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEMBERSHIP ROSTER 95

Charles L. Branch Jr., MD Frederick D. Brown, MD George T. Burson, MD WFU Baptist Medical Center University of Chicago Neurosurgery Arkansas Medical Center Blvd./Neurosurgery 5841 S. Maryland Ave. 9601 Lile Dr., Ste. 310 Winston-Salem, NC 27157-1029 Box 405 Chicago, IL 60637-1463 Little Rock, AR 72205 (336)716-4083 (773)702-6353 (501)224-0200 Gregory A. Brandenberg, MD, PhD Norman Neil Brown, MD, PhD Stephen D. Burstein, MD 3533 Southern Blvd., Ste. 3000 10989 N.W. 81st Manor 100 Merrick Rd., Ste. 128W Kettering, OH 45429 Parkland, FL 33076 Rockville Centre, NY 11570 (937) 299-8242 (909)425-0900 (516)255-9031 Jimmy C. Brasfield, MD Willis E. Brown Jr., MD David B. Bybee, MD, FACS Bristol Neurosurgical Assoc. 7523 Shadylane Drive 1524 McHenry Ave., Ste. 135 320 Bristol West Blvd., Ste. 2B San Antonio, TX 78209 Modesto, CA 95350 Bristol, TN 37620 (210)828-0023 (209)571-0288 (423)844-6407 Leonard A. Bruno, MD, FACS Robert J. Bye, MD Robert S. Bray Jr., MD 727 Welsh Rd., Ste. 108 109 Wild Grove Ln. 13160 Mindanao Way, Ste. 300 Huntingdon Valley, PA 19006 Longmeadow, MA 01106-2151 Marina Del Rey, CA 90292-7907 (215)914-2320 (413)567-1605 (310)854-3800 Michael Naldo Bucci, MD, FACS Edward B. Byrd, MD Kerry E. Brega, MD Piedmont Neurosurgical Group 2735 Royal Trace Ln. South Denver Neurosurgery 109 Montgomery Dr. Mount Pleasant, SC 29466-8124 7750 S. Broadway Ste. 150 Anderson, SC 29621-3333 Denver, CO 80122 (864)224-5700 Manuel A. Cacdac, MD (303)734-8650 Neurosurgery Martin J. Buckingham, MD 501 Hospital Ln., Ste. 100 James J. Brennan, MD Michigan Brain & Spine Inst. Terre Haute, IN 47802-4230 901 E. Cheves St., Ste. 420 5315 Elliott Dr., Ste. 102 (812)234-0787 Florence, SC 29506-2769 Ypsilanti, MI 48197-8634 (843)673-0122 (734)434-4110 Stephen K. Cagle, MD Neuroscience Specialists Kenneth C. Brewington II, MD James L. Budny, MD, FACS 4120 W. Memorial Rd., Ste. 300 Montana Neurological Assoc. Millard Fillmore Hospital Oklahoma City, OK 73120-9322 500 W. Broadway, Ste. 310 3 Gates Cir./Neurosurgery (405)748-3300 Missoula, MT 59802 Buffalo, NY 14209-1120 (406)728-6520 (716)887-5210 J. Michael Calhoun, MD, FACS 3500 Springhill Dr., Ste. 201 Rudy P. Briner, MD Kim J. Burchiel, MD, FACS North Little Rock, AR 72117-2948 Spinal & Neurological Surgery Assoc. Oregon Health & Science Univ. (501)771-2000 3201 University Dr. East, Suite 410 3181 S.W. Sam Jackson Park Rd., L472 Bryan, TX 77802-3479 Portland, OR 97239-3098 Arnold B. Calica, MD, PhD (979)776-8896 (503)494-6207 4139 E. Sandy Mountain Rd. Paradise Valley, AZ 85253 Anthony L. Brittis, MD James E. Burgess, MD, FACS (480)844-8550 18 Studio Arcade Alleghany Gen. Hospital Lake Ave. & Pondfield Rd. W. 420 E. North Ave., Ste. 302 James D. Callahan, MD Bronxville, NY 10708-2631 Pittsburgh, PA 15212-2340 St. Mary’s/Duluth Clinic (914) 961-8833 (412)359-6297 400 E. 3rd St. Duluth, MN 55804 Mario Brock, MD James P. Burke, MD, PhD (218)786-8364 Freie Universitat Berlin Allegheny Brain & Spine Surgeons Hindenburgdamm 30 501 Howard Ave., Bldg F-3 Travis H. Calvin, MD Berlin 12203 Altoona, PA 16601 1505 W. Ross Germany (814)946-9150 El Centro, CA 92243-9585 (30) 84452531 (760)353-1720 Mark G. Burnett, MD Douglas L. Brockmeyer, MD Barrow Neurological Inst. James N. Campbell, MD Primary Children’s Medical Center 2910 N. 3rd Ave. Johns Hopkins University Hospital 100 N. Medical Dr., Ste. 2400 Phoenix, AZ 85013 600 N. Wolfe St., Meyer 5-109 Salt Lake City, UT 84113-1103 (602)406-3000 Baltimore, MD 21287-0005 (801)588-3400 (410)955-2058 Daniel Bursick, MD, FACS Richard W. Broderick, MD Pittsburgh Neurosurgery Assoc. D. J. Canale, MD 880 W. Central Rd., #6100 1501 Locust St., Ste. 224 4639 Peppertree Ln. Arlington Heights, IL 60005 Pittsburgh, PA 15219-5128 Memphis, TN 38117-3920 (847)398-6464 (412)471-4772

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 96 MEMBERSHIP ROSTER

Issa S. Canavati, MD Israel P. Chambi-Venero, MD, FACS Bo-Young Cho Fort Wayne Neurological Center 801 N. Tustin Ave., Ste. 406 Nat’l Healthcare Insurance Med. Corp. 7910 W. Jefferson, Ste. 200 Santa Ana, CA 92705 Ilsan Hospital Fort Wayne, IN 46804-4159 (714)973-0810 Baekseok Dong Ilsan Ku (260)436-2416 Koyang Si Kyonggi Do 1232 Augusto R. Chavez, MD South Korea Mario P. Canlas, MD Invasive Spine Specialists (3) 19000580 731 W. Rivendale 20060 Governors Dr. Springfield, MO 65810-3117 Olympia Fields, IL 60461 Kyung Gi Cho, MD (417)269-5880 (708)283-2225 Ajou University Sch. of Med./Neuro. San 5 Woncheon-Dong Paldal-Gu Robert C. Cantu, MD, FACS Mokbel K. Chedid, MD, FACS Suwon 442749 John Cuming Bldg., Ste. 820 18181 Oakwood Blvd., Ste. 402 South Korea 131 Old Rd. to 9 Acre Corner Dearborn, MI 48124 (3) 12195661 Concord, MA 01742-4181 (313)436-2330 (978)369-1386 Paul H. Chodroff, MD Thomas C. Chen, MD, PhD 1455 Montego Dr., Ste. 200 Gregory W. Canute, MD LAC-USC Medical Center Walnut Creek, CA 94598-2990 SUNY Upstate Med. Univ. 1200 N. State St. Ste. 5046 (925)937-0404 750 E. Adams St./Neurosurgery Los Angeles, CA 90033-1029 Syracuse, NY 13210 (323)226-7421 Dean Chou, MD (315)464-5513 UCSF/Dept. of Neurosurgery Joseph S. Cheng, MD 505 Parnassus, M-799 Thomas A. Carlstrom, MD, PC, FACS 6541 Radcliff Dr. San Francisco, CA 94143 1215 Pleasant St., Ste. 608 Nashville, TN 37221 (415)353-9095 Des Moines, IA 50309 (615)322-1883 (515)241-5760 Tanvir F. Choudhri, MD Leo W. Cheng, MD Mount Sinai School of Medicine Carlos A. Carrion, MD 909 Hyde St., Ste. 609 1 Gustave L. Levy Pl./Box 1136 3800 E. Lincoln Dr. San Francisco, CA 94109 New York, NY 10029 Phoenix, AZ 85018 (415)673-3888 (212)241-8560 (602)840-8067 W. Bruce Cherny, MD Sean D. Christie, MD Richard L. Carter, MD, FACS 100 E. Idaho St., Ste. 202 Division of Neurosurgery 1796 Summer 5487 Walden Bay Dr. Boise, ID 83712 St. Rm. 3808 Halifax, NS B3H-3A7 Waunakee, WI 53597 (208)381-7360 Canada (608)242-9666 Randall M. Chesnut, MD, FACS (902)473 2096 John R. Caruso, MD, FACS Univ. of Washington/Neurosurgery Gordon K-T Chu, MD, MSc Neurosurgical Specialists LLC 325 9th Ave., Box 359924 Toronto Western Hospital 1150 Professional Ct., Ste. C Seattle, WA 98104 399 Bathurst St. #12-407 Hagerstown, MD 21740-5852 (206)744-9300 Toronto, ON M5T-2S8 (301)797-9240 John H. Chi, MD Canada Ernesto Carvallo-Cruz, MD, FACS University of California - San Francisco (416)603 5229 Av. San Juan Bosco Con 6ta. 505 Parnassus Ave., M779 Richard V. Chua, MD Transversal Altamira Box 0112 NorthWest Neuro Specialists PLLC Caracas San Francisco, CA 94143 5860 N. La Cholla Blvd. Venezuela (415)353-3904 Tucson, AZ 85741 (2) 287 0443 Bennie W. Chiles, III, MD, FACS Young Chung, MD Steven Casha, MD, PhD 280 North Central Ave., Suite 235 209 Spring Creek Rd. 330 Hospital Dr. N.W. Westchester Spine and Brain Surgery, PLLC Barrington, IL 60010 Calgary, AB T2N-4N1 Hartsdale, NY 10530 (847)695-6611 Canada (914)332-0396 (403)283 4449 John M. Cilluffo, MD John C. Chiu, MD 1221 6th St., Ste. 303 Joseph C. Cauthen, MD 1001 Newbury Rd. Traverse City, MI 49684 Neurosurgical & Spine Associates Newbury Park, CA 91320-6434 (616)348-2811 6510 N.W. 9th Blvd., Ste. 1 (805)375-7900 Gainesville, FL 32605-4245 Jonathan S. Citow, MD, FACS (352)331-0811 Anthony Alfred Chiurco, MD 755 S. Milwaukee Ave., Ste. 223 Bldg. 4, Ste. 201 Libertyville, IL 60048 Luis A. Cervantes, MD, FACS 3131 Princeton Pike (847)362-1848 110 Marter Ave., Ste. 309 Lawrenceville, NJ 08648-2201 Moorestown, NJ 08057-3124 (609)895-8898 Charles B. Clark, III, MD (856)727-1000 2955 Harrison, Ste. 203 Beaumont, TX 77702 (409)899-4999

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEMBERSHIP ROSTER 97

Charles H. Clark, III, MD Judson H. Cook, MD, MS John T. Cummings Jr., MD 833 St. Vincent’s Dr., Ste. 503 1950 Bluegrass Cir., #170 Community Hospital E. Prof. Bldg. Birmingham, AL 35205 Cheyenne, WY 82009 1400 N. Ritter Ave., Ste. 479 (205)933-8981 (307)778-2860 Indianapolis, IN 46219-3050 (317)355-1020 Lawrence E. Clark, MD Paul R. Cooper, MD 4000 14th St., Ste. 302 New York Univ. Med. Ctr. David L. Cunningham, MD Riverside, CA 92501 550 1st Ave. Semmes Murphey Clinic (909)682-3583 New York, NY 10016-6402 1211 Union Ave., Ste. 200 (212)263-6514 Memphis, TN 38104-3527 Ronald D. Clark, MD (901)726-6868 1512 Waterfront Dr. Gregory Corradino, MD Windsor, CO 80550-6198 999 Executive Park Blvd., Ste. 102 Otis D. Curling, MD, MBA (970)330-6996 Kingsport, TN 37660 Winston Neurol. & Spinal Surg. Assoc. (423)578-1518 149 N. Cherry St. W. Craig Clark, MD, PhD Kernersville, NC 27284-2823 55 Physician Ln., Ste. 1 Walter C. Cotter, MD (336)992-0455 Southaven, MS 38671-6102 3702 S.E. Starboard Ln. (662)349-5660 Stuart, FL 34997-6136 Joseph F. Cusick, MD Medical College of Wisconsin Richard Alan Close, MD, FACS Jean-Valery C. E. Coumans, MD 9200 W. Wisconsin Ave. Spine & Brain Neurosurgery Ctr. Massachusetts Gen. Hospital Milwaukee, WI 53226-3522 601 Spruce St. 15 Parkman St. WACC 021 (414)805-5405 West Reading, PA 19611-1443 Boston, MA 02114-3133 (610)375-4567 (617)726-3511 Scott G. Cutler, MD 4726 N. Habana, Ste. 201 Craig T. Coccia, MD George J. Counelis, MD Tampa, FL 33614-7144 Neuroscience Center 5483 Fernhoff Rd. (813)874-9922 580 W. College Ave. Oakland, CA 94619-3140 Marquette, MI 49855 (215)509-7775 George R. Cybulski, MD, FACS (906)225-4575 Galter Pavilion Christopher Covington, MD 201 E. Huron, Ste. 11-130 Benjamin R. Cohen, MD 1919 S. Wheeling, Ste. 600 Chicago, IL 60611-2957 1299 Corporate Dr., Apt.# 608 Tulsa, OK 74104-0000 (312)926-1960 Westbury, NY 11590 (918)749-0762 (516)255-9031 Ralph G. Dacey Jr., MD Lansing S. Cowles, MD Washington Univ./Neurosurgery Geoffrey P. Cole, MD 101 Blue Ridge Rd. 660 S. Euclid Ave. 293 McWhorter Dr. Louisville, KY 40223 Box 8057 Athens, GA 30606 St. Louis, MO 63110 (706)372-0648 George F. Cravens, III, MD Center for Neurologic Disorders (314)362-5039 Eugene Collins, MD 1319 Summit Ave., Ste. 200 Andrew T. Dailey, MD 1333 W. Lombard Fort Worth, TX 76102 Rocky Mountain Surgical Alliance Davenport, IA 52804-2101 (817)336-0551 701 E. Hampden Ave., Ste. 510 (319)322-6666 Jeffrey L. Crecelius, MD Englewood, CO 80113 Benedict Joseph Colombi, MD 2182 Tecumseh Park Ln. (303)788-4000 Univ. Hospital of Cleveland West Lafayette, IN 47906-2183 Mark D. D’Alise, MD, FACS 11100 Euclid Ave./Neurosurgery (765)448-8000 3601 21st St. Cleveland, OH 44106-1736 Lubbock, TX 79410 (216)844-8758 John R. Crockarell, MD 2645 Halle Pkwy. (806)793-8575 Christopher H. Comey, MD Collierville, TN 38017-8802 Charles M. D’Angelo, MD New England Neurological Assoc. LLC 5106 CTHZ 300 Carew St., Ste. 1 Paul D. Croissant, MD Neuro Pain Consultants Spring Green, WI 83588 Springfield, MA 01104 (312) 942-6644 (413)781-2211 44555 Woodward Ave., Ste. 406 Pontiac, MI 48341 Guy O. Danielson, III, MD Edward S. Connolly, MD (248)335-6129 NeuroCare Network Ochsner Clinic Foundation 1814 Roseland Blvd., 2nd Fl. 1514 Jefferson Hwy. Brian G. Cuddy, MD, FACS Charleston Neurosurgical Assoc. Tyler, TX 75701-2016 New Orleans, LA 70121-2429 (903)595-8077 (504)842-4033 2145 Henry Tecklenburg Dr. #220 Charleston, SC 29414 Stephen J. Dante, MD Louis W. Conway, MD (843)723-8823 360 Station Ave. 12816 N. 71st St. Haddonfield, NJ 08033-3721 Scottsdale, AZ 85254-5379 (215)955-7000

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 98 MEMBERSHIP ROSTER

Kaushik Das, MD Stephen O. Dell, MD Dzung Hong Dinh, MD, FACS St. Vincent’s Hospital Neuromuscular Consultants Univ. of Illinois at Peoria 153 W. 11th St., Ste. NR809 411 30th St., Ste. 508 719 N. William Kumpf Blvd., Ste. 100 New York, NY 10011-8305 Oakland, CA 94609-3303 Peoria, IL 61605-2513 (212)604-7767 (510)832-5496 (329)676-0766 Arthur Steven Daus, MD Peter K. Dempsey, MD Arthur J. DiPatri Jr., MD Midwest Neurosurgery Center Lahey Clinic 2015 Beechwood Ave. 1111 McIntosh Cir. Dr., Ste. 305 41 Mall Rd. Wilmette, IL 60091 Joplin, MO 64804-3639 Burlington, MA 01805-0001 (773)880-4373 (417)624-7700 (781)744-8698 David A. Ditsworth, MD Larry S. Davidson, MD Duane W. Densler, MD 442 S. Canon Dr. Eastern Neurosurgical & Spine Assoc. Inc. University of Louisville Beverly Hills, CA 90212 2325 Stantonsburg Rd. 210 E. Gray St., Ste. 1102 (310)551-0690 Greenville, NC 27834-7534 Louisville, KY 40202 (252)752-5156 (812)948-6309 A. Allan Dixon, MD 999 N. Tustin Ave., Ste. 109 Jordan K. Davis, MD Paul W. Detwiler, MD Santa Ana, CA 92705-6504 1905 Clint Moore Rd., Ste. 309 Tyler Neurosurgical Assoc. P.A. (714)564-1100 Boca Raton, FL 33496-2658 700 Olympic Plaza, Ste. 850 (561)988-8577 Tyler, TX 75701-1951 William R. Dobkin, MD (903)595-2441 361 Hospital Rd., Ste. 521 Arthur L. Day, MD, FACS Newport Beach, CA 92663 Brigham & Womens Hospital Darryl J. Di Risio, MD (714)646-2998 75 Francis St./Neurosurgery Albany Medical College Boston, MA 02115 47 New Scotland Ave. MC-61 George J. Dohrmann, MD, PhD (617)525-7777 Albany, NY 12208 University of Chicago (518)262-5088 5841 S. Maryland Ave., MC 3026 Don Robert De Feo, MD, FACS Chicago, IL 60637-1463 2617 E. Chapman, Ste. 201 Fernando G. Diaz, MD, PhD (773)702-6159 Orange, CA 92869 University NeuroSurgical Assoc. PC (714)639-3780 29275 Northwestern Hwy., Ste. 100 Devanand A. Dominique, MD Southfield, MI 48034 Temple University/Neurosurgery Alain C. J. De Lotbiniere, MD, FRCSC F (248)784-3718 3401 N. Broad St., Ste. 580 Yale-New Haven Med. Ctr. Philadelphia, PA 19140 333 Cedar St./Neurosurgery Phillip S. Dickey, MD (215)707-7700 New Haven, CT 06520-8082 New Haven Neurosurgical Assoc. (203)785-2808 60 Temple St., Ste. 4C Ronald J. Donaldson, MD New Haven, CT 06510-2716 700 Olympic Plaza Cir., Ste. 850 Alonso Luis De Sousa, MD (203)772-4001 Tyler, TX 75701-1954 R. Walter Jose Pasoline #63 (903)595-2441 Enseada do Sua Curtis A. Dickman, MD Vitoria, ES 29050490 Barrow Neurological Inst. Jose Dones-Vazquez, MD Brazil 2910 N. 3rd Ave. 3106 Indian Wells (02) 732 43800 Phoenix, AZ 85013-4434 Harlingen, TX 78550 (602)406-3932 (956)425-3164 David F. Dean, MD Texas Neurosciences Inst. Robert E. Dicks, III, MD Daniel Joseph Donovan, MD 4410 Medical Dr., Ste. 500 1021 Woodhollow Ln. 2228 Liliha St., Ste. 208 San Antonio, TX 78229-3755 Athens, GA 30606 Honolulu, HI 96817 (210)616-0795 (716)548-2767 (808)537-5900 H. Gordon Deen Jr., MD Donald D. Dietze Jr., MD Terence P. G. Doorly, MD, FACS Mayo Clinic Jacksonville PO Box 2290 North Shore Neurosurgery & Spine 4500 San Pablo Rd. LaCombe, LA 70445-2290 4 Centennial Dr. Jacksonville, FL 32224-1865 (985)871-4114 Peabody, MA 01960 (904)953-2103 (972)744-1920 James D. Dillon, MD Tomas E. Delgado, MD 1301 First Colonial Rd., Ste. 200 B Clifford C. Douglas, MD, PhD 6747 Gall Blvd. Virginia Beach, VA 23454 4000 14th St., Ste. 302 Zephyrhills, FL 33542-2522 (757)963-2881 Riverside, CA 92501 (813)782-1070 (951)682-3583 Daniel John DiLorenzo, MD, PhD, MBA NeuroBionics Corp. Richard A. Douglas, MD, FACS 140 4th Ave. N., Ste. 370 W.V. Neurosurgery & Spine Ctr. Seattle, WA 98109 4 Hospital Plaza, Ste. 103 (206)267-3700 Clarksburg, WV 26301-9327 (304)623-4800

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEMBERSHIP ROSTER 99

Aiden J. Doyle, MD Stewart B. Dunsker, MD Maged Ali Elhefnawi, MD 10 Cleveland Ln. 551 Abilene Trl. El-Sharkia Princeton, NJ 08540-3050 Cincinnati, OH 45215-2550 PO Box 49 (609)924-6131 (513)569-5212 El-Zagazig Egypt James M. Drake, MD James F. Dupre, MD Hospital for Sick Children 2151 Imperial Cir. William Jeffrey Elias, MD 555 University Ave., #1504-D Naples, FL 34110-1038 Univ. of Virginia Health Systems Toronto, ON M5G-1X8 (941)513-0723 Box 800212/Neurosurgery Canada Charlottesville, VA 22908-0212 (416)813-6125 Andrievs J. Dzenitis, MD (434)924-0451 591 Sunset Rd. William H. Druckemiller Jr., MD Louisville, KY 40206-2926 Richard G. Ellenbogen, MD, FACS 85 Seymour St., Ste. 707 (502)895-9130 5706 63rd Ave. N.E. Hartford, CT 06106 Seattle, WA 98105-2040 (860)246-1636 Calvin B. Early, MD, PhD, FACS (206)744-9300 9311 Ball Rd. Stephan Jean du Plessi, MD Ijamsville, MD 21754-9537 J. Paul Elliott, MD 1403 29th St. N.W. (717)263-3850 RMNA Calgary, AB T2N-2T9 701 E. Hampden Ave., #510 Canada James M. Ecklund, MD, FACS Englewood, CO 80110-2776 (403)944 4776 6425 Manor View Dr. (303)788-4000 Laytonsville, MD 20882 Jose G. Duarte, MD (202)782-9804 Henry J. Elsner, MD, FACS 89 Manor Ln. Guilford Neurosurgical Assoc. Dayton, OH 45429-5456 Fredric L. Edelman, MD 1313 Carolina St., Ste. 300 6815 Noble Ave., Ste. 410 Greensboro, NC 27401-1207 Luis E. Duarte, MD, FACS Van Nuys, CA 91405 (336)272-4578 102 N. Magdalen St. (818)781-3350 San Angelo, TX 76903-5400 Harry P. Engel, MD (915)481-2193 Alan Stewart Edelman, MD 57 Cherry St. 1300 E. Cypress, Ste. C-2 Milford, CT 06460-3414 Thomas B. Ducker, MD Santa Maria, CA 93454 (203)874-8268 2002 Medical Pkwy., #430 (805)928-0838 Annapolis, MD 21404-3263 Jerry Engelberg, MD (410)266-2720 Walter C. Edwards, MD Semmes Murphey Clinic 2876 Wyngate, N.W. 6325 Humphreys Blvd. Kent R. Duffy, MD Atlanta, GA 30305 Memphis, TN 38120 Neurosurgeons of New York (404) 355-1167 (901)522-2668 244 Westchester Ave., Ste. 310 White Plains, NY 10604 James Egnatchik, MD, FACS David J. Engle, MD, FACS (914)948-2288 Buffalo Neurosurgery Group Pittsburgh Neurosurgery Assoc. 550 Orchard Park Rd., Ste. A105 1501 Locust St., Ste. 224 Neil Duggal, MD West Seneca, NY 14224-2654 Pittsburgh, PA 15219-5128 1544 Gloucester (716)677-5005 (412)471-4772 London, ON N6G-2S6 Canada Eldan B. Eichbaum, MD Charles F. Engles, MD (519)663 2926 525 Doyle Park Dr., Ste. 102 4120 W. Memorial Rd., Ste. 208 Santa Rosa, CA 95405-4516 Oklahoma City, OK 73120-9322 Scott C. Dulebohn, MD (707)523-1873 (405)235-0559 1705 Ocean Blvd. S.E., Ste. B Coos Bay, OR 97420 Chris E. Ekong, MD Douglas M. Enoch, MD (541)267-4429 Medical Office Wing 3921 Wycombe Dr. 1440 14th Ave.. Ste. 122 Sacramento, CA 95864-6021 Scott T. Dull, MD, FACS Regina, SK S4P-0W5 (916)631-0112 Neurosurgical Network Inc. Canada 2222 Cherry St., Ste. M200 (306)781 7229 Nancy Epstein, MD, FACS Toledo, OH 43608 Long Island Neurosurgical Assoc. (419)251-1155 Mohamed Nagy El Wany, MD 410 Lakeville Rd.. Ste. 204 Elmadina Eltebiah Block B New Hyde Park, NY 11042-1101 Jack Hibbard Dunn, MD Alexandria 21411 (516)354-3401 4753 E. Camp Lowell Dr. Egypt Tucson, AZ 85712-1256 (5) 467 271 Franco Erculei, MD (520)881-8400 11520 Cannon Falls Ave. Nasser M. F. El-Ghandour, MD Las Vegas, NV 89138-1585 Robert J. Dunn, MD 81 Nasr Rd. (702)873-2533 1520 S. Dobson, Ste. 318 Nasr City Mesa, AZ 85202-4727 Cairo Scott Clements Erwood, MD (480)994-8586 Egypt 285 Boulevard St. N.E., Ste. 140 (2) 401 5535 Atlanta, GA 30312-0000 (404)265-1044

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 100 MEMBERSHIP ROSTER

Ghasem E. Eshaghi, MD Michael G. Fehlings, MD, PhD, FRCS James E. Finn, MD 514 Coachwood Ct. Toronto Western Hospital PO Box 885 Newtown, PA 18940-4203 399 Bathurst St., #4W-449 Middlebury, CT 06762 (215)955-1010 Toronto, ON M5T-2S8 (203)758-2253 Canada Eric Eskioglu, MD (416)603-5627 S. Sam Finn, MD 1015 Clayton Ave. Baylor Healthcare System Nashville, TN 37204 Frank Feigenbaum, MD 3600 Gaston Ave., Ste. 856 (352)219-1782 Midwest Neurosurgery Associates Dallas, TX 75246-1800 6420 Prospect Ave., Ste. T411 (214)823-2161 K. Dewayne Eubanks, MD Kansas City, MO 64132-1180 1513 Market Pl. (816)363-2500 Howard Lee Finney, MD Jonesboro, AR 72401 Box 1408 (870)931-0655 Joel A. Feigenbaum, MD Seeley Lake, MT 59865 7741 Hansen Rd. N.E. Marco T. Eugenio, MD Bainbridge Island, WA 98110-1614 Amory J. Fiore, MD 25081 Goldcrest Dr. Orthopaedic & Neurosurgery Specialists Bonita Springs, FL 34134-7952 James R. Feild, MD 6 Greenwich Office Park Mid-South Neurosurgical Clinic Greenwich, CT 06831 Bruce A. Everett, MD 234 Germantown Bend Cove (203)869-1145 8404 La Sierra Cordova, TN 38018-7237 Whittier, CA 90605-1222 (901)757-4199 Robert T. Fitzgerald, MD (909)427-7245 202 CR 450 John A. Feldenzer, MD, FACS Hondo, TX 78861 Charles A. Fager, MD McVitty Evecutive Ctr. (830) 741-5040 Lahey Clinic 2766 Electric Rd., Ste. A 41 Mall Rd. Roanoke, VA 24018 Brian C. Fitzpatrick, MD Burlington, MA 01803-4136 (540)989-6516 7301 E. 2nd St., Ste. 106 (781)744-5677 Scottsdale, AZ 85251-5609 Francis M. Fennegan, MD, FACS (480)425-8004 William Brenton Faircloth, MD 5505 S. Expressway 77, Ste. 300 Coastal Neurological Inst. Harlingen, TX 78550-3224 Robert E. Flandry Jr., MD, FACS PO Box 160848 (956)423-0020 1075 Boiling Springs Rd. Mobile, AL 36616 Spartanburg, SC 29303-2201 (334)450-3700 Richard G. Fessler, MD, PhD (864)542-0929 Univ. of Chicago/Neurosurgery Thomas B. Falloon, MD 5841 S. Maryland Ave., MC 3026 Thomas B. Flynn, MD 3116 Dunbar Rd. Chicago, IL 60637 The NeuroMedical Ctr. St. Cloud, MN 56301-9607 (773)702-9385 10101 Park Rowe Ave., Ste. 200 (320)492-0732 Baton Rouge, LA 70810 Henry Feuer, MD (225)769-2200 Jacques N. Farkas, MD, FACS Indianapolis Neurosurgical Group 701 Seaview Dr. 1801 N. Senate Blvd., Ste. 535 Kevin T. Foley, MD Juno Beach, FL 33408 Indianapolis, IN 46202-1228 Semmes Murphey Clinic (561)882-6060 (317)396-1205 1211 Union Ave., Ste. 200 Memphis, TN 38104-3527 Albert W. Farley, MD E. Malcolm Field, MD (901)516-0742 1121 Crandon Blvd., Apt. F601 Saginaw Valley Neurosurgery Key Biscayne, FL 33149-2781 4677 Towne Centre Rd., Ste. 301 Shee Yan Fong, FRCS (517)876-7619 Saginaw, MI 48604-2806 104/#23-60 (989)799-8712 Jalan Rajah Nasrollah Fatehi, MD Singapore Atlantic Neurosurgery Aaron G. Filler, MD, PhD (403)289 2885 1020 Independence Blvd., Ste. 210 Inst. for Nerve Medicine Virginia Beach, VA 23455-5500 2716 Ocean Park Blvd., #3082 Modesto Fontanez, MD, JD, FACS (757)460-0455 Santa Monica, CA 90405 PO Box 1466 (310)314-6410 Findlay, OH 45839-1466 Mahmood Fazl, MD (419)423-8881 Sunnybrook Hospital/Neurosurgery Frederick E. Finger, III, MD 2075 Bayview Ave., Ste. 138A Carolina Neurosurgery & Spine Assoc. Mina Foroohar, MD Toronto, ON M4N-3M5 225 Baldwin Ave. 880 W. Central Rd., Ste. 3200 Canada Charlotte, NC 28204-3109 Arlington Heights, IL 60005 (416)480 4741 (704)371-5129 (847)398-9100 Stephen L. Fedder, MD, FACS Lawrence H. Fink, MD, FACS Daryl R. Fourney, MD FRCSC Lankenau Medical Bldg. E. Sarasota Medical Centre Royal University Hospital 100 E. Lancaster Ave., Ste. 655 5741 Bee Ridge Rd., Ste. 530 103 Hospital Dr./Neurosurgery Wynnewood, PA 19096-3425 Sarasota, FL 34233-5061 Saskatoon, SK S7N-0W8 (610)649-4416 (941)379-3030 Canada (306)966 8814

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEMBERSHIP ROSTER 101

Wesley C. Fowler, III, MD Allan H. Freidman, MD, FACS Vishal C. Gala, MD Mountain Neurological Ctr. Duke University Medical Center 2968 Barclay Way 7 Vanderbilt Park Dr. Box 3807/Neurosurgery Ann Arbor, MI 48105 Asheville, NC 28803-0000 Durham, NC 27710 (734)516-8163 (828)255-7776 (919)684-3271 Michael R. Gallagher, MD Andrew Fox, MD Anthony K. Frempong-Boadu, MD Neurosurgical Group of Chattanooga 2800 L St., Ste. 500 New York Univ. Med. Ctr. 1010 E. 3rd St., Ste. Sacramento, CA 95816 550 1st Ave. 202 Chattanooga, TN 37403-2174 (916)454-6918 New York, NY 10016 (423)265-2233 (212)263-6514 Mark W. Fox, MD, PC Daniel D. Galyon, MD, FACS 1210 W. 18th St., Ste. 204 Barry N. French, MD Southern New York Neurosurgical Group Sioux Falls, SD 57104 Northern California Neurol. Surgeons Inc. 46 Harrison St. (605)367-9320 2801 K St., Ste. 300 Johnson City, NY 13790-2142 Sacramento, CA 95816 (607)729-4942 Robert H. Fox, MD (916)733-5028 2530 N. 8th St., Ste. 201 Francis W. Gamache Jr., MD Grand Junction, CO 81501-8856 Kathleen B. French, MD Neuroscience Institute (970)241-6990 3020 Hamaker Ct., Ste. B104 523 E. 72nd St., 7th Fl. Fairfax, VA 22031-2220 New York, NY 10021-4099 Paul C. Francel, MD, PhD (703)641-4877 (212)988-5200 3048 S.W. 89th St., Ste. C Oklahoma City, OK 73159-6359 Marc H. Friedberg, MD, PhD Edward O. Gammel, MD (405)424-5634 Neurosurgial Consultants Inc. 3644 Mission Ave. 825 Washington St., Ste. 100 Carmichael, CA 95608-2933 Joel Ira Franck, MD, PA Norwood, MA 02062 (916)482-8090 1180 Lisbon St., Ste. 101 (781)769-4640 Lewiston, ME 04240-5059 Yogesh N. Gandhi, MD (207)784-1730 Marvin E. Friedlander, MD, FACS J.H.S. Hospital Cook County The Back Institute 1901 W. Harrison/Neurosurgery Edmund Frank, MD, FACS 700 Rahway Ave., 2nd Fl. Chicago, IL 60612 Oregon Hlth. Sci. Univ. L472 Union, NJ 07083 (312)633-6328 3181 S.W. Sam Jackson Park Rd. (908)688-8800 Portland, OR 97201-3011 Kenneth M. Gang, MD (503)494-4314 Phillip Friedman, MD, FACS 15 Talcott Rd. 30200 Telegraph Rd., #179 Rye Brook, NY 10573-1420 Bruce M. Frankel, MD Bingham Farms, MI 48025 (914) 428-7296 8675 Classic Dr. (248)258-1919 Memphis, TN 38125 Aruna Ganju, MD (901)522-7788 Michael D. Fromke, MD Northwestern Univ. Med. Sch. 930 E. Emerald Ave., Ste. 611 675 N. St. Clair St., #2210 Justin F. Fraser, MD Knoxville, TN 37917 Chicago, IL 60611 Dept. of Neurological Surgery (865)633-8054 (312)695-6277 525 E. 68th St. Box 99 Stanley W. Fronczak, MD, JD, FACS William F. Ganz, MD, FACS New York, NY 10021 413 Suffolk Ln. Neurosurgery & Spine Northwest (212)746-4684 Oak Brook, IL 60523 2236 N. Merritt Creek Loop, Ste. A (630)655-1229 Coeur d’Alene, ID 83814 Lawrence J. Frazin, MD, FACS (208)664-5467 Euclid Med. Bldg./Neuro. Surgery SC Karsten Fryburg, MD 3201 S. 16th St., Ste. 2025 Univ. of Arizona Med. Ctr. Jason E. Garber, MD Milwaukee, WI 53215 1501 Campbell Ave. Western Reg. Ctr. for Brain & Spine Surg. (414)645-8977 Tucson, AZ 85724 3061 S. Maryland Pkwy., #200 (520)626-2646 Las Vegas, NV 89109-6227 Craig A. Fredericks, MD (702)737-1948 South Georgia Neurosurgical Inst. Kimball S. Fuiks, MD 704 S. Broad St. 17280 W. North Ave., Ste. 204 Javier Garcia-Bengochea, MD Thomasville, GA 31792-6107 Brookfield, WI 53045 Lyerly Neurosurgical Assoc. (229)226-8880 (262)784-4205 2151 Riverside Ave. Jacksonville, FL 32204-4416 Richard E. Freeman, MD Thomas Duane Fulbright, MD (904)388-6516 Minimally Invasive Spine Specialists Neurosurgical Group of Chattanooga 20060 Governors Dr. 1010 E. 3rd St., Ste. 202 Stephen R. Gardner, MD, FACS Olympia Fields, IL 60461 Chattanooga, TN 37403-2157 Southeastern Neurosurgical & Spine Inst. (708)283-2225 20 Medical Ridge Dr. Ching F. Fung, MD Greenville, SC 29605-5605 Stephen R. Freidberg, MD U of Hong Kong/Queen Mary Hospital (864)295-3600 Lahey Clinic Div. of Neurosurgery/Dept. of Surgery 41 Mall Rd. Burlington, MA 01805-0001 Hong Kong (781)744-8643 Hong Kong

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 102 MEMBERSHIP ROSTER

Guy W. Gargour, MD Ramsis F. Ghaly, MD, FACS Holly S. Gilmer-Hill, MD Lakeside Professional Bldg. 11136 Indian Woods Dr. Pediatric Neurosurgery 10401 Hospital Dr., Ste. 101 Indian Head Park, IL 60525-4980 3901 Beaubien, 2nd Fl. Clinton, MD 20735 (630)978-6793 Detroit, MI 48201-2119 (301)856-2323 (313)833-4490 Abdi S. Ghodsi, MD Lloyd M. Garland, MD 1212 Garfield Ave., Ste. 300 Arun R. Ginde, MD 2108 Topeka Ave. Parkersburg, WV 26101-3207 3700 Paxmore Ct. Lubbock, TX 79407-0000 (304)865-3600 Upper Marlboro, MD 20772-7700 (806)795-9916 Zoher Ghogawala, MD Howard J. Ginsberg, MD, PhD, FRCS Wallace K. Garner, MD Greenwich Neurosurgery Div. of Neurosurgery Hampton Rds. Neurosurgery & 75 Holly Hill Ln. 38 Shuter St., 5th Fl. Spine Ctr. Inc. Greenwich, CT 06830 Toronto, ON M5B-1A6 730 Thimble Shoals Blvd, #110 (203)661-3333 Canada Newport News, VA 23606-2574 (416)864 5703 (757)595-7608 Sanjay Ghosh, MD 6645 Alvarado Rd., Ste. 4000 Narni R. Giri, MD John Joseph Gartman Jr., MD San Diego, CA 92120 127 Kingswood Ct. 139 Eastwood Dr. (619)229-3105 Cherry Hill, NJ 08034-1333 Johnson City, NY 13790-4317 (609)755-1030 (607)729-4942 Peter G. Gianaris, MD 8333 Naab Rd., Ste. 250 Franz E. Glasauer, MD Marilyn L. G. Gates, MD Indianapolis, IN 46260 187 Bridle Path Henry Ford Hospital/Neurosurgery (317)396-1300 Williamsville, NY 14221 2799 W. Grand Blvd. (716)898-3809 Detroit, MI 48202 Kevin J. Gibbons, MD, FACS (313)916-2682 Millard Fillmore Hospital Andrew S. Glass, MD, FACS 3 Gates Cir./Neurosurgery 7901 Bayshore Dr. Lynn M. Gaufin, MD Buffalo, NY 14209-1120 Margate, NJ 08402 Utah Neurological Clinic (716)887-5200 (609)653-9110 1055 N. 300 W., Ste. 400 Provo, UT 84604-3344 Scott Randall Gibbs, MD, FACS Ryan S. Glasser, MD (801)379-7400 Brain & Neurospine Clinic NeuroSurgery & Spine Specialists 60 Doctors Park, Ste. 103 5831 Bee Ridge Rd., Ste. 100 Guy F. Gehling, MD Cape Girardeau, MO 63703-4928 Sarasota, FL 34233-5089 PO Box 1663 (573)339-1957 (941)366-5880 Walla Walla, WA 99362 (509)522-1030 Michael Gieger, MD John C. Godersky, MD Neurosurgery Institute of South Texas Anchorage Neurosurgical Associates Fred H. Geisler, MD, PhD 3643 S. Staples 3220 Providence Dr., Ste. E3-020 2020 Ogden Ave., Ste. 335 Corpus Christi, TX 78411-2456 Anchorage, AK 99508 Aurora, IL 60504 (361)561-1387 (907)258-6999 (630)236-4303 F. Gary Gieseke, MD, FACS Ziya L. Gokaslan, MD, FACS Mark B. Gerber, MD 1930 N.E. 47th St., Ste. 200 Johns Hopkins University Hospital Neuroscience & Spine Associates Fort Lauderdale, FL 33308-7786 600 N. Wolfe St., Meyer 7-109 670 Goodlette Rd. (954)771-4251 Baltimore, MD 21287 Naples, FL 34102 (443)287-4934 (941)649-8833 Philip L. Gildenberg, MD, PhD, FAC 3776 Darcus St. Gerald Nathan Gold, MD Mark S. Gerber, MD Houston, TX 77005-3704 1509 Harvard Ct. N.E. The Straub Clinic & Hospital (713)664-2246 Albuquerque, NM 87106-3712 888 S. King St., Palma 4 (505)255-0555 Honolulu, HI 96813 Wilbur M. Giles, MD (808)522-4476 9601 Lile Dr., Ste. 750 Mark A. Gold, MD, FACS Little Rock, AR 72205 Summit Professional Plaza Peter C. Gerszten, MD, MPH (501)225-0880 1111 Glynco Pkwy., 3rd Fl. Univ. of Pittsburgh Med. Ctr. Brunswick, GA 31525-7922 200 Lothrop St., Ste. B-400 Garrett G. Gillespie, MD (912)262-6552 Pittsburgh, PA 15213-2582 PO Box 3431 (412)647-0958 Nashua, NH 03061-3431 Robert P. Goldfarb, MD (508)420-9062 4753 E. Camp Lowell Dr. Stephen Z. Gervin, MD Tucson, AZ 85712-1256 2301 N. University Dr., Ste. 210 Arthur M. Gilman, MD (520)881-8400 Pembroke Pines, FL 33024-3617 101 Old Short Hills Rd., Ste. 409 (954)961-3365 West Orange, NJ 07052-1000 Marc S. Goldman, MD (973)322-6732 2000 10th Ave.,Ste. 100 Columbus, GA 31901 (706)321-9300

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEMBERSHIP ROSTER 103

Stephen I. Goldware, MD, FACS Ravindra N. Goyal, MD, FACS Robert L. Grubb Jr., MD 501 West St Mary Blvd., Ste. 320 601 Mulholland Washington University/Neurosurgery Lafayette, LA 70506 Bay City, MI 48708-4208 660 S. Euclid Ave. (337)233-8000 (517)894-4442 Box 8057 St. Louis, MO 63110-1010 Francisco Bras Gomes, MD Paul A. Grabb, MD (314)362-3567 17940 Gulf Blvd., Ste. 9A 1725 E. Boulder, Ste. 104 Redington Shores, FL 33708-1171 Colorado Springs, CO 80909 John Peter Gruen, MD (813)874-7217 (719)365-5888 LAC-USC Medical Center 1200 N. State St., Ste. 5046 Heldo Gomez, Jr., MD Stanley Grabias, MD Los Angeles, CA 90033-1029 3370 Burns Rd., Ste. 200 2201 Ridgewood Rd., #200 (323)226-7421 Palm Beach Gardens, FL 33410-0000 Wyomissing, PA 19610 (561) 627-7855 (610)373-9631 Robert A. Gruesen, MD 20007 698th Ave. E. Gabriel A. Gonzales-Portillo, MD, FACS M. Sean Grady, MD Bradenton, FL 34211-8101 4726 N. Habana Ave., Ste. 103 University of Pennsylvania Tampa, FL 33614 3400 Spruce St./Neurosurgery George Gruner, MD (813)879-4328 Philadelphia, PA 19104-4204 909 Hioaks Rd., Ste. A (215)349-8325 Richmond, VA 23225-4038 Salvador Gonzalez-Cornejo, MD (804)320-5778 Hospital Civil de Guadalajara Barth A. Green, MD, FACS Fray Antonio Alcalde Lois Pope LIFE Center Martin E. Gryfinski, MD Av. Chapultepec Sur 130-204 1095 N.W. 14th Ter., D4-6 Midwest Ortho. & Neurosurgery Spec. Guadalajara, JAL 44140 Miami, FL 33136-2104 2111 Midlands Ct. Mexico (305)243-3562 Sycamore, IL 60178 (3) 630 - 3033 Jonathan Greenberg, MD John J. Guarnaschelli, MD Hubert Lee Gooch, Jr., MD Ste. 201 500 Delaney Ave. 1 Medical Plaza, Ste. 505 523 Brookdale Dr. Orlando, FL 32801 225 Abraham Flexner Way Statesville, NC 28677 (407)648-9500 Louisville, KY 40202-1846 (704)795-6471 (502)584-4121 Richard P. Greenberg, MD, PhD Robert Goodkin, MD 520 Lewis Farm Rd. Cesar E. Guerrero, MD Univ. of Washington Bessemer City, NC 28016 3661 S. Miami Ave., Ste. 709 325 9th Ave., Box 359766 (704)487-1922 Miami, FL 33133 Seattle, WA 98195-6470 (305)856-9517 (206)744-9300 Jerry H. Greenhoot, MD 842 Cherokee Rd. Bernard H. Guiot, MD Jack Goodman, MD Charlotte, NC 28207-2308 Univ. of South Florida/Neurosurgery Mary Tower Bldg. (704)338-9104 4 Columbia Dr.,Ste. 730 9 Livingston St., Ste. 5 Tampa, FL 33606-3568 Poughkeepsie, NY 12601-4719 Kent Grewe, MD (813)259-0956 (914)454-0415 501 N. Graham St., Ste. 545 Portland, OR 97227-1604 Kern H. Guppy, MD, PhD Isaac Goodrich, MD (503)288-5151 Dept. of Neurosurgery Connecticut Neurosurgery PC 2025 Morse Ave. 300 Orchard St., Ste. 316 Michael L. Griffith, MD Sacramento, CA 95825-2115 New Haven, CT 06511-4412 2530 N. 8th St., Ste. 201 (916)973-5933 (203)781-3400 Grand Junction, CO 81501 (970)241-6990 Gustavo A. Gutnisky, MD James T. Goodrich, MD, PhD 1051 Gause Blvd., Ste. 410 Albert Einstein/Montefiore Med. Ctr. Oliver D. W. Grin, MD Slidell, LA 70458 111 E. 210th St./Neurosurgery 513 E. Division (985)641-4152 Bronx, NY 10467-2401 Rockford, MI 49341-1342 (718)920-4197 (616)893-8846 Mehdi Habibi, MD 1300 N. Vermont Ave., Ste. 504 Camilo A. Gopez, MD Michael W. Groff, MD Los Angeles, CA 90027-6005 4003 Valley Green Rd. Indiana University Medical Center (323)665-4690 Wilmington, DE 19807 545 Barnhill Dr., Emerson 139 (302)655-5776 Indianapolis, IN 46202-5112 John E. Hackman, MD (317)274-8549 1722 Pine St., Ste. 1001 Paul L. Gorsuch Jr., MD Montgomery, AL 36106 401 15th Ave. S., Ste. 101 Jeffrey D. Gross, MD (334)834-1663 Great Falls, MT 59405-4372 10 Orion Way (406)761-3181 Coto De Caza, CA 92679-5116 Souheil F. Haddad, MD (949)364-6888 700 S. College Ave., Ste. C C. Thomas Gott, MD Bloomington, IN 47403-2500 14 Hummingbird Cir. (812)331-8168 Henderson, NV 89014-2153 (702)891-0378

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 104 MEMBERSHIP ROSTER

Mark N. Hadley, MD, FACS Timothy Harrington, MD Javad Hekmatpanah, MD UAB Neurosurgery Barrow Neurological Institute University of Chicago 510 20th St. S./FOT, Ste. 1030 2910 N. 3rd Ave. 5841 S. Maryland Ave., MC 3026 Birmingham, AL 35294-3295 Phoenix, AZ 85013-4434 Chicago, IL 60637-1463 (205)934-1439 (602)406-3477 (773)702-6157 Regis W. Haid Jr., MD James S. Harrop, MD Fredric A. Helmer, MD Atlanta Brain & Spine Care 2001 Thomas Jefferson Univ./Neurosurgery 7636 Donald Ross Rd. W. Peachtree Rd. N.E., #645 909 Walnut St., 2nd Fl. Sarasota, FL 34240-8648 Atlanta, GA 30309 Philadelphia, PA 19107 (678)904-7158 (215)955-7959 Fraser C. Henderson, MD Georgetown University Med. Ctr. Andrea L. Halliday, MD, PA David J. Hart, MD 3800 Reservoir Rd. N.W. 1200 Hilyard St., Ste. S-530A Dept. of Neurosurgery Washington, DC 20007-2113 Eugene, OR 97401 11100 Euclid Ave. (202)444-4979 (541)686-3791 Cleveland, OH 44106 (216)844-3008 John P. Henderson, MD Harold Bruce Hamilton, MD Univ. of Illinois at Peoria 105 Old Hewitt Rd., Ste. 100 Roger Hartl, MD 719 N. William Kumpf Blvd., #100 Woodway, TX 76712 1320 York Ave., Apt. 36H Peoria, IL 61605 (254)776-9775 New York, NY 10021 (309)676-0766 (212)746-2152 Fadi Hanbali, MD Jeffrey S. Henn, MD Texas Tech University HSC Charles S. Haworth, MD Lee Memorial Hospital 4800 Alberta Ave. Duke Neuro Associates of Lumberton 2780 Cleveland Ave., Ste. 819 El Paso, TX 79905 2905 N. Elm St. Fort Myers, FL 33901 (409)772-8972 Lumberton, NC 28358-2982 (239)336-6800 (910)671-4415 Robert R. Hansebout, MD Robert G. Hennessy, MD 43 Charlton Ave. E., #310 Shaukat Hayat, MD 1001 Pine Heights Ave., Ste. 304 Hamilton, ON L8N-1Y4 PO Box 1706 Baltimore, MD 21229-5208 Canada Madisonville, KY 42431-0035 (410)646-0220 (905)541-0055 (270)825-7483 Deborah C. Henry, MD E. Jerome Hanson, Jr., MD Gale Hazen, MD PO Box 3545 15438 Iron Horse Cir. 1511 Lincoln Blvd. Newport Beach, CA 92659-3545 Leawood, KS 66224 Lorain, OH 44055-3138 (714)279-4673 (440)233-7183 Kimberly S. Harbaugh, MD James M. Herman, MD PSU/HMC/Neurosurgery Michael A. Healy, MD 168 N. Brent St., Ste. 408 500 University Dr. Neurosurgical Network Inc. Ventura, CA 93003 Peripheral Nerve Surg. 2222 Cherry St., Ste. MOB2 (805)643-2179 Hershey, PA 17033 Toledo, OH 43608 (717)531-8807 (419)251-1155 Martin D. Herman, MD, PhD Center of Brain & Spine Surgery Ira May Hardy, II, MD Robert F. Heary, MD 1875 W. Dempster St., Ste. 605 2390 Hemby Ln. UMDNJ-New Jersey Med. Sch. Park Ridge, IL 60068 Greenville, NC 27834-3775 90 Bergen St., Ste. 8100 (847)698-1088 (252)752-9794 Newark, NJ 07103-2425 (973)972-2334 T. William Hill, MD Russell W. Hardy, Jr., MD 401 E. Highland Ave., Ste. 551 PO Box 1496 Ian M. Heger, MD San Bernandino, CA 92404 Gualala, CA 95445 Joe Dimaggio Childrens Hospital/ (909)824-2895 Neurosurgery Haynes Louis Harkey, III, MD 1150 N. 35th Ave., Ste. 300 Donald L. Hilton, Jr., MD Univ. of Mississippi Med. Ctr. Hollywood, FL 33021 Texas Neuroscience Inst. Bldg. 2500 N. State St. 4410 Medical Dr., Ste. 610 Jackson, MS 39216-4505 John D. Heiss, MD San Antonio, TX 78229-3798 (601)984-5714 NIH/Surgical Neurology Branch (210)614-2453 10 Center Dr., Rm. 10-5D37 Raymond I. Haroun, MD Bethesda, MD 20892-1414 James R. Hirsch, MD 3449 Wilkens Ave., Ste. 100 (301) 496-2921 Guilford Neurosurgical Assoc. PA Baltimore, MD 21229-5216 1313 Carolina St., Ste. 300 (410)646-4800 Jeffrey Heitkamp, MD Greensboro, NC 27401-1224 1001 N. Waldrop Dr., Ste. 801 (336)272-4578 J. Frederick Harrington, Jr., MD Arlington, TX 76012 235 Plain St., Ste. 305 (817)274-4593 Leonard F. Hirsch, MD Providence, RI 02905-3241 Crozer Chester Med. Ctr. (401)455-1749 Ste. 428/Neurosurgery Chester, PA 19013 (610)874-4044

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEMBERSHIP ROSTER 105

Alan D. Hirschfeld, MD Robert S. Hood, MD Anthony G. Hucks-Folliss, MD St. Vincent’s Hospital Neurosurgical Clinic of Utah Inc. Rockfeller Bldg., PO Box 1904 153 W. 11th St./Neurosurgery 24 S. 1100 East, Ste. 302 289 Olmsted Blvd., Ste. 5 New York, NY 10011-8305 Salt Lake City, UT 84102-1500 Pinehurst, NC 28370 (212)604-7767 (801)531-7806 (910)295-3737 Michael H. Hitchcock, MD L. N. Hopkins, III, MD W. Robert Hudgins, MD 542 McArthur Dr. Univ. at Buffalo Neurosurgery Inc. Neurological Surgeons of Dallas PA Littleton, CO 80124-9614 3 Gates Cir./Neurosurgery 7515 Greenville Ave., #1030 (303)792-2946 Buffalo, NY 14209-1194 Dallas, TX 75231-3866 (716) 887-5200 (214)691-2111 Patrick W. Hitchon, MD University of Iowa Hospitals Timothy E. Hopkins, MD Joseph S. Hudson, MD 200 Hawkins Dr./Neurosurgery 1106 Alta Loma Cir. Semmes Murphey Clinic Iowa City, IA 52242-0002 San Angelo, TX 76901-4552 6325 Humphreys Blvd. (319)356-2775 (325)658-1511 Memphis, TN 38120-2300 (901)260-0712 Philip J. Hlavac, MD Tomokatsu Hori, MD 743 Jefferson Ave., Ste. 304 Tokyo Womens Med. Univ./Neuro. William S. Huestis, MD Scranton, PA 18501 8-1 Kawada Shinjuku (902)429-4123 (570)340-5077 Tokyo 1628666 Japan Herman Hugenholtz, MD Hector W. Ho, MD (3) 3353 - 8111 New Halifax Infirmary Central Minnesota Neurosciences 3809-1796 Summer St. 1400 W. St. Germain St. William C. Horton, MD Halifax, NS B3H-3A7 St. Cloud, MN 56301 The Emory Clinic Canada (320)259-1405 2165 N. Decatur Rd. (902)473 2096 Decatur, GA 30033-5307 Victor T. Ho, MD (404) 778-7115 Michael G. Hughes, MD NeuroSurgery Neurosurgical Service P.C. 1551 Richmond Rd. Edgar M. Housepian, MD 154 West St.-LL Staten Island, NY 10304-2313 New York Neurological Institute Battle Creek, MI 49017-3462 (718)980-5000 710 W. 168th St. (616)969-6150 New York, NY 10032-2603 William F. Hoffman, MD (212)305-5252 Matthew K. Hummell, MD 11155 Dunn Rd., Ste. 211-N Neurosurgical Specialists St. Louis, MO 63136 James Robert Howe, MD, FACS 400 W. 15th St., Ste. 800 (314) 355-0018 3303 Water St. N.W., Ste. 5A Austin, TX 78701-1655 Washington, DC 20007 (512)306-1323 Peter H. Hollis, MD (703)470-9883 900 Northern Blvd. Alan T. Hunstock, MD, FACS Great Neck, NY 11021 Deborah A. Hrustich, MD 525 Doyle Park Dr., Ste. 102 (516)773-7737 Albany-Troy Neurosurgical Assoc. Santa Rosa, CA 95405-4516 63 Shaker Rd., Ste. 201 (707)523-1873 James P. Hollowell, MD Albany, NY 10024-1030 Integrated Spine Care SC (518)446-1850 R. John Hurlbert, MD, PhD 2801 W. Kinnickinnic River Pkwy., #440 1403 29th St. NW Milwaukee, WI 53215 Jason H. Huang, MD Calgary, AB T2N-2T9 (414)805-5434 Univ. of Pennsylvania/Neurosurgery Canada 3400 Spruce St./3 Silverstein (403)944-4496 Weems O. Hollowell, MD Philadelphia, PA 19104-4204 9664 W. River Cove Pl. (215)662-3487 Gary C. Hutchison, MD Homosassa, FL 34448-3539 Dallas Neurosurgical Associates (352)666-3271 Judy Huang, MD 8230 Walnut Hill Ln., Ste. 220 Johns Hopkins Bayview Med. Ctr. Dallas, TX 75231-4482 Langston T. Holly, MD 4940 Eastern Ave. (214)750-3646 UCLA Medical Center B119/Neurosurg. Div. of Neurosurgery Baltimore, MD 21224 John W. Hutchison, MD, FACS 74-144 CHS (410)550-4076 Dakota Clinic-Innovis Los Angeles, CA 90095 3000 32nd Ave. South (310)267-5580 Jerry L. Hubbard, MD Fargo, ND 58103-6132 Western Neurosurgery P.C. (701)364-4629 Eric K. Holm, MD, FACS 875 Oak St. S.E., Ste. 5060 606 Museum Rd. Salem, OR 97301-3907 Panos Ignatiadis, MD Reading, PA 19611-1427 (503)399-1386 PO Box 3107 (610)373-4007 Huntington, WV 25702-0107 John L. Hubbard, MD (304) 525-6825 770 Seigel Decatur, IL 62522-2404 (217)423-6905

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 106 MEMBERSHIP ROSTER

Abelardo D. Inoa, MD Saied Jamshidi, MD Martin Johnson, MD 6 Normandy Pkwy. PO Box 60735 31870 S.W. Country View Ln. Morristown, NJ 07960-5716 Potomac, MD 20859 Wilsonville, OR 97070-7476 (201)361-1919 (301)567-1800 (503)694-5900 Tatsushi Inoue, MD John A. Jane Sr., MD, PhD Neil G. Johnson, MD Aichi Medical Univ. University of Virginia Health System 401 E. Highland Ave., Ste. 553 21 Karimata Yazako Box 800212/Neurosurgery San Bernardino, CA 92404-3839 Nagakute-cho 4801195 Charlottesville, VA 22908 (909)881-6427 Japan (434)924-2203 561623311 Richard William Johnson, MD Rashid M. Janjua, MD Neurosurgery Dennis M. S. Izukawa, MD 210 E. Gray St., Ste. 1102 95-25 Queens Blvd., 2nd Fl. 101 Queensway West, Ste. 210 Louisville, KY 40202 Rego Park, NY 11374-4511 Mississauga, ON L5B-2P7 (502)552-5733 (718)459-7700 Canada (905)566-9750 Jorge J. Jaramillo-de la Torre, MD Robert M. Johnson, MD 2921 Scioto Ln., Apt. 604 272 Prairiewood Dr. Avery M. Jackson, III, MD Cincinnati, OH 45219-2072 Fargo, ND 58103-4613 4620 Genesys Health Park (513)556-8458 (701)234-4023 Grand Blanc, MI 48439 (810)606-7200 Tariq Javed, MD Stephen H. Johnson, MD 631 Campbell Hill St., Ste. 100 South Suburban Neurosurgical Assoc. John D. Jackson, MD Marietta, GA 30060-1301 780 Main St. South 9605 Red Gate Dr. (770)422-0444 Weymouth, MA 02190-1612 River Ridge, LA 70123-2025 (781)331-0250 (504)734-9300 Sam P. Javedan, MD Lee Memorial Neurosurgery Kim W. Johnston, MD, FACS Richard Henry Jackson, MD 2780 Cleveland Ave., Ste. 819 Georgia Neurosurgical Associates Dallas Neurosurgical Associates Fort Myers, FL 33901-5817 840 Pine St., Ste. 880 8230 Walnut Hill Ln., Ste. 220 (239)410-7719 Macon, GA 31201-2100 Dallas, TX 75231-4469 (478)743-7092 (214)750-3646 Arthur L. Jenkins, III, MD Mt. Sinai MC/Annenberg 8-06 David S. Jones, MD Thad R. Jackson, MD 1 Gustave L. Levy Pl. #1136 Wendover Medical Center U.K. Medical Center/Neurosurgery New York, NY 10029-6574 301 E. Wendover Ave., Ste 211 800 Rose St. MS 108A (212)241-8175 Greensboro, NC 27401 Lexington, KY 40536-0298 (336)378-1040 (859)323-1334 Jeffrey D. Jenkins, MD, FACS 823 Bass Landing Pl. Mark W. Jones, MD Karl A. Jacob, MD Greensboro, NC 27455 2004 Court St. PO Box 348 (336)288-3193 Saginaw, MI 48602 Chesterfield, MO 63006-0348 (989)792-8800 (636)532-3595 Byung Chan Jeon, MD 34 Amnam-Dong Shu-Ku Raymond M. Joson, MD R. Patrick Jacob, MD Pusan 350 Grays Ln. Univ. FL Gainesville/Neuro. Surg. HSC South Korea Haverford, PA 19041 Box 100265 (5) 12406124 (610)649-5616 Gainesville, FL 32610-0265 (352)392-4331 Hae-Dong Jho, MD, PhD Jose L. Joy, MD, PA Allegheny Gen. Hospital/Snyder Pavilion 170 Isla Dorada Blvd. George B. Jacobs, MD, FACS 320 E. North Ave., 7th Fl. Miami, FL 33143-6554 PO Box 4148 Pittsburgh, PA 15212-4746 (305)225-1777 South Hackensack, NJ 07606 (412)359-6110 (201)996-2535 Terrence D. Julien, MD Dale K. Johns, MD 10318 Venitia Real Ave., Apt. 304 Line Jacques, MD 920 Bambi Dr. Tampa, FL 33647 Montreal Neurological Hospital Destin, FL 32541-1833 (813)994-5747 3801 University #145 (850)863-1271 Montreal, PQ H3A-2B4 Patrick Alton Juneau, III, MD Canada J. Patrick Johnson, MD St. Francis MOB, Ste. 210 (514)398-3081 Cedars Sinai Inst. for Spinal Disorders 501 W. St. Mary Blvd. 444 S. San Vicente Blvd., #800 Lafayette, LA 70506 Steven M. James, MD Los Angeles, CA 90048 (337)267-1319 110 N. 17th St., Ste. 120 (310)423-9782 Beechgrove, IN 46107 (317)781-2500 John K. Johnson, MD, FACS Southeastern Neurosurgical & Spine Inst. 20 Medical Ridge Dr. Greenville, SC 29605-5605 (864)295-3600

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEMBERSHIP ROSTER 107

Wayel Kaakaji, MD Michael E. Karnasiewicz, MD Daniel H. Kim, MD 468 Wexford Rd. Neurosurgery Assoc. of NW Connecticut Stanford University Medical Center Valparaiso, IN 46385 500 Chase Pkwy. 300 Pasteur Dr., R201 (313)343-4240 Waterbury, CT 06708-3346 Palo Alto, CA 94304-2203 (203)573-1423 (650)498-6971 Dimitrios Kafritsas, MD Stuttgarter Str. 30 John F. Keller, MD Kee D. Kim, MD Ludwigsburg 71638 Great Lakes Neurosurgical Assoc. PC University of California - Davis Germany 414 Plymouth N.E. 4860 Y St., Ste. 3740 (71) 4193790 Grand Rapids, MI 49505-6041 Sacramento, CA 95817-2307 (616)454-3465 (916)734-3072 Christopher D. Kager, MD Lancaster Neurosci. & Spine Assoc. Donald B. Kelman, MD Se-Hoon Kim, MD, PhD 1671 Crooked Oak Dr. Marshfield Clinic Dept. of Neurosurgery Lancaster, PA 17601 1000 N. Oak Ave. 300 Pasteur Dr., Rm. 201 (717)569-5331 Marshfield, WI 54449-5772 Stanford, CA 94305-5327 (715)387-5297 (650)796-4124 Michael G. Kaiser, MD New York Neurological Institute F. Donovan Kendrick, MD Glenn W. Kindt, MD 710 W. 168th St., Rm. 424 2065 E. South Blvd., Ste. 204 Univ. of Colorado Hlth. Sci. Ctr. New York, NY 10032 Montgomery, AL 36116-2002 4200 E. 9th Ave., Box C307 (212)305-0378 (334)281-6990 Denver, CO 80220-3706 (303)315-7577 Iain H. Kalfas, MD David G. Kennedy, MD Cleveland Clinic Foundation 3009 N. Ballas Rd., Ste. 269C Jerome Stovall King, MD 9500 Euclid Ave., S80 St. Louis, MO 63131 3218 Mount Gilead Church Rd. Cleveland, OH 44195-0001 (314)743-0330 Pittsboro, NC 27312 (216)444-9064 (919) 542-2270 W. Joseph Ketcherside, MD Yogish Dasappa Kamath, MD 1026 Harbor Bend Cir. Joseph T. King Jr., MD 6 Whittier Pl., #4E Memphis, TN 38103-5836 VA Connecticut #112 Boston, MA 02114 (901)516-0011 950 Campbell Ave. (617)367-3438 West Haven, CT 06516 Kaveh Khajavi, MD, FACS (412)647-3685 Kenneth S. Kammer, MD, PA Ste. 710, 2675 N. Decatur Rd. 305 E. Cheves St., Ste. 300 Decatur, GA 30033 Paul K. King, MD Florence, SC 29506-2610 (404)299-3338 Metro Atlanta Neurosurgery PC (843)665-4758 285 Boulevard St. N.E., Ste. 635 Ahmed M. Khan, MD Atlanta, GA 30312-4212 Nicolas Kandalaft, MD 49 Belcrest Rd. (404)265-3304 14008 Hughes Ln. West Hartford, CT 06107-3305 Dallas, TX 75240-8651 (860)225-1227 Robert B. King, MD (972)985-8000 6230 The Hamlet Larry T. Khoo, MD Jamesville, NY 13078-9789 Barry J. Kaplan, MD UCLA Medical Center (315)464-4470 Ocala Neurosurgical Ctr. 1245 16th St., Ste. 220 1901 S.E. 18th Ave., Bldg. 101 Santa Monica, CA 90404 Douglas B. Kirkpatrick, MD Ocala, FL 34471-8311 (310)319-2257 330 Harvard Pl. (352)622-3360 Medford, OR 97504 Houman H. Khosrovi, MD (541)772-2232 Stuart S. Kaplan, MD 1212 Garfield Ave., #300 9213 White Tail Dr. Parkersburg, WV 26101-3207 Phillip Kissel, MD Las Vegas, NV 89134 (304)424-4130 628 California Blvd., Ste. F (702)851-3653 San Luis Obispo, CA 93401 Michael P. B. Kilburn, MD (805)544-4455 George J. Kaptain, MD Carolina Neurosurgery & Spine Comprehensive Neurosurgical 303C W. Alexander Ave. Daniel L. Kitchens, MD, FACS 20 Prospect Ave., Ste. 907 Greenwood, SC 29646-4009 Cardinal Neurosurgery & Spine Hackensack, NJ 07601 (864)943-1267 3009 N. Ballas Rd., Ste. 213B (201)342-2550 St. Louis, MO 63131 Keun Su Kim, MD (314)842-2100 Dean G. Karahalios, MD Yongdong Severance 736 N. Western Ave., Ste. 218 Hospital/Neurosurgery Peter M. Klara, MD, PhD Lake Forest, IL 60045 Dogok-dong 135-720 Gangnam-gu 730 Kings Ln. (773)250-0500 Seoul 135720 Tullahoma, TN 37388 South Korea (931)393-2121 Jeffrey L. Karasick, MD (2) 34973390 9700 Kenton Ave., Ste. K401 Skokie, IL 60076-1259 (847)674-9394

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 108 MEMBERSHIP ROSTER

William L. Klempner, MD Robert J. Kowalski, MD William B. Kuhn, MD 225 Dayton St. 110 Rio Sedona Way 311 N. Clyde Morris Blvd., Ste. 550 Ridgewood, NJ 07450-4407 Helotes, TX 78023 Daytona Beach, FL 32114-2766 (201)612-0020 (210)292-6323 (386)255-8582 Enrique Kleriga, MD Yakov U. Koyfman II, MD Vijay S. Kumar, MD Cirugia Neurologica S.C. 4745 Ogletown-Stanton Rd., Ste. 117 D 1/28 Vasant Vihar Observatorio Esq. Sur 138 411 Newark, DE 19713-2067 India Mexico City, DF 01120 (302)366-7671 Mexico Charles Kuntz, IV, MD (5) 272-3765 Louis L. Kralick, MD Mayfield Clinic & Spine Inst. 3220 Providence Dr., Ste. E3-020 222 Piedmont Ave., Ste. 3100 A. Bernhard Kliefoth, III, MD Anchorage, AK 99508-2956 Cincinnati, OH 45219-4216 718 Westborough Rd. (907)258-6999 (513)558-4968 Knoxville, TN 37909-2133 (865)524-9400 Paul W. Kramer, MD Kosuke Kuribayashi, MD 2765 N.E. 35th Dr. Minase Hospital/Spine Surgery David G. Kline, MD Fort Lauderdale, FL 33308-6315 3-2-26 Takahama Shimamoto-cho Ochsner Clinic Foundation (954)565-6336 Japan 1514 Jefferson Highway/Dept. of Neuro. (7) 7454 - 2646 7 Fl. New Orleans, LA 70121 William E. Krauss, MD (504)568-2641 Mayo Clinic Steven P. Kuric, MD 200 1st St./Neurosurgery S.W. 350 W. Columbia St., Ste. 350 Thomas Klump, MD Rochester, MN 55905-0002 Evansville, IN 47710 4720 Sunset Ridge Rd. (507)284-2816 (812)425-9999 Klamath Falls, OR 97601-9310 (541)882-4459 William Kraut, MD Sagi M. Kuznits, MD PO Box 1864 958 County Line Rd. John Joseph Knightly, MD Venice, FL 34284-1864 Bryn Mawr, PA 19010 Atlantic Neurosurgical Specialists P.A (941)484-0789 (610)527-2443 310 Madison Ave. Morristown, NJ 07960 Michael Adam Kremer, MD David A. Kvam, MD (973)285-7800 2817 McClelland Blvd., Ste. 120 Neurosurgeons of Central Connecticut Joplin, MO 64801 100 Retreat Ave., Ste. 705 Nachshon Knoller, MD (417)621-4653 Hartford, CT 06106-2528 Simtad Hayarnuk 6 (860)278-0070 Kiryat-Ono 55231 Mark J. Krinock, MD Israel Neurosurgery of Kalamazoo PC Richard S. Kyle, MD (353)0-2650 1541 Gull Rd., Ste. 200 1502 S.E. 28th St., Ste. 2 Kalamazoo, MI 49048 Bentonville, AR 72712 David Luke Knox, MD (269)343-1264 Northwest Arkansas Neurosurgery Frank La Marca, MD 1706 E. Joyce Blvd. #2 Joseph Philip Krzeminski, MD Univ. of Michigan MC TC3470 Fayetteville, AR 72703-5249 York Neurosurgical Associates PC 1500 E. Medical Dr. (479)921-0900 2319 S. George St. Ann Arbor, MI 48109-0338 York, PA 17403-5009 (734)936-5024 Robin F. Koeleveld, MD (717)747-9911 Raleigh Neurosurgical Clinic James R. La Morgese, MD 3700 Barrett Dr. Mark J. Kubala, MD St. Luke’s Hospital Raleigh, NC 27609-7213 Golden Triangle NeuroCare 1026 A Ave., PO Box 3026 (919)785-3400 2965 Harrison, Ste. 111 Cedar Rapids, IA 52406 Beaumont, TX 77702-1148 (319)369-7391 Joseph L. Koen, MD (409)898-7800 1706 S. Woodside Ln. Roderick G. Lamond, MD Virginia Beach, VA 23454 Yoshichika Kubo, MD, DMSc Western Neurological Group (757)625-4455 Sakakibaraonsen Hospital/Neurosci. Ctr. 1601 E. 19th Ave., Ste. 4400 1033-4 Sakakibara-cho Denver, CO 80218-1253 Tadashi Kojima, MD Tsu-city, mie 5141293 (303)861-2266 1574 Kurimamachi Ya Chou Japan Tsu 5140102 (5) 9252 - 1111 Michael K. Landi, MD, FACS Japan 325 Essjay, Ste. 305 Keith R. Kuhlengel, MD Williamsville, NY 14221 Akinori Kondo, MD Lancaster Neuro-Association (716)631-3555 Shiroyama Hospital/Brain & 1671 Crooked Oak Dr. Spine Surgical Ctr. Lancaster, PA 17601-4207 Todd Hopkins Lanman, MD 7-10-5 Furuich (717)569-5331 120 S. Spalding Dr., Ste. 400 Japan Beverly Hills, CA 90212-1842 (7) 2958 - 1000 (310)385-7766

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEMBERSHIP ROSTER 109

Giuseppe Lanzino, MD Sang-Ho Ho Lee, MD, PhD Mark C. Lester, MD Dept. of Neurosurgery Wooridul Spine Hospital St. Mary’s Medical Center 530 N.E. Glen Oak Ave. 47-4 Chungdam-Dong Kangnam-Gu 800 S. Washington Ave. Peoria, IL 61637 South Korea Saginaw, MI 48601 (309)655-2700 (2) 5138155 (610)433-6166 Paul W. LaPrade Jr., MD Bothwell Graves Lee, MD Frank Scott Letcher, MD 6036 N. 19th Ave., Ste. 504 8101 Hinson Farm Rd., Ste. 112 1145 S. Utica, Ste. 903 Phoenix, AZ 85015 Alexandria, VA 22306-3404 Tulsa, OK 74104 (602)242-0299 (703)780-7908 (918)584-3461 Sanford J. Larson, MD, PhD Chin Tai Lee, MD Marc A. Letellier, MD 4385 Continental Dr. 10550 Montgomery Rd., Ste. 33 4566 E. Inverness Ave., Suite 205 Brookfield, WI 53045 Cincinnati, OH 45242-4422 Mesa, AZ 85206-4634 (414)454-5407 (513) 791-6400 (480)730-1844 Jorge J. Lastra-Power, MD Sun H. Lee, MD, PhD Leon Levi, MD 369 Dorado BCH E Robert Wood Johnson Univ. Hospital Rambam Medical Center Dorado, PR 00646-2216 125 Paterson St., Ste. 2100 PO Box 9602 (787)764-7166 New Brunswick, NJ 08901 Haifa 31096 (732)235-7756 Israel Henry E. Laurelli, MD (4) 854 2320 22 Bay St. Thomas T. Lee, MD Wickford, RI 02852 150 White Plains Rd., Ste. 209 Allan D. Levi, MD, PhD, FRCS (401)739-4988 Tarrytown, NY 10591 Lois Pope Life Center (914)631-9207 1095 N.W. 14th Ter., D4-6 Carl Lauryssen, MD Miami, FL 33136-2104 8670 Wilshire Blvd., Ste. 202 Michael A. Lefkowitz, MD (305)243-2088 Beverly Hills, CA 90211 410 Lakeville Rd., Ste. 204 (310)855-0751 New Hyde Park, NY 11042 Robert Levinthal, MD, FACS (516)354-3401 College Station Neurosurgery Michael H. Lavyne, MD 1602 Rock Prairie Rd., #4400 Neuroscience Institute Richard M. Lehman, MD College Station, TX 77845 523 E. 72nd St., 7th Fl. Robert Wood Medical School (979)696-2422 New York, NY 10021-4099 125 Paterson St., Ste. 2100 (212)717-0200 New Brunswick, NJ 08901-1962 Louis A. Levy, MD (732)235-7756 864 Marsh Ave. Edmund P. Lawrence, Jr., MD Reno, NV 89509-1945 Neurosurgical Network Inc. Warren H. Leimbach II, MD (775)322-6575 2222 Cherry St., Ste. M200 (614)566-9709 Toledo, OH 43608 Richard J. Lewin, MD (419)251-4447 James Mark Leipzig, MD 2030 N. Chettro Trail 1940 Braeburn Cir. St. George, UT 84770 Amado M. Layno, Jr., MD Salem, VA 24153 (435)674-2943 Cebu Doctors Hospital Osmena Blvd. (540)725-9771 Cebu City 6000, Ste. A-110 Howard Lieberman, MD Philippines Thomas J. Leipzig, MD 361 N. Ridgewood Rd. (3) 225 44 181 Indianapolis Neurosurgical Group South Orange, NJ 07079-1646 8333 Naab Rd., Ste. 250 (973) 762-3386 Robert H. Le Grand, Jr., MD Indianapolis, IN 46260 211 E. College (317)926-5411 Robert Lifeso, MD San Angelo, TX 76903-5902 462 Grider St. (915)655-4164 Gerald Michael Lemole, Jr., MD Buffalo, NY 14215-3021 Univ. of Illinois-Chicago/Neurosurgery (716)898-4732 Roseanna M. Lechner, MD 912 S. Wood St., M/C 799 Metrohealth Medical Center Chicago, IL 60612-0000 Matt John Likavec, MD 2500 Metrohealth Dr. (312)996-4842 Dept. of Neurosurgery Cleveland, OH 44109-1900 2500 Metrohealth Dr. (216)778-4386 Steven P. Leon, MD Cleveland, OH 44109-1900 130 Arlington Ave. (216)778-3170 Jon T. Ledlie, MD Port Jefferson, NY 11777-1336 Tyler Neurosurgical Associates PA (631)475-5511 Mark A. Liker, MD 700 Olympic Plaza, Ste. 850 16814 Oak View Dr. Tyler, TX 75701-1951 Michael A. Leonard, MD Encino, CA 91436-3240 (903)595-5382 8715 Village Dr., Ste. 610 (323)226-7421 San Antonio, TX 78217 (210)564-8300 Paul M. Lin, MD 1030 Glendeven Dr. Ambler, PA 19002-1859 (215)793-4599

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 110 MEMBERSHIP ROSTER

James G. Lindley, Jr., MD Sean Raymond Logan, MD Walter X. Loyola, MD, FACS Neurological Institute of Savannah 322 Fox Run Rd. 3200 Glenhurst Ct. 4 Jackson Blvd. Findlay, OH 45840 Plano, TX 75093 Savannah, GA 31405 (419)420-7304 (972)312-0607 (912)355-1010 George Y. Lohmann, Jr., MD William Y. Lu, MD Kenneth I. Lipow, MD PO Box 80921 Orlando Neurosurgery Connecticut Neurosurgical Specialists Midland, TX 79708-0921 1605 W. Fairbanks Ave. 267 Grant St. (915) 570-8880 Winter Park, FL 32789-4603 Bridgeport, CT 06610-2805 (407)894-2362 (203)384-4500 Dean C. Lohse, MD 4063 Salisbury Rd., Ste. 210 John T. Lucas, MD Philipp M. Lippe, MD, FACS Jacksonville, FL 32216 145 Sunset Blvd. PO Box 41217 (904)296-2522 Beaufort, SC 29907 San Jose, CA 95160 (864)297-5127 (408)927-0802 Donlin M. Long, MD, PhD Johns Hopkins University Hospital Gary J. Lustgarten, MD Caleb R. Lippman, MD 600 N. Wolfe St., Carnegie 466 100 N.W. 170th St., Ste. 302 800 Alderbrook Ct. Baltimore, MD 21287-0005 Miami, FL 33169 Crown Point, IN 46307 (410)614-3536 (305)653-5155 (219)756-2900 Marie L. Long, MD Jonathan H. Lustgarten, MD Kenneth M. Little, MD PO Box 164 121 Hwy. 36 W.,Ste. 330 6140 W. Curtisian, Ste. 400 Mt. Zion, IL 62549 West Long Beach, NJ 07764 Boise, ID 83704 (217)876-2784 (732)222-8866 (208)367-3500 Ralph C. Loomis, MD Mark A. Lyerly, MD Sella R. Littlepage II, MD Mountain Neurological Center 145 Kimel Park Dr., Ste. 220 115 W. Queen Ann Rd. 7 Vanderbilt Park Dr. Winston-Salem, NC 27103-6972 Greenville, SC 29615 Asheville, NC 28803 (336)794-0057 (864)295-3690 (828)255-7776 Harold N. Lynge, MD John Chung-Liang Liu, MD Rafael A. Lopez, MD 1998 Vallejo St., Ste. 3 676 N. St. Clair, Ste. 2210 11500 Cedar Run Ln. San Francisco, CA 94123-4941 Chicago, IL 60611 Owings, MD 20736 (312)695-4299 (202) 223-0111 Mark K. Lyons, MD, FACS Mayo Clinic - Scottsdale/Neurosurgery Raeburn C. Llewellyn, MD Juan de Dios Lora, MD, FACS 13400 E. Shea Blvd. 3 Poydrae St., Unit 8-B 1130 S.E. 18th Pl. Scottsdale, AZ 85259-5404 New Orleans, LA 70130-1665 Ocala, FL 34471-5422 (480)301-8042 (504) 523-3909 (352)732-3966 Thomas A. Lyons, MD James R. Lloyd, MD Kenneth M. Louis, MD, FACS Neuroscience Group of NE Wisconsin 9200 W. Loomis Rd., Ste. 221 3000 E. Fletcher Ave., #340 130 2nd St. Franklin, WI 53132-9621 Tampa, FL 33613-4656 Neenah, WI 54956-2883 (414)529-9254 (813)977-3776 (920)725-9373 George E. Locke, MD Lucy Carole Love, MD Nelson T. Macedo, MD 12021 S. Wilmington Ave. Fletcher Medical Center Rocky Mt. Neurosurg. & Spine Cons. PA Los Angeles, CA 90059-3019 3000 E. Fletcher Ave., Ste. 230 PO Box 7546 (310)668-4523 Tampa, FL 33613 Rocky Mount, NC 27804-0546 (813)971-2883 (252)443-4563 Keith Raman Lodhia, MD, MS 1602 Westminster Pl. Thomas John Lovely, MD, FACS John Richard Macfarlane, Jr., MD Ann Arbor, MI 48104 1201 Nott St., Ste. 204 Neurosurgical Associates (734)936-7010 Schenectady, NY 12308 370 E. Ninth Ave., Ste. 111 (518)382-2616 Salt Lake City, UT 84103 Daniel V. Loesch, MD (801)408-2067 Tristate Neurosurgery James G. Lowe, MD 333 State St., Ste. 206 Lowe-Greenwood Neuro. Assoc. Christopher J. Madden, MD Erie, PA 16507-1466 1999 New Rd. UT Southwestern/Neurological Surgery (814)459-1013 Linwood, NJ 08221 5323 Harry Hines Blvd. (609)601-6363 Dallas, TX 75390-8855 Morris D. Loffman, MD (214)648-7905 17173 Strawberry Dr. Gary L. Lowery, MD, PhD Encino, CA 91436 5635 Clifton Ln. Parley William Madsen, III, MD, PhD (818)905-9935 Jacksonville, FL 32211 501 S. Sante Fe (904)727-9825 Visalia, CA 93292-2940 Bertil A. Loftman, MD (559)625-1054 8249 Cox Mountain Rd., 11342 Big Canoe Jasper, GA 30143-5107 (678)493-2308

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEMBERSHIP ROSTER 111

Subu N. Magge, MD Jack Earl Maniscalco, MD Marcos Masini, MD Lahey Clinic 2816 W. Virginia Ave. Shin QL 01 Conj 6 Casa 5 41 Mall Rd. Burlington, MA 01805-0001 Tampa, FL 33607-6330 Lago Norte (781)744-8644 (813)876-6321 Brasilia, DF 71505-065 Brazil Cormac O. Maher, MD Robert F. Mann, MD (61) 577 4101 109 Pleasant St. 815 W. 20th Ave. Cambridge, MA 02139-4446 Oshkosh, WI 54902-6766 Eric M. Massicotte, MD, MSc (617)661-6292 (920)223-0560 #4W432 4th Fl. West Wing P. Colby Maher, MD J. Alexander Marchosky, MD 399 Bathurst St. 3922 Kilbourne Ave. Neurospinal Surgery PC Toronto, ON M5T-2S8 Cincinnati, OH 45209 226 S. Woods Mill Rd., Ste. 54W Canada (513)703-1964 Chesterfield, MO 63017-3663 (416)603-5675 (314)878-0808 Farhad S. Mahjouri, MD Farzad Massoudi, MD, FACS PO Box 3793 Paul J. Marcotte, MD Massoudi & Jackson Neuro. Med. Grp. Clovis, CA 93613-3793 Univ. of Pennsylvania 23961 Calle de la Magdalena #504 (787)753-7440 3400 Spruce St./Neurosurgery Laguna Hills, CA 92653-3616 Philadelphia, PA 19104-4204 (949)588-5800 Dennis J. Maiman, MD, PhD (215)349-8327 Dept. of Neurosurgery George J. Mathews, MD 9200 W. Wisconsin Ave. Michael J. Markham, MD PO Box 628 Milwaukee, WI 53226-3522 200 N.E. Mother Joseph Pl., Ste. 210 Waldorf, MD 20604-0628 (414)805-3682 Vancouver, WA 98664 (301) 855-1302 (360)256-8584 Ghaus M. Malik, MD William E. Mathews, MD Henry Ford Hospital Jerry V. Marlin, MD 30 Presher Way 2799 W. Grand Blvd./Neurosurgery 8220 Walnut Hill Ln., Ste. 604 Lafayette, CA 94549 Detroit, MI 48202-2608 Dallas, TX 75231-4406 (925)825-0500 (313)876-1093 (214)363-2587 Marshall I. Matz, MD Lloyd I. Maliner, MD Philip J. Marra, MD St. Elizabeth’s Prof. Plaza 1601 N. Flamingo Rd., #206 1201 Nott St., Ste. 204 1431 N. Western Ave., Ste. 306 Pembroke Pines, FL 33028 Schenectady, NY 12308 Chicago, IL 60622 (941)293-2107 (518)377-2341 (312)332-2226 Gunwant S. Mallik, MD George F. Martin, MD Paul G. Matz, MD 285 E. State St., #430 9105 E. Hackamore Dr. Faculty Office Tower Columbus, OH 43215 Scottsdale, AZ 85255-2205 510 20th St. South, Ste. 1034 (614)566-9777 (480)502-9684 Birmingham, AL 35294 David S. Malloy, MD George J. Martin, Jr., MD (205)975-8872 7551 Lake Cove Dr. 3210 Riverview Blvd. Paul K. Maurer, MD Meridian, MS 39305-9423 Bradenton, FL 34205-3444 1401 Stone Rd., Ste. 303 (601)703-4057 (941)750-0602 Rochester, NY 14615-1537 David G. Malone, MD Robert J. Martin, MD (585)581-6790 1919 S. Wheeling, Ste. 600 425 E. 9th St., Apt. 402 Peter L. Mayer, MD Tulsa, OK 74104-5635 Rome, GA 30161 NeuroSurgery & Spine Specialists (918)749-0762 (706)291-6793 5831 Bee Ridge Rd., Ste. 100 Stavros N. Maltezos, MD Lucas J. Martinez, MD Sarasota, FL 34233-5089 Tower 1, Ste. 5M Rocky Mt. Neurosurgical & Spine (941)308-5700 3825 Highland Ave. Consultants PA Matthew Thomas Mayr, MD Downers Grove, IL 60515 PO Box 7546 Mid Atlantic Spine Specialists (630)725-9890 Rocky Mount, NC 27804-0546 7650 Parham Rd. (919)443-4563 Ronald E. Manicom, MD, PA Richmond, VA 23294 317 Ranch Rd. 620 S., Ste. 200 Roberto Martinez-Gomez, MD (804)270-5163 Lakeway, TX 78734-4700 25 Calle Pte. Phillip V. McAllister, MD (512)248-9000 Y 23 Ave. Norte #1256 199 Autumn Dr. San Salvador Houma, LA 70360-6099 Allen H. Maniker, MD El Salvador UMDNJ-New Jersey Medical School (985)917-3007 90 Bergen, St., Ste. 8th Fl. Jeffrey E. Masciopinto, MD Newark, NJ 07103-2425 Dean Hlth. System/Neurosurgery (973)972-2323 1313 Fish Hatchery Rd. Madison, WI 53715 (608)252-8377

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 112 MEMBERSHIP ROSTER

Duncan Q. McBride, MD Rick L. McKenzie, MD Michael W. Meriwether, MD Harbor UCLA Medical Center 701 University Blvd. E., Ste. 702 4054 Sawyer Rd. Box 424 Tuscaloosa, AL 35401-2086 Sarasota, FL 34233 1000 W. Carson St. (205)752-0441 (941)379-3789 Torrance, CA 90509 (310) 222-2754 Daniel L. McKinney, MD Sheldon B. Meyerson, MD, PA 304 N. 97th Ct. 590 E. 25th St., Ste. 601 Randall R. McCafferty, MD Omaha, NE 68114 Hialeah, FL 33013 502 Ruidosa Downs (402)393-4161 (305)696-2824 Helotes, TX 78023-4609 (210)292-5530 Mark R. McLaughlin, MD Ronald Michael, MD Princeton Brain 455 W. Court St., Ste. 404 Dennis E. McClure, MD 713 Executive Dr. Kankakee, IL 60901-3681 8654 N. Main St. Princeton, NJ 08540 (815)936-5160 Dayton, OH 45415 (609)468-4146 (937)898-9735 W. Jost Michelsen, MD Fred G. McMurry, MD 330 Borthwick Ave., Ste. 108 Paul R. McCombs, III, MD Yellowstone Medical Center E. Portsmouth, NH 03801 2400 Patterson, Ste. 203 2900 12th Ave. N., Ste. 400 St. Nashville, TN 37203 Billings, MT 59101-7506 Rajiv Midha, MD, MS, FRCS (615)986-1256 (406)238-6650 Foothills Med. Ctr./Clinical Neurosciences Cavert Keith McCorkle, MD John A. McRae, MD 1403-29 St. N.W., Rm. 1195 Spartanburg Neurosurgical Associates 1903 Vista Grande Dr. Calgary, AB T2N-2T9 1075 Boiling Springs Rd. Vista, CA 92084-2725 Canada Spartanburg, SC 29303-2201 (760)639-1851 (403)944-1259 (864)583-7265 Thomas F. Mehalic, MD Luis A. Mignucci, MD Bruce M. McCormack, MD 18 McGee Pt. Rd. 4001 W. 15th, Ste. 225 2100 Webster St., Ste. 110 Cape Elizabeth, ME 04167 St. Plano, TX 75093-5818 San Francisco, CA 94115 (207)885-0011 (972)599-2559 (415)923-3040 Hamid M. Mehdizadeh, MD Robert Wayne Milas II, MD, FACS Paul C. McCormick, MD 2505 Samaritan Dr., Ste. 502 2131 1st St., #A New York Neurological Institute San Jose, CA 95124-4006 Moline, IL 61265-7745 710 W. 168th St. (408)356-6600 (309)762-9300 New York, NY 10032-2603 (212)305-7976 James W. Melisi, MD, FACS Carole A. Miller, MD 8316 Arlington Blvd., Ste. 640 5745 New Bank, Cir., #405 Dennis E. McDonnell, MD Fairfax, VA 22031 Dublin, OH 43017 Gundersen Clinic (703)208-0820 (614)293-0821 1900 South Ave. La Crosse, WI 54601-5429 B. Theo Mellion, PhD, MD Charles J. Miller, MD (608)782-7300 8413 Bridlewood 310 S. Penn St. Wichita, KS 67206 Aberdeen, SD 57401 Frederick McEliece, MD (316)685-2525 (605)225-1133 3100 Princeton Pike, Bldg. 1 Ste. E Lawrenceville, NJ 08648-2300 Muhammed Y. Memon, MD David W. Miller, MD (609)895-1117 2400 Harbor Blvd., Ste. 10 Western Plains Neurosurgery Port Charlotte, FL 33952 2 W. 42nd St., Ste. 2550 David M. McGee, MD (941)625-0414 Scottsbluff, NE 69361 400 E. 56th St., Apt. 9L (308)630-1947 New York, NY 10022 Ehud Mendel, MD, FACS Univ. of TX/MD Anderson Cancer Ctr. Jay D. Miller, MD Gerald T. McGillicuddy, MD PO Box 301402 200 N.E. Mother Joseph Pl., Ste. 210 10 Winthrop St. Houston, TX 77230-1402 Vancouver, WA 98664-3202 Worcester, MA 01604-4435 (713)563-8710 (360)256-8584 (508)752-4336 Richard C. Mendel, MD, FACS John I. Miller, MD, FACS John E. McGillicuddy, MD 640 Lyme Ct. 544 E. 86th St., Ste. 6W Univ. of Michigan/MC TC3470 Erie, PA 16505 New York, NY 10028-7536 1500 E. Medical Center Dr. (814)452-4935 (718)780-1388 Ann Arbor, MI 48109-0338 (734)936-5017 Arnold H. Menezes, MD Joseph H. Miller, MD University of Iowa Hospitals 941 Bunkerview Dr. 200 Hawkins Dr./Neurosurgery Apollo Beach, FL 33572 Iowa City, IA 52242-1009 (813)641-7775 (319)356-2768 Robert C. Meredith, MD, FACS 1660 Hotel Circle N., Ste. 302 San Diego, CA 92108-2803 (619)232-0612

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEMBERSHIP ROSTER 113

Thomas I. Miller, MD Federico Mora, MD Patricio Hernan Mujica, MD, FACS 3301 Meadow Ridge Dr. 1809 Avenida Alturas N.E. 12 High St., #401 Melbourne, FL 32901-8744 Albuquerque, NM 87110-4956 Lewiston, ME 04240 (321)727-7879 (505)265-2026 (207)795-2494 Ronnie I. Mimran, MD Jay More, MD Karim Mukhida, MD 20055 Lake Chabot Rd., Ste. 110 Neurosurg. Assoc. of Central Jersey PA Upper Flat Castro Valley, CA 94546 1952 Rt. 22E 5745 Inglis St. (510)886-3138 Bound Brook, NJ 08805 Halifax, NS B3J-1K5 (732)302-1720 Canada Philip Arthur Minella, MD (902)494 8896 Ohio Neurosurgical Institute Inc. Douglas B. Moreland, MD 30 E. Apple St., Ste. 6253 Buffalo Neurosurgery Group John C. Mullan, MD Dayton, OH 45409-2939 550 Orchard Park Rd., Ste. A105 305 Piper Bldg. (937)208-2088 West Seneca, NY 14224 800 E. 28th St. (716)677-6000 Minneapolis, MN 55407-3799 Abraham Mintz, MD (612)871-7278 5520 Park Ave., Ste. 210 Howard Morgan, MD, FACS Trumbull, CT 06611 Univ. of TX Southwestern Med. Ctr. Bradford B. Mullin, MD (203)372-6460 5323 Harry Hines Blvd. Central Ohio Neurological Surgeons Dallas, TX 75390-8855 5965 E. Broad St., Ste. 420 Sanjay N. Misra, MD (214)648-8530 Columbus, OH 43213-1562 1600 N. Grand Ave., Ste. 245 (614)868-5872 Pueblo, CO 81003 Michael A. Morone, MD, PhD (719)544-3030 Deaconess Billings Clinic Kevin J. Mullins, MD, PC 2825 8th Ave. N. 329 Woodland Dr. William Mitchell, MD PO Box 37000 Brightwaters, NY 11718-1924 805 Loveland Rd. Billlings, MT 59107-7000 Moorestown, NJ 08057 (406)238-5502 Jenny Jasbir Multani, MD (732)321-7950 440 Arbol Via Kevin C. Morrill, MD Walnut Creek, CA 94958 Junichi Mizuno, MD Dept. of Neurological Surgery (925)212-5485 Aichi Medical Univ./Neurosurgery 5323 Harry Hines Blvd. 21 Karimata Yazako Dallas, TX 75390-8855 Praveen V. Mummaneni, MD Nagakute Aichi 4801195 (214)648-8791 Emory Orthopedic & Spine Ctr. Japan 59 Executive Park S. (5) 6162 - 3311 David Lawrence Morris, MD Atlanta, GA 30329 Center for Neurological Surgery (404)778-6227 Lloyd W. Mobley, III, MD 515 W. Jefferson St. 701 E. Hampton, Ste. 510 Petoskey, MI 49770 Raj Murali, MD Englewood, CO 80113 (231)348-5622 New York Med. Coll./Neurosurgery (303)788-4000 Munger Pavilion 329 Enoch Carter Morris, III, MD Valhalla, NY 10595 Michael C. Molleston, MD 513 Brookwood Blvd., Ste. 375 (914)493-8392 PO Box 15159 Birmingham, AL 35209-6862 Hattiesburg, MS 39402-5159 (205)986-5200 Karin M.Muraszko, MD (601) 268-8535 Univ. of Michigan MC TC3470 Richard H. Mortara, MD 1500 E. Medical Center Dr. H. Dennis Mollman, MD, PhD 1600 Eastwood Ln. Ann Arbor, MI 48109-0338 3200 Westhill Dr., Ste. 102 Lexington, KY 40502 (734)936-5015 Wausau, WI 54401 (859)266-5369 (715)847-2019 Daniel J. Murphy, MD John Innis Moseley, MD 168 N. Brent St., Ste. 408 William Thomas Monacci, MD Yellowstone Medical Center E. Ventura, CA 93003-2824 2520 Mondeinin Farm Rd. 2900 12th Ave. N., Ste. 400-E (805)643-2179 Lancaster, PA 17601 Billings, MT 59101-0143 (202)782-8114 (406)238-6650 Kenneth J. Murray, MD Joppa Green II Daniel W. Moore, MD, FACS Harrison T. M. Mu, MD 2328 W. Joppa Rd., Ste. 103 Cranial Spinal Inst. of Georgia 50-60 Horatio Pkwy. Lutherville, MD 21093-4668 611 Campbell Hill St., Ste. 103 Bayside, NY 11364 (410)828-7513 Marietta, GA 30060-1301 (718)459-7700 (770)424-2025 Chikao Nagashima, MD Wade M. Mueller, MD Nagashima Clinic/Neurosurgery John J. Moossy, MD Medical College of Wisconsin 3-1-14 Ogose-Higahsi Ogose Irumagun Univ. of Pittsburgh Med. Ctr. 9200 W. Wisconsin Ave. Saitama 3500414 200 Lothrop St., B400 Milwaukee, WI 53226-3522 Japan Pittsburgh, PA 15213 (414)454-5402 492-92-7227 (412)647-0182

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 114 MEMBERSHIP ROSTER

Mahmoud G. Nagib, MD Daniel G. Nehls, MD, FACS William G. Obana, MD 305 Piper Bldg. Neurosurgery Northwest 1380 Lusitana St., Ste. 410 800 E. 28th St. 1708 Yakima Ave., Ste. 105 Honolulu, HI 96813-2449 Minneapolis, MN 55407-3799 Tacoma, WA 98405-5300 (808)523-9993 (612)871-7278 (253)426-4243 Serge K. Obukhoff, MD, PhD Richard C. Nagle, MD John Neill, MD PO Box 2060 8625 Don Carol Dr. PO Box 321442 Santa Monica, CA 90406-2060 El Cerrito, CA 94530-2752 Flowood, MS 39232-1442 (323)933-3434 (510)524-0162 (601)932-1733 Herbert M. Oestreich, MD Aurangzeb N. Nagy, MD Paul B. Nelson, MD One Wellhouse Ln. 10001 S. Eastern Ave., Ste. 408 Indiana University Medical Center Mamaroneck, NY 10543 Henderson, NV 89052-3908 545 Barnhill Dr. Emerson Hall 139 (914)493-8392 (702)737-7070 Indianapolis, IN 46202 (317)274-5725 Stephen K. Ofori-Kwakye, MD Hiroshi Nakagawa, MD 3201 W. Gore Blvd., Ste. 303 Aichi Medical University/Neurosurgery Andrew Nicholas Nemecek, MD Lawton, OK 73505-6350 Nagakute-cho Aichi-gun Box L-472 (580)353-6000 Aichi-Ken 4801195 3181 S.W. Sam Jackson Park Rd. Japan Portland, OR 97239-3098 Seong-Hoon Oh, MD 561623311 (503)494-2360 Hanyang Univ. Hospital/Neurosurgery 17 Haengdang-dong Sungdong-gu Victor B. Nakkache, MD, FACS Jaime H. Nieto, MD Seoul 133792 166 Hanover St., Ste. 202 Dept. of Surgery & Orthopedic Surgery South Korea Wilkes-Barre, PA 18702-3544 927 49th St. (570)824-7566 Brooklyn, NY 11219 John Bramley Oldershaw, MD (718)283-8049 62 Huntington Ct. Robert A. Narotzky, MD Burr Ridge, IL 60521 1026 E. 2nd St. Daniel E. Nijensohn, MD (630)910-4249 Casper, WY 82601-2946 340 Capitol Ave. (307)266-4000 Bridgeport, CT 06606-5445 William C. Olivero, MD (203)336-3303 University of Illinois at Peoria William B. Naso, MD 719 N. William Kumpf Blvd., Ste. 100 901 E. Cheves St. Fariborz Nobandegani, MD Peoria, IL 61605 Florence, SC 29506-2769 125 E. 84th St., Ste. 4B (309)655-2642 (803)673-0122 New York, NY 10028-0902 (718)459-7700 John P. Olson, MD, PhD Andrew K. Nataraj, MD Heartland Neurosurgery 2457 Collins Ave., #606 Russ P. Nockels, MD 105 Far West Dr., Ste. 202 Miami Beach, FL 33140 Loyola University Medical Center St. Joseph, MO 64506 (305)243-8143 2160 S. 1st Ave. Bldg., 105 Rm. 1900 (816)271-4025 Maywood, IL 60153-3304 Stephen E. Natelson, MD (708)216-0005 Neil P. O'Malley, MD 103 Newland Prof. Bldg. Neurosurgical Specialists LLC 2001 Laurel Ave. Alexis Norelle, MD 1150 Professional Ct., Ste. C Knoxville, TN 37916-1810 Lexington Clinic Hagerstown, MD 21740 (865)525-2601 1401 Harrodsburg Rd., Ste 540 (301)797-9240 Lexington, KY 40504 Ricardo Naumann Flores, MD (859)258-6760 Stephen L. Ondra, MD Hospital Angeles del Pedregral 676 N. St. Clair St., Ste. 2210 Camino A Sta Teresa 1055-960 Richard B. North, MD Chicago, IL 60611 Mexico City, DF 10700 Johns Hopkins University Hospital (312)695-6282 Mexico 600 N. Wolfe St., Meyer 7-113 5555680180 Baltimore, MD 21287-7713 Carlos M. Ongkiko Jr., MD (410)955-2438 210 S. Breiel Blvd. Ramon L. Navarro-Balbuena, MD Middletown, OH 45044-5152 Jaume Cantarer 4 2-2 Robert T. Numoto, MD (513) 422-3251 Terrassa Jikei Univ./Neuros./Minato-Ku Barcelona 08221 3-25-8 Nishi Shinbashi Hirohisa Ono, MD Spain Tokyo 1050003 2058 Summit Dr. (6) 077 07 959 Japan (3) 3433 -1111 Lake Oswego, OR 97034-3624 (503)652-2880 Charles W. Needham, MD Leslie Ann Nussbaum, MD 4811 E. Winged Foot Pl. 3033 Excelsior Blvd., Ste. 403 Jeffrey H. Oppenheimer, MD Tucson, AZ 65718-1727 Minneapolis, MN 55416-4676 1850 Gause Blvd. E., Ste. 304 (203)838-2300 (612)374-0177 Slidell, LA 70461 (985)781-2702 John C. Oakley, MD 3330 37th St. W. Billings, MT 59102 (406)238-6650

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEMBERSHIP ROSTER 115

Bernardo J. Ordonez, MD David Michael Pagnanelli, MD, FACS Paul Park, MD Neurosurgical Associates 676 S.W. Paint Rd. 3552 Taubman Center. 400 Gresham Dr. Cache, OK 73527-3733 Box 0338 Norfolk, VA 23507 (828)697-2346 1500 E. Medical Center Dr. (757)622-5325 Ann Arbor, MI 48109 T. Glenn Pait, MD (734)936-9579 Julio A. Ordonez, MD University of Arkansas - Little Rock 24900 S.E. Stark St., Ste. 209 4301 W. Markham St., Slot 826 Fereidoon Parsioon, MD Gresham, OR 97030-3380 Little Rock, AR 72205-7101 5673 S. Rex Road, Ste. 1149 (503)665-5522 (501)686-5271 Memphis, TN 38119 (901)276-6400 Humberto J. Ortiz-Suarez, MD Sylvain Palmer, MD 890 Ashford Ave., Apt. 5-G Mission Hospital & Reg. Med. Ctr. Robert A. Partain, III, MD San Juan, PR 00907 26732 Crown Valley Pkwy.,Ste. 561 33 Longsford Mission Viejo, CA 92691-7305 San Antonio, TX 78209 Richard K. Osenbach, MD (949)364-1060 (210)614-2453 Duke University Medical Center Box 3807/Neurosurgery Jeff Pan, MD Guillermo A. Pasarin, MD Durham, NC 27710 Emory Healthcare/Neurosurgery 550 350 N.W. 84th Ave., Ste. 108 (919)681-6338 Peachtree St. N.E., Ste. 6400 Plantation, FL 33324-1847 Atlanta, GA 30308-2247 (954)733-9838 Joan Frances O’Shea, MD (404)686-3477 Spine Inst. of South Jersey Naresh P. Patel, MD 538 Lippinoctt Dr. Walter Panganiban, MD Mayo Clinic - Scottsdale Marlton, NJ 08053 Northern California Neuro. Med. 13400 E. Shea Blvd./Neurosurgery (856)797-9161 2400 Country Dr., Ste. 100 Scottsdale, AZ 85259 Fremont, CA 94536-0000 (480)301-8042 Roger Harold Ostdahl, MD, FACS (510)494-5700 Neurosurgery Ltd. Stephen E. Paul, MD 920 Century Dr. Stephen M. Papadopoulos, MD 186 Dusky Ln. Mechanicsburg, PA 17055-4351 Barrow Neurological Institute Suffield, CT 06078 (717)697-5800 2910 N. 3rd Ave. Phoenix, AZ 85013-4473 Wayne S. Paullus Jr., MD Jewell L. Osterholm, MD (602)406-3181 PO Box 579 Hustom Rd. 51690 Amarillo, TX 79159-1690 Radnor, PA 19087-4434 Christopher G. Paramore, MD (806)353-6400 (215)955-6744 Florence Neurosurgery and Spine 901 E. Cheves Street, #420 John Bruce Payne, DO Richard C. Ostrup, MD Florence, SC 29506 PO Box 879 501 Washington, Ste. 700 (843)673-0122 Bedford, TX 76095-0879 San Diego, CA 92103-2231 (817)868-9300 (619)297-4481 Laura S. Pare, MD, FRCS(C) Bldg. 3, Rt. 81, Room 313 William F. Peach, MD John E. O’Toole, MD 101 The City Dr. S./Neurosurg. 11 Burton Ave. 2000 N. Lincoln Park W., Apt. 712 Orange, CA 92868-3298 Newport News, VA 23601-1601 Chicago, IL 60614 (714)456-6966 (757)595-7608 (773)702-2123 Michel C. Pare, MD Valmore A. Pelletier, MD Kenneth H. Ott, MD Dalton Neurosurgical & Spine Assoc. Northeastneurosurgical LLC 501 Washington, Ste. 700 1107 Memorial Dr., Ste. G3 63 Shaker Rd. San Diego, CA 92103-2231 Dalton, GA 30720 Albany, NY 12204 (619)297-4481 (706)259-7072 (518)446-1850 M. Chris Overby, MD Hyung-Chun Park, MD, PhD Stan Pelofsky, MD 12 Overlook Dr. 7-206 3-GA Shinheung-Dong Neuroscience Specialists Port Washington, NY 11050 Jung-Gu/Neurosurgery 4120 W. Memorial Rd., Ste. 300 (516)773-7737 South Korea Oklahoma City, OK 73120-9322 (405)748-3300 A. E. Oygar, MD (3) 28903506 P.O. Box 90569 Jung Yul Park, MD, PhD Richard E. Pelosi, MD San Diego, CA 92161 Korea Univ. Med. Coll./Ansan Hospital 1 W. Ridgewood Ave., Ste. 208 (858)642-3083 516 Gojan-dong Danwon-Ku Paramus, NJ 07652 (201)445-8666 Burak M. Ozgur, MD Ansansi Kyungki-do 425707 Univ. of California/San Diego Med. Ctr. South Korea Terrence L. Pencek, MD, PhD 200 W. Arbor Dr./Neurosurgery 8893 (8) 24125053 2921 Montvale Dr. San Diego, CA 92103-8893 Springfield, IL 62704-5359 (619)543-5540 (217)793-9600

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 116 MEMBERSHIP ROSTER

Mick J. Perez-Cruet, MD Chee Pin Chee, MD Randall W. Porter, MD 1070 Timberlake Dr. 11 Lorong Bukit Pantai 6 1411 W. Caribbean Ln. Bloomfield, MI 48302-2849 Kuala Lumpur 59100 Phoenix, AZ 85023-6792 (248)440-2162 Malaysia (602)406-4856 (3) 207 26331 Noel I. Perin, MD Harold D. Portnoy, MD St. Luke’s Roosevelt Hospital Center Anselmo Pineda, MD, FACS Michigan Head & Spine PLLC 1000 10th Ave., Ste. 5G-80 PMB 301 44555 Woodward Ave., Ste. 506 New York, NY 10019 5267 Warner Ave. Pontiac, MI 48341-2982 (212)523-6720 Huntington Beach, CA 92649-4079 (248)334-2568 (714)369-8897 Srinivasan Periyanayagam, MD John B. Posey, MD 390 W. 17th St. Cesar A. Pinilla, MD 13101 Dover Rd. Hopkinsville, KY 42240 Box 11051 Reisterstown, MD 21136 (502)886-1944 Panama 6 (410)584-2632 Panama City Thomas P. Perone, MD Panama Elisabeth M. Post, MD 62 Jamestowne Ct. 263 - 7977 Professional Building East, #201 Baton Rouge, LA 70809-2169 Rancocas (225)923-2701 John G. Piper, MD 1113 Hospital Dr. Iowa Clinic/Neurosurgery & Spinal Willingboro, NJ 08046-1103 Phanor L. Perot, Jr., MD, PhD Surgery 411 Laurel St., Ste. 2350 (609)877-5112 Medical University of South Carolina Des Moines, IA 50314 96 Jonathan Lucas St., Ste. 428 CSB (515)223-3800 Kalmon D. Post, MD Charleston, SC 29425-0001 Mount Sinai School of Medicine (843)792-2424 Madhavan Pisharodi, MD 1 Gustave L. Levy Pl. 942 Wildrose Ln. Box 1136 R. G. Perrin, MD Brownsville, TX 78520-8817 New York, NY 10029-6500 Room 948, 9th Floor (956)541-6725 (212)241-0933 55 Queen St. E. Toronto, ON M5C-1R6 Walter S. Piskun, MD Michael W. Potter, MD Canada 3501 Soncy, Ste. 126 628 N. Main St. (416)864 5503 Amarillo, TX 79119 Ashland, OR 97520-1710 (806)350-7813 (541)774-8985 Daniel L. Peterson, MD Neurosurgical Specialists Frederick W. Pitts, MD Eric A. Potts, MD 400 W. 15th St., Ste. 800 929 McCarthy Ct. Indianapolis Neurosurgical Group Austin, TX 78701-1655 El Sequndo, CA 90245 5766 N. Pennsylvania St. (512)306-1323 (213)977-1102 Indianapolis, IN 46220 (317)396-1300 Christopher J. Pham, DO Francis J. Pizzi, MD 555 Tachevah Dr., Ste. 3-W103 3131 Princeton Pike, Bldg. 4 Ste. 201 Neil Garrett Powell, MD Palm Springs, CA 92262-0000 Lawrenceville, NJ 08648-2526 393 Wallace Rd., Ste. 100 (760)320-2120 (609)895-8898 Nashville, TN 37211 (615)834-4321 Matthew F. Philips, MD Howard A. Platt, MD 30 Brigham St. 226 Holly Ln. Kimball N. Pratt, MD, FACS New Bedford, MA 02747 Clarks Summit, PA 18411 3891 Norton Hills Rd. (508)993-3555 Muskegon, MI 49441-4454 Ian F. Pollack, MD (231)728-4243 John G. Phillips, MD Children’s Hospital of Pittsburgh 224 Malibu Cove 3705 5th Ave./Neurosurgery William T. Price, MD Bonita Springs, FL 34134-0000 Pittsburgh, PA 15213-2524 2505 Teckla Blvd. (412)692-5881 Amarillo, TX 79106-6044 Joel D. Pickett, MD (806)355-8296 The Spine & Neurosurgery Center Alfredo Pompili, MD 105 Rand Ave. Div. of Neurosurgery/Inst. Regina Elena Patrick R. Pritchard, MD Huntsville, AL 35801-4317 Via Elio Chianesi 53 UAB/Div. of Neurosurgery (256)533-1600 Italy 510 20th St. S./FOT 1008 652662721 Birmingham, AL 35294-3410 Prem K. Pillay MBBS, FACS (205)996-4556 Asian Brain-Spine-Nerve Center Francois Porchet, MD 3 Mt. Elizabeth #15-03 Schulthess Clinic Donald J. Prolo, MD Singapore 228510 Lengghalde 2 203 Di Salvo Ave. Singapore Zurich 8008 San Jose, CA 95128-1628 683 54325 Switzerland (408)295-4022 (01) 385 78 74

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEMBERSHIP ROSTER 117

Melvin E. Prostkoff, MD William M. Rambo, Jr., MD Charles D. Ray, MD Great Bay Neurosurgical Associates 2728 Sunset Blvd., Ste. 106 Hope Ranch 750 Central Ave., Ste. H West Columbia, SC 29169 4320 Via Presada, Dover, NH 03820-3434 (803)794-3700 Santa Barbara, CA 93110 (603)749-0888 (757)988-0600 Archimedes Ramirez, MD Gregory J. Przybylski, MD 1125 Sir Francis Drake Blvd., #A Joel W. Ray, MD, FACS JFK Med. Ctr. Neuroscience Institute Kentfield, CA 94904-1418 Cape Neurosurgical Assoc. 65 James St. (415) 461-3502 150 S. Mount Auburn Rd., #320 PO Box 3059 Cape Girardeau, MO 63703-6364 Edison, NJ 08818 Rafael M. Ramirez, MD (573)339-0900 (732)744-5848 PO Box 36132 Cincinnati, OH 45236-0132 Morris William Ray, MD Morris Wade Pulliam, MD (513)984-4133 Semmes-Murphey Clinic 9485 Hunt Club Trail N.E. 6325 Humphreys Blvd. Warren, OH 44484-1740 Gustavo Ramos, MD Memphis, TN 38120-2300 (330)884-5833 1200 E. Savannah, Ste. 3 (901)522-7700 McAllen, TX 78503-1240 David Buenor O. Puplampu, MD (956) 687-1998 Roger A. Ray, MD 1390 Saddle Rack St., Apt. 243 426 E. Dr. Hicks Blvd. San Jose, CA 95126-5115 Jeffrey B. Randall, MD Florence, AL 35630 Pacific Brain & Spine Med. Group (256)764-7721 Donald O. Quest, MD 20055 Lake Chabot Rd., #110 New York Neurological Institute Castro Valley, CA 94546-5332 Richard B. Raynor, III, MD 710 W. 168th St. (510)886-3138 112 E. 74th St. New York, NY 10032-2603 New York, NY 10021-3503 (212)305-5582 Sanjay C. Rao, MD (212)535-1255 Marshfield Clinic Matthew R. Quigley, MD 1000 N. Oak Ave. Nizam Razack, MD Allegheny General Hospital Marshfield, WI 54449-5777 Spine & Brain Neurosurgery Center 420 E. North Ave., Ste. 302 (715)387-5297 77 W. Underwood St., Ste. 400 Pittsburgh, PA 15212-4746 Orlando, FL 32806 (412)359-6200 George H. Raque, Jr., MD (407)423-7172 Kosiar Children’s Hospital Alfredo Quinones-Hinojosa, MD 210 E. Gray St., Ste. 1102 Gary L. Rea, MD Johns Hopkins Univ./Neurosurgery Louisville, KY 40202-3907 Univ. Orthopaedics Physicians 4940 Eastern Ave./B 121 (502)629-5510 1335 Dublin Rd., Ste. 110E Baltimore, MD 21224 Columbus, OH 43215 (410)550-3367 Robert A. Ratcheson, MD (614)487-8807 University Hospitals of Cleveland Alejandra T. Rabadan, MD 11100 Euclid Ave., Rm. 526 Glenn R. Rechtine II, MD, FACS A.V. La Plata 393 8C Cleveland, OH 44106-1736 Univ. of Rochester/Dept. of Orthopaedics Buenos Aires (216)844-5747 601 Elmwood Ave., Box 665 Argentina Rochester, NY 14642 (11)4958-4212 John Kevin Ratliff, MD (585)275-5168 909 Walnut, 2nd Fl. Majid Rahimifar, MD Philadelphia, PA 19107 Mark P. Redding, MD 2601 Oswell St., Ste. 101 (215)955-7000 Carolina Neurosurgery & Spine Assoc. Bakersfield, CA 93306 200 Medical Park Dr., Ste. 350 (805)872-9999 Paul K. Ratzker, MD Concord, NC 28025-0938 The Back Institute (704)792-2672 Ali I. Raja, MD, MS 700 Rahway Ave., 2nd Fl. 2200 Riverfront Dr., #1109 Union, NJ 07083-5715 John D. Reeves, MD Little Rock, AR 72202 (908)688-1999 Clinics of North Texas (501)296-1138 501 Midwestern Pkwy. East Michael J. Rauzzino, MD Wichita Falls, TX 76302 Viswanathan Rajaraman, MD Cheasepeake Neurosurgical Assoc. (940)766-8405 Comprehensive Neurosurgical PC 1364 S. Milwaukee St. 20 Prospect Ave., Ste. 907 Denver, CO 80210 Mark V. Reichman, MD Hackensack, NJ 07601-1997 (303)752-2724 Neurosurgical Associates (201)342-2550 370 E. 9th Ave., Ste. 111 Stephen E. Rawe, MD, PhD Salt Lake City, UT 84103-2877 Richard A. Rak, MD 9275-B Medical Plaza Dr. (801)408-2067 Carle Clinic Association Charleston, SC 29406 602 W. University Ave. (843)553-9300 Steven A. Reid, MD Urbana, IL 61801 4343 W. Newberry Rd., Ste. 2 (217)383-3340 Raymond Blaine Rawson, MD Gainesville, FL 32607-2822 515 W. Jefferson St. (352)332-7246 Petoskey, MI 49770 (231)348-5622

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 118 MEMBERSHIP ROSTER

Edward Reifel, MD Eric Loren Rhoton, MD Michael H. Robbins, MD 1901 94th Ave. N.E. Mountain Neurological Center 3939 J St., Ste. 380 Clyde Hill, WA 98004-2525 7 Vanderbilt Park Dr. Sacramento, CA 95819-3631 Asheville, NC 28803 (916)453-0911 Ronald Reimer, MD (828)255-7776 Mayo Clinic Jacksonville Clifford Roberson, MD 4500 San Pablo Rd. Albert L. Rhoton Jr., MD Samaritan Neurosurgery Jacksonville, FL 32224-1865 University of Florida - Gainesville 3615 NW Samaritan Dr., Ste. 210 (904)953-2252 Box 100265 Corvallis, OR 97330 Gainesville, FL 32610 (541)768-5210 George Timothy Reiter, MD (352)392-4331 PSMS Hershey MC/Neurosurgery H110 Cavett M. Robert, Jr., MD 500 University Dr. J. Ronald Rich, MD 3959 Canyon Rd. PO Box 850 2811 Wilshire Blvd., Ste. 840 Lafayette, CA 94549-2701 Hershey, PA 17033-0850 Santa Monica, CA 90403 (925) 980-5908 (717)531-8807 (310)315-3404 Melville P. Roberts, MD Robert L. Remondino, MD Kenneth J. Rich, MD Waterloo House Candie Rd. Neuroscience Specialists 4120 W. Capital Neurosurgery Inc. St. Peter Port Guernsey Memorial Rd., Ste. 300 1100 Dresser Ct., Ste. 100 Channel Islands, EN GY11UP Oklahoma City, OK 73120-9322 Raleigh, NC 27609-7300 United Kingdom (405)748-3300 (919)850-9911 Daniel Payne Robertson, MD Justin W. Renaudin, MD Michael T. Richard, MD Ocala Neurosurgical Center 1782 Colgate Cir. Ottawa General Hospital 1901 S.E. 18th Ave., #101 La Jolla, CA 92037-6908 501Smyth Rd. Ocala, FL 34471 (858)459-7543 Ottawa, ON K1H-8L6 (325)622-3360 Canada Setti S. Rengachary, MD (613)737-8107 Bernard Robinson, MD Wayne State University 98-944 Kahapili St. 4160 John R St., Ste. 930 Donald E. Richardson, MD Aiea, HI 96701 Detroit, MI 48201-2153 Tulane University School of Medicine (808)834-5333 (313)966-5007 1430 Tulane Ave. SL47 New Orleans, LA 70112-2699 James C. Robinson, MD Kenneth I. Renkens, MD (504)588-5565 Robinson Neurosurgery Indiana Spine Group 2001 Peachtree Rd., Ste. 645 8402 Harcourt Rd., Ste. 400 Robert Richardson, MD Atlanta, GA 30309-1766 Indianapolis, IN 46260 8426 Buckingham Ct. (404)350-0106 (317)228-7000 Willow Springs, IL 60480-1144 (708)839-1918 John R. Robinson, Jr., MD Daniel K. Resnick, MD Center for Cranial & Spinal Surgery University of Wisconsin - Madison Isabelle L. Richmond, MD 509 Riverside Dr., Ste. 203 600 Highland Ave. K4/834 CSC 912 Cedar Meadow Dr. Stuart, FL 34994-2579 Madison, WI 53792-0001 Nellysford, VA 22958 (561)288-5862 (608)263-9651 (434)361-9392 Gaylan L. Rockswold, MD Arden F. Reynolds Jr., MD Todd R. Ridenour, MD, FACS Neurosurgical Associates Ltd. Quincy Medical Group 1351 W. Central Park, Ste. 4300 701 Park Ave. South 1025 Maine St. Davenport, IA 52804-1889 Minneapolis, MN 55415-1623 Quincy, IL 62301-4038 (319)383-2763 (612)347-2810 (217)222-6550 Charles J. Riedel, MD James A. Rodgers, MD Ian Reynolds, MD Virginia Neurosurgeons PC Tulsa NeuroSpine 450 Medical Center Blvd. 1625 N. George Mason Dr., #445 6565 S. Yale Ave., Ste. 709 Webster, TX 77598-4234 Arlington, VA 22205 Tulsa, OK 74136 (281)332-9676 (703)248-0111 (918)481-4965 Laurence D. Rhines, MD Stephen Ritland, MD Jose L. Rodriguez, MD, FACS 6202 Orchard Canyon Ct. 1150 N. San Francisco St. 255 E. Bonita Ave., #9 Kingwood, TX 77345 Flagstaff, AZ 86001-3200 Pomona, CA 91767-1923 (713)563-8710 (928)779-7880 (909)450-0369 R. L. Patrick Rhoten, MD Raul V. Rivet, MD Gerald E. Rodts, Jr., MD 120 S. Spalding Dr., Ste. 400 Four Corners Neurosurgical Services Emory Clinic Beverly Hills, CA 90212-1842 555 S. Schwartz Ave. 550 Peachtree St. N.E., Ste. 806 (310)659-6628 Farmington, NM 87401-5955 Atlanta, GA 30308-2247 (505)564-8073 (404)778-7000

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEMBERSHIP ROSTER 119

Ben Z. Roitberg, MD Vincent B. Runnels, MD Pritam S. Sahni, MD University of Illinois at Chicago Northwest Arkansas Neurosurgery PO Box 1587 912 S. Wood St., MC 799 2396 N. Crossover Rd., #1 1702-B Broadway Chicago, IL 60612-7325 Fayetteville, AR 72703-4366 Mount Vernon, IL 62864-1587 (312)996-4842 (501)521-0900 (618)242-6464 Juan F. Ronderos, MD Stephen M. Russell, MD Romualdas Sakalas, MD Ronderos Neurosurgery Center 530 First Ave., Ste. 8R 177 Springline Dr. 6701 Airport Blvd., B-114 New York, NY 10016-9196 Vero Beach, FL 32963-2940 Mobile, AL 36608 (212)263-8002 (561)569-0303 (334)450-3700 Michael J. Rutigliano, MD Sean A. Salehi, MD William S. Rosenberg, MD 70 Lakewood Rd. 1701 S. 1st. Ave., Ste. 302 Midwest Neurosurgery Associates Greensburg, PA 15601-9745 Maywood, IL 60153 6420 Prospect St., Ste. T411 (724)532-0866 (708)343-3566 Kansas City, MO 64132 (816)363-2500 Lenard J. Rutkowski, MD Ayman M. Salem, MD 2413 Malmaison St. 1980 Chickasaw Ave. Jacob Rosenstein, MD Greenville, MS 38701 Los Angeles, CA 90041 800 W. Arbrook Blvd., Ste. 150 (662)332-7720 (818)383-9622 Arlington, TX 76015-4327 (817)467-5551 Patrick G. Ryan, MD Anthony A. Salerni, MD Montgomery Neurosurgical Assoc. Orthopedic Professional Associates Alan Rosenthal, MD 1510 Forest Ave. 14 Maple St., Ste. 100 7840 Talavera Pl. Montgomery, AL 36106 Gilford, NH 03246-6574 Delray Beach, FL 33446 (334)834-6422 (603)528-9100 (516)365-9414 Timothy C. Ryken, MD Julio E. Salinas, MD Michael J. Rosner, MD University of Iowa Hospitals 1005 Bellefontaine Ave., Ste. 260 406 Burge Mountain Rd. 200 Hawkins Dr. Room 1844 JPP Lima, OH 45804-2851 Hendersonville, NC 28792-8224 Iowa City, IA 52242-1009 (419) 223-1702 (828)684-1076 (319)356-3853 Gene Zachary Salkind, MD Michael K. Rosner, MD Stephen I. Ryu, MD 727 Welsh Rd., Ste. 108 817 Woodside Pkwy. Stanford University Medical Center Huntingdon Valley, PA 19006 Silver Spring, MD 20910-6218 300 Pasteur Dr., R297 (215)914-2320 (240)498-7368 Palo Alto, CA 94305-5327 (650)725-0701 Dino Samartzis, BS Matthew J. Ross, MD 5600 N. St. Louis 672 Robinwood Ct. Bernardo Saavedra, MD Chicago, IL 60659 Wheaton, IL 60187-8700 635 E. 78th Ln. (617)270-3841 (630)690-5990 Merrillville, IN 46410-5616 (219)736-1205 Srinath Samudrala, MD David A. Roth, MD LAC-USC Medical Center 3 Woodland Rd., Ste. 412 Robert A. Sabo, MD, FACS 1200 N. State St., Ste. 5046 Stoneham, MA 02180-1702 Harbor Medical Bldg. 110 Los Angeles, CA 90033-1029 (781)665-3355 Harbor Ln., Ste. A (323)226-7421 Somers Point, NJ 08244-2470 George Ryan Roth, Jr., MD (609)653-9110 Thomas E. Sanchez, MD 311 Murphy’s Corner Rd. 5601 De Soto Ave. Woolwich, ME 04579 David P. Sachs, MD, FACS Woodland Hills, CA 91365-4084 (717)697-6251 Neurosurgical Consultants of So. Florida (818) 719-3519 5130 Linton Blvd., Ste. E3 Allen S. Rothman, MD, FACS Delray Beach, FL 33484-6595 Roderick G. Sanden, MD 175 Memorial Hwy. (561)499-5633 3609 Mission Ave., Ste. F New Rochelle, NY 10801-5640 Carmichael, CA 95608-2955 (914)633-4070 Donald J. Sage, MD (916)484-4444 PO Box 100 Norman J. Rotter, MD 569 Old Mammoth Rd. James Leonard Sanders, Jr., MD, FAC Oakwood Hospital Mammoth Lakes, CA Neurology & Neurosurgery Assoc. PA 18181 Oakwood Blvd., Ste. 402 93546-0100 50 2nd St. S.E. Dearborn, MI 48124-5032 Winter Haven, FL 33880-6300 (313)436-2330 K. Singh Sahni, MD (863)293-2107 1651 N. Parham Rd. Catherine A. Ruebenacker-Mazzola, MD Richmond, VA 23229-4605 Steven Allen Sanders, MD, FACS 99 Powder Hill Rd. (804)433-8540 Neurosurgery & Spine Consultants Montvale, NJ 07645-1017 9314 Park West Blvd., Ste. 200 (973)285-7800 Knoxville, TN 37923-4330 (423)694-0577

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 120 MEMBERSHIP ROSTER

Faheem A. Sandhu, MD, PhD Irving Bernard Schacter, MD Steven J. Schneider, MD, FACS Georgetown Univ. 1849 Yonge St., Ste. 400 Long Island Neurosurgical Associates Hospital/Neurosurgery Toronto, ON M4S-1Y2 410 Lakeville Rd., Ste. 204 3800 Reservoir Rd., NW-1PHC Canada New Hyde Park, NY 11042-1101 Washington, DC 20007 (416)489 4917 (516)354-3401 (312)654-8581 Dale M. Schaefer, MD Michael Schneier, MD Paul Santiago, MD 1300 28th St. South, Ste. 7 13160 Mindanao Way, Ste. 300 Dept. of Neurological Surgery Great Falls, MT 59405-5296 Marina Del Rey, CA 90292 660 S. Euclid Ave. CB8057 (406)454-0375 (310)854-3800 St. Louis, MO 63110 (314)362-3580 David George Scheetz, MD Joseph B. Schnittker, MD 4326 Panorama Dr. 303 S. Nappanee St. Theodore Sarafoglu, MD Santa Rosa, CA 95404-6229 Elkhart, IN 46514 6201 SW 118 St. (707)528-1414 (574)296-3262 Miami, FL 33156 (305)271-6159 Gerald R. Schell, MD Glenn W. Schoenhals, MD Saginaw Valley Neurosurgery Neuroscience Specialists Stephen C. Saris, MD 4677 Towne Centre Rd., Ste. 301 4120 W. Memorial Rd., #300 Neurosurgery Associates Inc. Saginaw, MI 48604-2846 Oklahoma City, OK 73120-9322 3 Davol Square, Ste. B200, Box 177 (989)799-8712 (405)748-3300 Providence, RI 02903 (401)453-3545 Thomas C. Schermerhorn, MD Daria D. Schooler, MD 4228 Stone Ridge Dr. 2675 Foxpointe Dr., Ste. B John Sarris, MD Traverse City, MI 49684-7958 Columbus, IN 47203 9 Hospital Dr. (507)281-1464 (812)375-0000 Toms River, NJ 08755-6425 (732)341-1881 Stanton Schiffer, MD Lary A. Schulhof, MD 3868 Mowry Ave. Mountain Neurological Center Raymond Louis Sattler, MD, FACS Fremont, CA 94538-1430 7 Vanderbilt Park Dr. 510 N. 10th St. (510)792-2911 Asheville, NC 28803 PO Box 980489 (828)255-7776 Richmond, VA 23298-0489 Lawrence B. Schlachter, MD JD (804)828-0045 540 Stonemoor Cir. James M. Schumacher, MD Roswell, GA 30075-2279 1921 Waldemere St., Ste. 809 Richard L. Saunders, MD (770)335-3800 Sarastoa, FL 34239 Upper Valley Neurology & Neurosurgery (305)243-4675 106 Hanover St. Daniel Schmelka, MD Lebanon, NH 03766-1037 4710 River Oaks Cir. Hart Schutz, MD (603)448-0447 Grand Forks, ND 58201 101 Queensway West, Ste. 134 (701)780-6283 Mississauga, ON L5B-2P7 Douglas F. Savage, MD Canada 12700 Creekside Ln. James F. Schmidt, MD (416)279-3533 Fort Myers, FL 33919 5050 N.E. Hoyt St., Ste. 410 (239)432-9355 Portland, OR 97213-2983 Frederic T. Schwartz, MD (503)234-0996 5454 Wisconsin Ave., Ste. 840 Martin H. Savitz, MD, PhD, FAC Chevy Chase, MD 20815-6919 30 Old Phillips Hill Rd. Meic H. Schmidt, MD (301)652-6621 New City, NY 10956-2108 Univ. of Utah Hospital/Neurosurgery (845)634-5075 30 N. 1900 E., Ste. 3B-409 Richard Harbison Schwartz, MD, FACS Salt Lake City, UT 84132-2303 1220 E. 3900 S., Ste. 4E Paul D. Sawin, MD (801)581-6908 Salt Lake City, UT 84124 Orlando Neurosurgery (801)261-8507 1605 W. Fairbanks Ave. Karl M. Schmitt, Jr., MD Winter Park, FL 32789-4603 Univ. of Maryland Med. Ctr. P. Robert Schwetschenau, MD (407)894-2362 22 S. Greene St., Ste. S-12D 10550 Montgomery Rd., Ste. 33 Baltimore, MD 21201 Cincinnati, OH 45242-4498 Robert H. Saxton, MD (979)776-8896 (513)791-6400 284 Cross Creek Rd. Mc Gregor, TX 76657-9511 Charles L. Schnee, MD, FACS Charles J. Scibetta, MD (254)848-4472 Lawner-Schnee Neurosurgery Inc. 1661 Soquel Dr. Bldg. F 13320 Riverside Dr., 208 Santa Cruz, CA 95065-1709 Alan M. Scarrow, MD, JD Sherman Oaks, CA 91423 (408)476-8900 1965 S. Fremont, Ste. 1800 (818)783-4949 Springfield, MO 65804 Daniel J. Scodary, MD, FACS (417)820-5150 John H. Schneider,Jr., MD North County Neurosurgery 3611 Tommy Armour Circle 12255 DePaul Dr., Ste. 830 Billings, MT 59106-1014 Bridgeton, MO 63044 (406)237-5760 (314)291-6556

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEMBERSHIP ROSTER 121

Brett Andrew Scott, MD Khalid A. Sethi, MD Christopher B. Shields, MD, FRCS(C) Neurosurgical Associates PSC Neurosurgery 210 E. Gray St., Ste. 1105 1401 Harrodsburg Rd., Ste. B-485 46 Harrison St. Louisville, KY 40202-3907 Lexington, KY 40504-3797 Johnson City, NY 13790 (502)629-5510 (859)277-6143 (607)729-4942 John Shillito, MD Eric W. Scott, MD Itzhack Shacked, MD 102 Cedar Meadows Ln. ATTN: J. N. Scott 6 Hameshorer St. Kiryat Krinizy Chapel Hill, NC 27517 PO Box 140764 Ramat-Gan 526 Retired Gainesville, FL 32614-0764 Israel (352)332-0030 (363)5-8744 Won-Han Shin, MD, PhD Soonchunhyang Univ. Hospital/Neurosurg. Thomas B. Scully, MD Christopher I. Shaffrey, MD 1174 Jung-Dong, Wonmi-Gu,Bucheon-Si Northwest Neuro. Specialists PLLC University of Virginia South Korea 5860 N. LaCholla Blvd., Ste. 100 PO Box 800212 (3) 26215104 Tucson, AZ 85741-3537 Charlottesville, VA 22908 (520)742-7890 (434)243-9714 Roger W. Shortz, MD, FACS PO Box 619 Ricardo Segal, MD Syed Javed Shahid, MD Pinole, CA 94564-0619 Hadassah Univ. Hospital 67 Sandpit Rd., #208 (510)243-2130 PO Box 72000 Kiryat Hadassah Danbury, CT 06810-4032 Jerusalem 91120 (203)792-2003 Raj K. Shrivastava, MD Israel 124 W. 60th St., #12N (267)7-7091 Scott A. Shapiro, MD New York, NY 10023 Wishard Hospital (212)523-6720 Harold L. Segal, MD 1001 W. 10th St., Room 303 1301 20th St., Ste. 240 Indianapolis, IN 46202-2859 Henry M. Shuey, Jr., MD Santa Monica, CA 90404-2053 (317)630-7625 1001 Pine Heights Ave., Ste. 304 (310)829-5888 Baltimore, MD 21229 Ashwini D. Sharan, MD (410)646-0220 Pennie S. Seibert, PhD Neurosurgery Idaho Neuro Inst; 909 Walnut St., 2nd Fl. Grant H. Shumaker, MD Sant Alphonsus Reg Med Philadelphia, PA 19107 5000 Three Mile Rd. 1055 N. Curtis Rd. (215)955-7000 Racine, WI 53406-1014 Boise, ID 83706-1352 (262)637-6106 (208)367-6750 Mohan Raj Sharma, MD PO Box 8974 CPC 085 Malcolm Shupeck, MD Saul William Seidman, MD, FACS Kathmandu Pinehurst Surgical Clinic PA 15055 Montebello Rd. Kathmandu Bagmati 35 Memorial Dr. Cupertino, CA 95014-5429 Nepal Pinehurst, NC 28374-8708 (1) 412 605 (910)295-0237 Lali H. S. Sekhon, MD, PhD Spine Nevada Donald Sheffel, MD Donald P. Sickler, MD 75 Pringle Way, Ste. 605 7844 Villa d’Este Way 6959 Rosecliff Pl. Reno, NV 89502 Delray Beach, FL 33446-4305 Dayton, OH 45459-1389 (775)348-8800 (513)433-0608 Peter E. Sheptak, MD Edward L. Seljeskog, MD, PhD 10 Edgewood Rd. Javed Siddiqi, MD Neurosurgical & Spinal Surgery Pittsburgh, PA 15215 Dept. of Neurosurgery Associates (412)647-1700 480 N. Pepper Ave. 4141 5th St. Colton, CA 92346 Rapid City, SD 57701 Jonathan D. Sherman, MD (909)380-1366 (605)341-2424 7 Vanderbilt Park Dr. Asheville, NC 28803 Shah N. Siddiqi, MD, FRCS(C) David Louis Semenoff, MD (828)225-2608 PO Box 12267 Oconee County Spring, TX 77391-2267 1041 Chestnut Glen William Daniel Sherman, MD (281)469-0339 320 Grand Ave. Athens, GA 30606-7648 Tariq Sifat Siddiqi, MD (706)548-6881 South Pasadena, CA 91030-1633 (323)783-4487 Neuro Sensory Center Moris Senegor, MD 120 Carnie Blvd., Ste. 6 2209 N. California St. Andrew George Shetter II, MD, FACS Voorhees, NJ 08043-4520 Stockton, CA 95204-5503 Barrow Neurological Inst. (609)751-6600 (209)943-0305 2910 N. 3rd Ave. Phoenix, AZ 85013-4434 Khawar M. Siddique, MD Anthony K. Sestokas, PhD (602)406-3469 444 S. San Vicente Blvd., Ste. 800 Surgical Monitoring Associates, Inc. Los Angeles, CA 90048 25 Bala Ave., Ste. 105 (310)903-7790 Bala Cynwyd, PA 19004 (610)668-2183

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 122 MEMBERSHIP ROSTER

Marco T. Silva, MD William D. Smith, MD William W. Sprich, MD, FACS 5110 Oakmount Dr. 3061 S. Maryland Pkwy., #200 1031 Bellevue Ave., Ste. 300 Beaumont, TX 77706 Las Vegas, NV 89109-6227 St. Louis, MO 63117 (409)898-7800 (702)737-1948 (314)644-0042 Jon M. Silver, MD Brian E. Snell, MD Paul E. Spurgas, MD Mountain Neurological Center 7143 Turnberry Cir. 47 New Scotland Ave., #M61 7 Vanderbilt Park Dr. Tyler, TX 75703 Albany, NY 12208-3412 Asheville, NC 28803-0000 (903)595-2441 (518)262-5088 (828)255-7776 Lewis S. Snitzer, MD Samuel K. St. Clair, MD Scott L. Simon, MD PO Box 661 Neurosurgical Associates PC Orthopaedic & Neurosurgery Spec. Huntingdon Valley, PA 19006 4201 Lake Boone Tr., Ste. 202 32 Strawberry Hill Ct., (814)255-4260 Raleigh, NC 27607-6520 Stanford, CT 06902 (919)235-0500 (203)487-0363 Robert B. Snow, MD 523 E. 72nd St. Noam Y. Stadlan, MD Charles W. Simpson, MD New York, NY 10021-4099 CINN Specialty Care Pavilion 3924 Gillon (212)717-0256 4501 N. Winchester Ave., 3rd Fl. Dallas, TX 75205 Chicago, IL 60640-5205 (214)750-3646 William E. Snyder. Jr., MD (773)388-7700 University of Tennessee - Knoxville Anthony H. Sin, MD 1932 Alcoa Hwy., Ste. 550 J. Michael Standefer, MD, FACS LSU/Neurosurgery Knoxville, TN 37920-1588 520 Lexington Ave. PO Box 33932 (865)524-1869 Fort Smith, AR 72901-4641 Shreveport, LA 71130-3932 (479)785-3400 (318)675-4970 William W. S. So, MD 411 N. Lakeview Ave. Richard A. Stea, MD Donald Slaughter, MD Anaheim, CA 92807-3028 51 Night Shade Ln. 200 E. 33rd St. (714)279-4673 Irvine, CA 92603 Baltimore, MD 21218-3322 (949)725-0658 (410)467-3995 Donald Soloniuk, MD PO Box 1103 Karl Stecher Jr., MD Andrew E. Sloan, MD 324 5th St., Ste. 101 5200 DTC Pkwy., #200 Moffitt Cancer Center/Neuro-Oncology Lewiston, ID 83501-2408 Greenwood Village, CO 80111-2715 12902 Magnolia Dr. (208)746-5025 (303)779-8887 Tampa, FL 33612 (813)979-3871 Volker K. H. Sonntag, MD Bennett M. Stein, MD Barrow Neurological Institute 411 Claremont Rd. Jonathan R. Slotkin, MD 2910 N. 3rd Ave. Bernardsville, NJ 07924-1105 400 Brookline Ave., Apt. 17F Phoenix, AZ 85013-4434 Boston, MA 02215-5407 (602)406-3458 Alfred Steinberger, MD (617)272-0803 309 Engle St., Ste. 6 Peter M. Sorini, MD Englewood, NJ 07631-1822 Hugh F. Smisson, III, MD Big Sky Neuroscience & Spine (201)569-7737 Georgia Neurosurgical Institute 700 W. Gold St. 840 Pine St., Ste. 880 Butte, MT 59701-2358 Michael Patrick Steinmetz, MD Macon, GA 31201 (406)782-6391 3117 Stratton Way, #308 (478)743-7092 Madison, WI 53719 Thomas N. Spagnolia, MD, PhD Bryson Swain Smith, MD 222 N. 7th. St. Erick Stephanian, MD 425 E. 5350 S, Ste. 315 Bismarck, ND 58506 1621 N. 4th St. Ogden, UT 84405-7407 (701)530-8297 Terre Haute, IN 47804-4067 (801)479-9119 (812)232-4771 Mark A. Spatola, MD Donald A. Smith, MD Orange Park Neurosurgery PL Sigurdur A. Stephensen, MD University of South Florida 2021 Kingsley Ave., Ste. 101 Neurologic Associates 4 Columbia Dr., Ste. 730 Orange Park, FL 32073 931 Chatham Ln., Ste. 200 Tampa, FL 33606-3568 (904)276-3376 Columbus, OH 43221-2486 (813)259-0633 (614)324-4661 Caple A. Spence, MD Mark D. Smith, MD 2710 St. Francis Dr., Ste. 110 Jack Stern, MD 175 Amendment Ave., Ste. 104 Waterloo, IA 50702-5664 5911 Walnut Hill Ln. Rock Hill, SC 29732 (319)272-5000 Dallas, TX 75230-5013 (803)325-1618 (214)373-0162 Robert J. Spinner, MD Stewart C. Smith, MD Mayo Clinic Mark Stern, MD 3330 N.W. 56th St., Ste. 600 200 1st St./Neurosurgery S.W. S. California Institute of Neurosurgery Oklahoma City, OK 73112 Rochester, MN 55905 705 E. Ohio Ave. (405)552-2888 (507)284-2376 Escondido, CA 92025-3418 (760)489-9490

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEMBERSHIP ROSTER 123

Mark K. Stevens, MD, PhD Ann R. Stroink, MD Steven E. Swanson, MD, FACS Franciscan Skemp Healthcare Central Illinois Neuro Health Science Neurosurgery 700 W. Ave. South 1015 S. Mercer Ave. 1221 Whipple St. La Crosse, WI 54601-4783 Bloomington, IL 61701-7107 PO Box 4105 (608)791-9831 (309)662-7500 Eau Claire, WI 54702-4105 (715)838-1950 George C. Stevenson, MD Brian R. Subach, MD 2690 Bechelli Ln., Ste. C Virginia Spine Inst. Karin R. Swartz, MD Redding, CA 96002-0930 1831 Wiehle Ave., Ste. 200 University of Kentucky Neurosurgery (530)243-7531 Reston, VA 20190-5200 800 Rose St., MS108C (703)709-1114 Lexington, KY 40536 John C. Stevenson, MD (859)323-5928 4500 Newberry Rd. P. Daniel Suberviola, MD, FRCSC Gainesville, FL 32607 3255 Yale Ct. Thomas A. Sweasey, MD (352)336-6000 Brookfield, WI 53005-2772 235 Fox Lake Ct. (414)385-2710 Winston-Salem, NC 27106- Kevin L. Stevenson, MD (336)714-0263 5455 Meridian Mark Rd., Ste. 540 Loubert Steven Suddaby, MD Atlanta, GA 30342-1551 Southwestern Blvd., Ste. A 3775 Martin Swiecicki, MD, FACS (404)255-6509 Orchard Park, NY 14127-1232 1101 N. Park Ave. (716)667-1980 Haddon Heights, NJ 08035-1607 Todd J. Stewart, MD (856)547-2489 Campus Box 8057-WUSM Michael G. Sugarman, MD 660 Euclid Ave. Delaware Neurosurgical Group PA David W. Swingle, MD St. Louis, MO 63132 774 Christiana Rd., Ste. 202 Box 1449 (314)362-3576 Newark, DE 19713-4221 701 Pennsylvania Ave. (302)366-7671 Fort Washington, PA 19034 Charles B. Stillerman, MD (215)542-1240 Trinity Professional Building Jung-Keun Suh, MD, PhD 20 Burdick Expy. W., #401 Anam-Dong Seungnbuk-Gu George Walter Sypert, MD Minot, ND 58701-4498 126-1 5 Ga 352 6th St. S. (701)857-5877 Seoul 136075 Naples, FL 34102-6349 South Korea (239)432-0774 Paul E. Stohr, MD (2) 9205729 2 Kirken Knoll Dennis C. Szymanski, MD St. Louis, MO 63131-2310 Daniel Y. Suh, MD, PhD 411 Momany Dr. (314)567-4046 Neurological Institute of Savannah St. Joseph, MI 49085 4E Jackson Blvd. (616)429-2888 Amos Stoll, MD, FACS Savannah, GA 31405 1314 S.E. 2nd Ave. (912)355-1010 Asher H. Taban, MD Fort Lauderdale, FL 33316-1810 18350 Roscoe Blvd., Ste. 304 (954)763-6655 MariaElaina Sumas, MD Northridge, CA 91325-4109 46 Shalebrook Dr. (818)993-6063 Jim Lewis Story, MD Morristown, NJ 07960 3135 Stonehaven (973)425-0213 Leonello Tacconi, MD, FRCS San Antonio, TX 78230 Neurosurgery/Ospedale Di Cattinara (510)567-5625 Narayan Sundaresan, MD Strada Di Fiume 447 1148 5th Ave. Trieste 34100 Andrea L. Strayer MSN, CNRN New York, NY 10128-0807 Italy Univ. of Wisconsin Hospital (212)876-7575 403994735 600 Highland Ave., K4/844 Box 8660 Mitchell L. Supler, MD Tomoko Takahashi, MD Madison, WI 53792 Brevard Orthopaedic Spine & Pain Clinic Tohoku University School of Medicine (608)262-4401 205 E. NASA Blvd., Ste. 200 Dept. of Neurosurgery Melbourne, FL 32901 Sendai 980-8574 Scott W. Strenger, MD, MMM (321)723-7716 Japan Harbor Medical Bldg. (2) 2717 - 7230 110 Harbor Ln., Ste. A Leonardo Svarzbein, MD Somers Point, NJ 08244 2B Ayacucho Yoshiro Takaoka, MD, PhD (609)653-9110 1096 Buenos Aires, BA 1111 MetroHealth Medical Center Argentina 2500 MetroHealth Dr. Douglas L. Stringer, MD 91150521214 Cleveland, OH 44109-1900 2011 N. Harrison Ave. (216)778-4258 Panama City, FL 32405-4545 Karl W. Swann, MD (850)769-3261 Texas Neurosciences Institute Masakazu Takayasu, MD 4410 Medical Dr., Ste. 610 3-1 Goshoai Merle Preston Stringer, MD San Antonio, TX 78229-3737 Koryuji-cho 2011 N. Harrison Ave. (210)614-2453 Japan Panama City, FL 32405-4545 (5) 2744 - 2353 (850)769-3261

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 124 MEMBERSHIP ROSTER

Gordon Tang, MD Geoffrey M. Thomas, MD Troy M. Tippett, MD 20055 Lake Chabot, Ste. 110 Michigan Brain & Spine Institute 1717 N. E St., Ste. 422 Castro Valley, CA 94546 5315 Elliott Dr., Ste. 102 Pensacola, FL 32501-6339 (510)886-3138 Ypsilanti, MI 48197-8634 (850)444-7050 (734)434-4110 Edward C. Tarlov, MD Frederick D. Todd, II, MD Lahey Clinic B. Gregory Thompson Jr., MD 800 W. Arbrook Blvd., Ste. 250 41 Mall Rd. Univ. of Michigan Arlington, TX 76015-4393 Burlington, MA 01805-0001 1500 E. Medical Center Dr., MC TC3470 (817)465-7764 (781)273-8644 Ann Arbor, MI 48109-0338 (734)936-7493 Sidney Tolchin, MD Charles H. Tator, MD, PhD, MA 9804 Grandview Dr. Toronto Western Hospital Gregory Errol Thompson, MD La Mesa, CA 91941-5622 399 Bathurst St., 4W-433 Allen Neurosurgical Assoc. (619)462-3715 Toronto, ON M5T-2S8 830 Ostrum St. Bethlehem, PA 18015 Canada (610)954-9005 Daniel J. Tomes, MD (416)603-5889 6311 Woodstock Ave. Mark K. Thompson, MD Lincoln, NE 68512 Robert W. Taylor, MD Box 1189 (913)663-0209 9188 Chalfonte Dr. N.E. 450 Clarkson Ave./Neurosurgery Warren, OH 44484 Brooklyn, NY 11203 Roland A. Torres, MD (330)856-1884 (718)245-4707 Stanford University Medical Center Dept. of Neurosurgery, MC5327 William R. Taylor, MD William E. Thorell, MD Stanford, CA 94305 University of California - San Diego 9802 Westchester Dr. 200 W. Arbor Dr., Ste. 8893 Omaha, NE 68114 Richard M. Toselli, MD San Diego, CA 92103-8893 (402)559-3995 7 Crestwood Rd. (619)543-5540 Barrington, RI 02806-4013 Phillip A. Tibbs, MD (802)658-5142 Richard J. Teff, MD University of Kentucky Medical Center 5655 Upper Valley Rd. 800 Rose St., Room MS107 Russell L. Travis, MD El Paso, TX 79932-3038 Lexington, KY 40536-0001 2032 Von List Way (915)569-2724 (859)323-5863 Lexington, KY 40502-2704 (859)224-2006 Francesca D. Tekula, MD Robert E. Tibbs, Jr., MD 13625 Golden Ridge Ln. Neuroscience Specialists Vincent C. Traynelis, MD McCordsville, IN 46055 4120 W. Memorial Rd., Ste. 300 University of Iowa Hospitals (317)336-6860 Oklahoma City, OK 73120-9322 200 Hawkins Dr./Neurosurgery (405)748-3300 Iowa City, IA 52242-1009 Mark A. Testaiuti, MD (319)356-2774 CoastalSpine, PC Robert L. Tiel, MD 4000 Church Rd. Louisiana State University Medical Center Steven J. Tresser, MD Mt. Laurel, NJ 08054 1542 Tulane Ave. Neurological Specialties (856)222-4444 Box T7-3 2816 W. Virginia Ave. New Orleans, LA 70112 Tampa, FL 33607-6330 Larry L. Teuber, MD (504)568-6120 (813)876-6321 Neurosurgical & Spinal Associates 4141 Fifth St. Humberto Tijerina, MD Gregory R. Trost, MD Rapid City, SD 57701 PO Box 5426 University of Wisconsin - Madison (605)341-2424 McAllen, TX 78502-5426 600 Highland Ave., K3/803 (956)631-8717 Madison, WI 53792 Nicholas Theodore, MD (608)263-1411 2141 E. Rancho Dr. Stephen L. Tillim, MD Phoenix, AZ 85016-2719 101 First St., Ste. 287 Eve C. Tsai, MD, PhD (602)406-3621 Los Altos, CA 94022 Cleveland Clinic/Neurosurgery (650)559-1880 9500 Euclid Ave., S-80 Charles S. Theofilos, MD Cleveland, OH 44195 11621 Kew Gardens Ave., Ste. 101 George T. Tindall, MD (216)444-5539 Palm Beach, FL 33410-2853 Mid Georgia Neurosurgery (561)630-3870 227 Rose Hill Rd. Goro Tsuchiya, MD Meansville, GA 30256-2221 3535 30th Ave., Ste. 205 Phudhiphorn Thienprasit, MD (770)567-3874 Kenosha, WI 53144 Millennium Neurosurgery (262)553-9700 1560 Beam Ave., Ste. D Richard H. Tippets, MD Maplewood, MN 55109-1171 Neurosurgical Associates Gerald F. Tuite Jr., MD (651)748-1461 370 E. 9th Ave., Ste. 111 CSB/PO Box 250616 Salt Lake City, UT 84103-2877 96 Jonathan Lucas St., Ste. 428 (801)408-2067 Charleston, SC 29425 (843)792-9782

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Donn Martin Turner, MD Federico C. Vinas, MD John B. Wahlig, Jr., MD Front Range Center for Brain & Spine 311 N. Clyde Morris Blvd., Ste. 550 Neurosurgery Associates PA 1313 Riverside Ave. Daytona Beach, FL 32114-2766 49 Spring St. Fort Collins, CO 80524-4352 (904)251-7644 Scarborough, ME 04074-8926 (970)493-1292 (207)885-0011 A. Giancarlo Vishteh, MD William R. Turpin, MD 21 E. Sixth St., Ste. 304 Alan S. Waitze, MD PO Box 302890 Tempe, AZ 85281 500 Chase Pkwy. Austin, TX 78703-0049 (480)827-2200 Waterbury, CT 06708 (512)454-4836 (203)778-5770 Massimiliano Visocchi, MD Clyde G. Tweed, MD Univ. Cattolica/Istituto Di Joseph Robert Walker, MD 1435 Dunn Ave. Neurochirugia Sierra Neurosurgery Group Daytona Beach, FL 32114-1437 Largo Agostino Gemelli 8 85 Kirman Ave., Ste. 202 (386)253-5601 Roma 00168 Reno, NV 89502 Italy (775)323-2080 William A. Tyler, Jr., MD 360-807781 525 Arrowhead Trail Michael D. Walker, MD Knoxville, TN 37919 Todd W. Vitaz, MD 244 Cedar Park Cir. (865)524-1869 210 E. Gray St., Ste. 1102 Sarasota, FL 34242-1216 Louisville, KY 40202 (941)346-7866 Christopher Uchiyama, MD, PhD (502)629-5510 Scripps Clinic Patrick R. Walsh, MD, PhD 10666 N. Torrey Pines Rd., SW210 Amir A. Vokshoor, MD 15480 W. Burleigh Rd. La Jolla, CA 92037 Neurosurgery/4th Fl. Brookfield, WI 53005 (858)554-8163 1505 N. Edgemont St. Los Angeles, CA 90027 Beverly C. Walters, MD David D. Udehn, MD (323)783-4704 The Carriage House 4350 7th St., Unit E 100 Butler Dr./Neurosurgery Moline, IL 61265-6870 Dennis G. Vollmer, MD Providence, RI 02906-4862 (309)764-3993 Univ. of TX Medical School - Houston (401)421-4703 6431 Fannin MSB 7.148 M. Unnikrishnan, MD Houston, TX 77030 Carrie L. Walters, MD Chairman Neurosurgery (713)500-6110 Neurological Surgeons Aims Amrita Ln. Elamakara (PO) Cochin 345 E. Virginia Ave. Kerala 682026 Edward Von der Schmidt, III, MD Phoenix, AZ 85004 India 419 N. Harrison St., Ste. 204 (602)254-3151 (48) 434 0425 Princeton, NJ 08540-3521 (609)924-3614 Jeremy C. Wang, MD Prabhundha Vanasupa, MD 18333 Egret Bay Blvd., Ste. 200 3491 E. Highland Dr. Arbha Vongsvivut, MD Houston, TX 77058 Bay City, MI 48706-2414 815 E. 5th St., Ste. 101 (281)333-1300 Alton, IL 62002-6471 Arnold B. Vardiman, MD (618)462-0547 Michael Y. Wang, MD Texas Neurosciences Institute LAC/USC Med. Ctr./Neurosurgery 4410 Medical Dr., Ste. 610 Rand M. Voorhies, MD 1200 N. State St., Rom 5036 San Antonio, TX 78229 Ochsner Clinic Foundation Los Angeles, CA 90033 (210)614-2453 1514 Jefferson Hwy. (323)226-7421 New Orleans, LA 70121-2429 Alfredo C. Velasquez, MD (504)842-4033 John D. Ward, MD 209 W. Washington St., Ste. 100 Medical College of Virginia Charleston, WV 25302-2345 Nicholas F. Voss, MD Box 980631 MCV (304)344-3551 Neurosurgical Assoc. of Dothan PC Station Richmond, VA 23298 PO Box 2247 (804)828-9165 Raul A. Vernal, MD Dothan, AL 36302-2247 360 Dardanelli Ln., Ste. 2G (334)793-6573 Thomas M. Wascher, MD Los Gatos, CA 95032-1421 NeuroSpine Center of Wisconsin (408)374-4570 Shiro Waga, MD 5601 Grande Market Dr. Benten 1-2-30-1010 Appleton, WI 54913-8400 Frank T. Vertosick Jr., MD Minato-ku (920)882-8200 5318 Ranalli Dr., Ste. 408 Osaka 5520007 Gibsonia, PA 15044 Japan Tim J. Watt, MD (724)444-5710 (6) 5520 - 091 The Spine Center 4141 5th St. Alan T. Villavicencio, MD Franklin C. Wagner, Jr., MD Rapid City, SD 57701 8315 Niwot Meadow Farms Rd. 44777 S. El Macero Dr. Longmont, CO 80503-4620 El Macero, CA 95618 (303)998-0004 (530)753-2103

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 126 MEMBERSHIP ROSTER

John P. Weaver, MD Joe Ellis Wheeler, MD, PA Joseph P. Williams II, MD, FACS University of Massachusetts Med. Ctr. 750 8th Avenue Place, Ste. 530 4911 N.E. 19th Ave., #1 55 Lake Ave. N. Fort Worth, TX 76104-2500 Fort Lauderdale, FL 33308 Worcester, MA 01655-0002 (817)335-3966 (270)443-3316 (508)856-4199 Walter Whisler, MD, PhD Richard B. Williams, MD Stuart M. Weil, MD 1211 Chesnut Ave. 6300 Royer Ave. 6624 Fannin St., Ste. 2140 Wilmette, IL 60091-1615 Woodland Hills, CA 91367 Houston, TX 77030-2333 (312)942-6644 (818)719-3697 (713)794-0500 Benjamin T. White, MD Richard C. Williams, MD Monte B. Weinberger, MD Univ. of Oklahoma HSC/Neurosurgery 55 Highland Dr. 5200 Centre Ave., Ste. 617 1000 N. Lincoln Blvd., #400 San Luis Obispo, CA 93405-1017 Pittsburgh, PA 15232-1326 Oklahoma City, OK 73104-5021 (412)623-2972 (405)271-4912 Diana E. Wilson, MD Harris Center, Ste. 440 Philip R. Weinstein, MD John Deason White, MD 1325 Pennsylvania University of California - San Francisco 3582 El Dorado Loop South Fort Worth, TX 76104 Box 0112 Room 787-M Salem, OR 97302-9723 (817)878-5491 San Francisco, CA 94143-0001 (503)378-0265 (415)353-3998 John A. Wilson, MD, FACS William L. White, MD Wake Forest University Medical Center David Leslie Weinsweig, MD Barrow Neurological Associates Dr./Neurosurgery 2860 3rd Ave., Ste. 10 2910 N. 3rd Ave. Winston-Salem, NC 27157-1029 Huntington, WV 25702-1452 Phoenix, AZ 85013-4434 (336)716-4020 (304)525-6825 (602)406-3466 Fremont P. Wirth, Jr., MD Harry C. Weiser, MD Melvin D. Whitfield, MD, FACS Neurological Inst. of Savannah 414 5th Ave. PO Box 98 4 Jackson Blvd. Albany, GA 31701 Dania, FL 33004-0098 Savannah, GA 31405-5810 (229)883-4707 (216)445-4314 (912)355-1010 Richard Elliott Weiss, MD Donald M. Whiting, MD Diana B. Wiseman, MD 23770 Spectacular Bid Ln. Allegheny General Hospital 4625 Black Pine Pl. Monterey, CA 93940 420 E. North Ave., Ste. 302 San Diego, CA 92130 (831)643-2324 Pittsburgh, PA 15212-4746 (619)532-7275 (412)228-1414 William C. Welch, MD Aizik L. Wolf, MD University of Pittsburgh Medical Center Timothy M. Wiebe, MD Healthsouth Doctors Hospital 200 Lothrop St., Ste. B-400 1 Lincoln Pkwy., Ste. 300 5000 University Dr. Pittsburgh, PA 15213-2582 Hattiesburg, MS 39402 Coral Gables, FL 33146-2008 (412)647-0987 (601)583-2800 (305)669-3427 Bryan J. Wellman, MD Gregory C. Wiggins, MD Christopher E. Wolfla, MD PMB 123 1989-7 Peabody Rd, #172 Dept. of Neurosurgery 2601 S. Minnesota Ave., Ste. 105 Vacaville, CA 95687 9200 W. Wisconsin Ave. Sioux Falls, SD 57105-4741 (707)446-1298 Milwaukee, WI 53226 (605)335-8470 (414)805-5400 Jack E. Wilberger Jr., MD Jan B. Wemple, MD Allegheny General Hospital James H. Wood, MD PO Box 1279 420 E. North Ave., Ste. 302 Suite 125/Neurosurgery Bethlehem, PA 18016-1279 Pittsburgh, PA 15212-4746 3193 Howell Mill Rd. N.W. (412)359-6200 Atlanta, GA 30327-2100 G. Alexander West, MD, PhD (404)350-5501 4230 S.W. Council Crest Dr. David A. Wiles, MD Portland, OR 97239-1531 East Tennessee Brain & Spine Matthew W. Wood, Jr., MD (503)494-7896 310 N. State of Franklin Rd., Ste. 103 Highland Neurosurgery P.C. Johnson City, TN 37604-6063 1 Medical Park Blvd., #400 Richard M. Westmark, MD (423)232-8301 East Bristol, TN 37620 18333 Egret Bay Blvd., Ste. 200 (423)844-5400 Houston, TX 77058 Harold A. Wilkinson, MD, PhD (281)333-1300 5 Rockridge Rd. Eric J. Woodard, MD Wellesley Hills, MA 02481-1432 New England Baptist Hospital Robert E. Wharen, Jr., MD Boston Spine Group 349 San Juan Dr. Steven F. Will, MD 125 Parker Hill Ave. Ponte Vedra Beach, FL 32082-1819 20 Myers Farm Rd. Boston, MA 02120 (904)953-2252 Hingham, MA 02043 (617)754-6576 (781)749-5369

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES MEMBERSHIP ROSTER 127

David Bruce Woodham, MD Julie E. York, MD Andrew Stephen Zelby, MD Neurosurgical Assoc. of Dothan PC Loyola University Medical Center 1701 S. 1st Ave., Ste. 302 PO Box 2247 2160 S. 1st Ave. Bldg. Maywood, IL 60153-2419 Dothan, AL 36302-2247 1900 Maywood, IL 60153 (708)343-3566 (334)793-6573 (708)216-5126 William R. Zerick, MD Steven D. Wray, MD Alfred Byron Young, MD Central Ohio Neuro. Surgeons 4540 Runnemede Rd. Univ. of Kentucky Medical Center 3555 Olentangy River Rd., #4000 Atlanta, GA 30327 800 Rose St., Room MS101 Columbus, OH 43212-3915 (404)350-0106 Lexington, KY 40536-0084 (614)268-0105 (859)323-5864 Neill M. Wright, MD Mehmet Zileli, MD Washington Univ./Neurosurgery Harold F. Young, MD Ege University Faculty of Medicine 660 S. Euclid Ave. Medical College of Virginia Dept. of Neurosurgery/Bornova Box 8057 Box 980631 Turkey St. Louis, MO 63110 Richmond, VA 23298-0631 (232) 388 30 42 (314)362-3630 (804)828-9165 Frank A. Zimba, MD, FRCSC Isao Yamamoto, MD William F. Young, MD 207 Foote Ave., Ste. 330 Yokohama City Univ. Medical School Fort Wayne Neurological Center Jamestown, NY 14701 3-9 Fukuura Kanazawa-ku 2622 Lake Ave. (716)488-9541 Yokohama 236 Fort Wayne, IN 46805-5410 Japan (4) 5787 - 2661 Christian G. Zimmerman, MD Kemal Yucesoy, MD 6140 W. Curtisian Ave., Ste. 400 Kevin C. Yao, MD DEUTF Norosirurji AD Boise, ID 83704 Tufts-NEMC / Dept. of Neurosurgery Inciralti-Izmir 35340 (208)367-3500 750 Washington St. Turkey Box 178 Boston, MA 02111 (237) 259 59 59 J. Eric Zimmerman, MD (617)636-5878 1221 6th St., Ste. 303 Eric L. Zager, MD Traverse City, MI 49684-2359 Wesley Y. Yapor, MD Univ. of Pennsylvania/Neurosurgery (231)941-7312 201 E. Huron, Ste. 9-160 3400 Spruce St., 3rd Fl. Chicago, IL 60611-2980 Silverstein Bldg. Greg Zorman, MD (312)926-3490 Philadelphia, PA 19104-4204 Memorial Healthcare System/Neurosurgery (215)662-3497 1150 N. 35th Ave., Ste. 300 Philip A. Yazbak, MD, FACS Hollywood, FL 33021-5424 Neuroscience Group of NE Wisconsin Peter A. Zahos, MD, FACS (954)985-1490 130 2nd St. Cleveland Clinic Florida/Neurosurgery Neenah, WI 54956-2883 2950 Cleveland Clinic Blvd. Geoffrey Zubay, MD (920)725-9373 Dept. 2950 Neurosurgical Med. Clinic Weston, FL 33331 501 Washington St., Ste. 700 David Allan Yazdan, MD (954)659-5630 San Diego, CA 92103 MCOC-Brick (619)297-4481 425 Jack Martin Blvd. Ahmad Zakeri, MD Brick, NJ 08724-2320 4235 Secor Rd. Lloyd Zucker, MD (732)458-6556 Toledo, OH 43623-4231 Neurosurgical Consultants of S. Florida (419)479-5588 5130 Linton Blvd., Ste. E3 Joseph S. Yazdi, MD Delray Beach, FL 33484 The Toledo Clinic Luis Manuel Zavala, MD (561)499-5633 4235 Secor Rd. 555 Mowry Ave., Ste. A-B Toledo, OH 43623 Fremont, CA 94536-4101 (419)479-5590 (510)793-1466 Kenneth S. Yonemura, MD Arnold A. Zeal, MD, FACS 30 N. 1900 E, Ste. 3B409 836 Prudential Dr., Ste. 1105 Salt Lake City, UT 84132-2303 Jacksonville, FL 32207-8338 (801)585-2453 (904)398-2756 Bo H. Yoo, MD Seth M. Zeidman, MD 703 Tyler St., Ste. 101 11 Roxbury Ln. Sandusky, OH 44870 Pittsford, NY 14534-4202 (419)626-7070 (585)334-5560 Kevin Yoo, MD H. Evan Zeiger, MD Palomar Neurosurgery Center Neurosurgery Dept. 255 N. Elm St., Ste. 202 1528 Carraway Blvd. Escondido, CA 92025 Birmingham, AL 35234-1998 (760)740-9394 (205)250-6805

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 128 NOTES

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 129

SPECIAL COURSE I – INTERVENTIONAL SPINE SURGERY

Name Member ID

Your comments to the following questions are needed to assist RATING SCALE the Annual Meeting Committee in developing future programs. Excellent Average Poor Your time and effort in completing this evaluation form is appreciated. ABCDE

1. Because of this special course I am able to :

Describe basic spinal injections A B C D E

Review the indications for spine interventional procedures A B C D E

Recognize patients with vertebral compression fractures A B C D E

2. John C. Oakley, MD communicated clearly and effectively A B C D E

Ray M. Baker, MD communicated clearly and effectively A B C D E

Isador Lieberman, MD communicated clearly and effectively A B C D E

Kevin E. Macadaeg, MD communicated clearly and effectively A B C D E

Richard M. Spiro, MD, MPH communicated clearly and effectively A B C D E

3. The level to which this special course met my expectations was: A B C D E

4. The opportunity for questions and discussion was: A B C D E

5. The applicability of the information presented to my practice was: A B C D E

6. The overall rating of this special course was: A B C D E

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON 130 DISORDERS OF THE SPINE AND PERIPHERAL NERVES

7. What did you learn in this special course that you will apply to your practice?

8. Overall, how could this special course be improved (i.e. topics covered, speakers, audiovisual)?

9. Did you perceive any type of commercial bias during this program? Yes No If yes, please explain:

10. What other topics and/or speakers would you like to see presented at future Annual Meetings?

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 131

SPECIAL COURSE II – CODING UPDATE AND REVIEW

Name Member ID

Your comments to the following questions are needed to assist RATING SCALE the Annual Meeting Committee in developing future programs. Excellent Average Poor Your time and effort in completing this evaluation form is appreciated. ABCDE

1. Because of this special course I am able to:

Recognize the newest changes in CPT coding A B C D E

Review the methodology for correct spine coding A B C D E

Identify specific coding scenarios that can be difficult to code A B C D E and bring clarity to the relevant scenarios

2. Gregory J Przybylski, MD communicated clearly and effectively A B C D E

Robert R. Johnson, II, MD, FACS communicated clearly and effectively A B C D E

3. The level to which this special course met my expectations was: A B C D E

4. The opportunity for questions and discussion was: A B C D E

5. The applicability of the information presented to my practice was: A B C D E

6. The overall rating of this special course was: A B C D E

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON 132 DISORDERS OF THE SPINE AND PERIPHERAL NERVES

7. What did you learn in this special course that you will apply to your practice?

8. Overall, how could this special course be improved (i.e. topics covered, speakers, audiovisual)?

9. Did you perceive any type of commercial bias during this program? Yes No If yes, please explain:

10. What other topics and/or speakers would you like to see presented at future Annual Meetings?

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 133

SPECIAL COURSE III – MOVING YOUR PRACTICE TO THE DIGITAL AGE/OFFICE AUTOMATION

Name Member ID

Your comments to the following questions are needed to assist RATING SCALE the Annual Meeting Committee in developing future programs. Excellent Average Poor Your time and effort in completing this evaluation form is appreciated. ABCDE

1. Because of this special course I am able to:

Describe the criteria by which to evaluate utilization and effectiveness A B C D E of electronic medical records

Discuss negotiating contracts with vendors and pricing protection A B C D E

Discuss market trends and vendor performance A B C D E

2. Joel D. MacDonald, MD communicated clearly and effectively A B C D E

Brian R. Greer communicated clearly and effectively A B C D E

David W. Polly, Jr., MD communicated clearly and effectively A B C D E

Ashwini D. Sharan, MD communicated clearly and effectively A B C D E

3. The level to which this special course met my expectations was: A B C D E

4. The opportunity for questions and discussion was: A B C D E

5. The applicability of the information presented to my practice was: A B C D E

6. The overall rating of this special course was: A B C D E

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON 134 DISORDERS OF THE SPINE AND PERIPHERAL NERVES

7. What did you learn in this special course that you will apply to your practice?

8. Overall, how could this special course be improved (i.e. topics covered, speakers, audiovisual)?

9. Did you perceive any type of commercial bias during this program? Yes No If yes, please explain:

10. What other topics and/or speakers would you like to see presented at future Annual Meetings?

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 135

SPECIAL COURSE IV– MOTION MAINTENANCE AND DISC REGENERATION

Name Member ID

Your comments to the following questions are needed to assist RATING SCALE the Annual Meeting Committee in developing future programs. Excellent Average Poor Your time and effort in completing this evaluation form is appreciated. ABCDE

1. Because of this special course I am able to:

Recognize indications and pitfalls of arthroplasty A B C D E

Identify the advantages of motion preservation A B C D E

Recognize indications for less invasive treatments of spinal disorders A B C D E

2. Christopher I. Shaffrey, MD communicated clearly and effectively A B C D E

Stephen Badylak, DVM, PhD, MD communicated clearly and effectively A B C D E

Vadim N. Bikmullin, MD, PhD communicated clearly and effectively A B C D E

Rick Delamarter, MD, communicated clearly and effectively A B C D E

Fred H. Geisler, MD, PhD communicated clearly and effectively A B C D E

Brian R. Subach, MD communicated clearly and effectively A B C D E

Charles S. Theofilos, MD communicated clearly and effectively A B C D E

Jeffrey C. Wang, MD communicated clearly and effectively A B C D E

3 The level to which this special course met my expectations was: A B C D E

4. The opportunity for questions and discussion was: A B C D E

5. The applicability of the information presented to my practice was: A B C D E

6. The overall rating of this special course was: A B C D E

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON 136 DISORDERS OF THE SPINE AND PERIPHERAL NERVES

7. What did you learn in this special course that you will apply to your practice?

8. Overall, how could this special course be improved (i.e. topics covered, speakers, audiovisua)l?

9. Did you perceive any type of commercial bias during this program? Yes No If yes, please explain:

10. What other topics and/or speakers would you like to see presented at future Annual Meetings?

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 137

SCIENTIFIC SESSION I – THE EVOLUTION OF CERVICAL SPINE SURGERY

Name Member ID

Your comments to the following questions are needed to assist RATING SCALE the Annual Meeting Committee in developing future programs. Excellent Average Poor Your time and effort in completing this evaluation form is appreciated. ABCDE

1. Because of this general session I am able to:

Recognize the newest technologies for cervical fusion A B C D E

Recognize the biological and biomechanical aspects of A B C D E cervical arthroplasty

Review the current experiences of senior surgeons that have A B C D E experience with this technology

2. Vincent C. Traynelis, MD communicated clearly and effectively A B C D E

Regis W. Haid, Jr., MD communicated clearly and effectively A B C D E

Praveen V. Mummaneni, MD, communicated clearly and effectively A B C D E

Gregory R. Trost, MD communicated clearly and effectively A B C D E

Robert F. Heary, MD communicated clearly and effectively A B C D E

Oral Abstract Presenters communicated clearly and effectively A B C D E

3. The level to which this general session met my expectations was: A B C D E

4. The opportunity for questions and discussion was: A B C D E

5. The quality of the written material provided was: A B C D E

6. The applicability of the information presented to my practice was: A B C D E

7. The overall rating of this general session was: A B C D E

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON 138 DISORDERS OF THE SPINE AND PERIPHERAL NERVES

8. What did you learn in this general session that you will apply to your practice?

9. Overall, how could this general session by improved (i.e. topics covered, speakers, audio/visual)?

10. Did you perceive any type of commercial bias during this program? Yes No If yes, please explain:

11. What other topics and/or speakers would you like to see presented at future Annual Meetings?

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 139

SCIENTIFIC SESSION II – THE EVOLUTION OF LUMBAR SPINE SURGERY ANTERIOR/POSTERIOR

Name Member ID

Your comments to the following questions are needed to assist RATING SCALE the Annual Meeting Committee in developing future programs. Excellent Average Poor Your time and effort in completing this evaluation form is appreciated. ABCDE

1. Because of this general session I am able to:

Explain the various options in treating lumbar spine disease A B C D E from an anterior approach

Identify patients that may have better outcomes with A B C D E posterior approaches

Recognize the rationale for approaching the spine either A B C D E anteriorlyor posteriorly

2. Joseph T. Alexander, MD communicated clearly and effectively A B C D E

Ray M. Baker, MD communicated clearly and effectively A B C D E

Charles L. Branch, Jr., MD communicated clearly and effectively A B C D E

Paul McAfee, MD communicated clearly and effectively A B C D E

Richard G. Fessler, MD communicated clearly and effectively A B C D E

Fred H. Geisler, MD communicated clearly and effectively A B C D E

André Van Ooij, MD communicated clearly and effectively A B C D E

William C. Welch, MD communicated clearly and effectively A B C D E

Oral Point Abstract Presenters communicated clearly and effectively A B C D E

3. The level to which this general session met my expectations was: A B C D E

4. The opportunity for questions and discussion was: A B C D E

5. The quality of the written material provided was: A B C D E

6. The applicability of the information presented to my practice was: A B C D E

7. The overall rating of this general session was: A B C D E

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON 140 DISORDERS OF THE SPINE AND PERIPHERAL NERVES

8. What did you learn in this general session that you will apply to your practice?

9. Overall, how could this general session by improved (i.e. topics covered, speakers, audio/visual)?

10. Did you perceive any type of commercial bias during this program? Yes No If yes, please explain:

11. What other topics and/or speakers would you like to see presented at future Annual Meetings?

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 141

SCIENTIFIC SESSION III – SPECIAL TECHNOLOGY SESSION

Name Member ID

Your comments to the following questions are needed to assist RATING SCALE the Annual Meeting Committee in developing future programs. Excellent Average Poor Your time and effort in completing this evaluation form is appreciated. ABCDE

1. Because of this general session I am able to:

Recognize available radiological guidance systems that can be A B C D E implemented in the OR

Summarize the newest diagnostic imaging techniques A B C D E

Explain the benefits and pitfalls of frameless stereotactic guidance A B C D E

Discuss how telemedicine can be incorporated into spine practices to A B C D E increase efficiency

2. Gerald E. Rodts, Jr., MD communicated clearly and effectively A B C D E

Deborah L. Benzel, MD communicated clearly and effectively A B C D E

Christopher H. Comey, MD communicated clearly and effectively A B C D E

Richard G. Fessler, MD, communicated clearly and effectively A B C D E

Kevin T. Foley, MD communicated clearly and effectively A B C D E

Brian R. Greer communicated clearly and effectively A B C D E

Iain H. Kalfas, MD communicated clearly and effectively A B C D E

Isador Lieberman, MD communicated clearly and effectively A B C D E

Najeeb Thomas, MD communicated clearly and effectively A B C D E

Oral Abstract Presenters communicated clearly and effectively A B C D E

3. The level to which this general session met my expectations was: A B C D E

4. The opportunity for questions and discussion was: A B C D E

5. The quality of the written material provided was: A B C D E

6. The applicability of the information presented to my practice was: A B C D E

7. The overall rating of this general session was: A B C D E

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON 142 DISORDERS OF THE SPINE AND PERIPHERAL NERVES

8. What did you learn in this general session that you will apply to your practice?

9. Overall, how could this general session by improved (i.e. topics covered, speakers, audio/visual)?

10. Did you perceive any type of commercial bias during this program? Yes No If yes, please explain:

11. What other topics and/or speakers would you like to see presented at future Annual Meetings?

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 143

SPECIAL COURSE V – ABC’S OF PERIPHERAL NERVE SURGERY

Name Member ID

Your comments to the following questions are needed to assist RATING SCALE the Annual Meeting Committee in developing future programs. Excellent Average Poor Your time and effort in completing this evaluation form is appreciated. ABCDE

1. Because of this special course I am able to: Convey basic information on diagnosis and management A B C D E of common nerve injuries, nerve entrapments and nerve disorders

Prepare the residents for the written board examinations and the young A B C D E neurosurgeons for the oral board examinations on nerve topics and questions

Review the diagnosis and differential diagnoses of nerve conditions, A B C D E particularly those that have overlap to medical and spinal conditions

Distinguish those nerve conditions needing emergent and urgent A B C D E management versus those that can be managed in a more delayed fashion

Recognize common peripheral nerve conditions and distinguishing A B C D E these from the unusual conditions, which should be referred to subspecialists

2. Robert J. Spinner, MD communicated clearly and effectively A B C D E

Eric L. Zager, MD communicated clearly and effectively A B C D E

Allan J. Belzberg, MD communicated clearly and effectively A B C D E

Aaron G. Filler, MD, PhD communicated clearly and effectively A B C D E

Holly S. Gilmer-Hill, MD communicated clearly and effectively A B C D E

Line Jacques, MD communicated clearly and effectively A B C D E

Allen H. Maniker, MD communicated clearly and effectively A B C D E

John E. McGillicuddy, MD communicated clearly and effectively A B C D E

Robert L. Tiel, MD communicated clearly and effectively A B C D E

3. The level to which this special course met my expectations was: A B C D E

4. The opportunity for questions and discussion was: A B C D E

5. The quality of the written material provided was: A B C D E

6. The applicability of the information presented to my practice was: A B C D E

7. The overall rating of this special course was: A B C D E

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON 144 DISORDERS OF THE SPINE AND PERIPHERAL NERVES

8. What did you learn in this special course that you will apply to your practice?

9. Overall, how could this special course by improved (i.e. topics covered, speakers, audio/visual)?

10. Did you perceive any type of commercial bias during this program? Yes No If yes, please explain:

11. What other topics and/or speakers would you like to see presented at future Annual Meetings?

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 145

MEETING THE CHALLENGES OF CARING FOR THE PATIENT WITH A SPINAL TUMOR – A SPECIAL SYMPOSIUM FOR NURSES, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS

Name Member ID

Your comments to the following questions are needed to assist RATING SCALE the Annual Meeting Committee in developing future programs. Excellent Average Poor Your time and effort in completing this evaluation form is appreciated. ABCDE

1. Because of this symposium I am able to:

Discuss the significance of spinal tumors and the neurosurgical A B C D E decision making for patients with a spinal tumor

Analyze perioperative care considerations, adjunctive treatment A B C D E options and when neurosurgical treatment is no longer indicated

2. Shannon Hagy, BSN, CNRN communicated clearly and effectively A B C D E

Andrea L. Strayer, NP, CNRN communicated clearly and effectively A B C D E

Edward C. Benzel, MD communicated clearly and effectively A B C D E

Robert D. Hager, MMSC, PAC communicated clearly and effectively A B C D E

Michael P. Steinmetz, MD communicated clearly and effectively A B C D E

Christina M. Stewart-Amidei, MSN, RN, APN, CNRN, CCRN A B C D E communicated clearly and effectively

3. The level to which this symposium met my expectations was: A B C D E

4. The opportunity for questions and discussion was: A B C D E

5. The quality of the written material provided was: A B C D E

6. The applicability of the information presented to my practice was: A B C D E

7. The overall rating of this symposium was: A B C D E

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON 146 DISORDERS OF THE SPINE AND PERIPHERAL NERVES

8. What did you learn in this symposium that you will apply to your job responsibilities?

9. Overall, how could this symposium by improved (i.e. topics covered, speakers, audio/visual)?

10. Did you perceive any type of commercial bias during this program? Yes No If yes, please explain:

11. What other topics and/or speakers would you like to see presented at future Annual Meetings?

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 147

DAVID CAHILL MEMORIAL CONTROVERSIES SESSION

Name Member ID

Your comments to the following questions are needed to assist RATING SCALE the Annual Meeting Committee in developing future programs. Excellent Average Poor Your time and effort in completing this evaluation form is appreciated. ABCDE

1. Because of this general session I am able to:

Discuss the indications for surgery in the management of asymptomatic A B C D E spinal cord compression

2. R. John Hurlbert, MD, PhD communicated clearly and effectively A B C D E

Christopher I. Shaffrey, MD communicated clearly and effectively A B C D E

Ronald I. Apfelbaum, MD communicated clearly and effectively A B C D E

Ray M. Baker, MD communicated clearly and effectively A B C D E

Edward C. Benzel, MD communicated clearly and effectively A B C D E

Anthony K. Frempong-Boadu, MD communicated clearly and effectively A B C D E

Richard G. Fessler, MD communicated clearly and effectively A B C D E

Larry T. Khoo, MD communicated clearly and effectively A B C D E

Stephen M. Papadopoulos, MD communicated clearly and effectively A B C D E

Fred H. Geisler, MD communicated clearly and effectively A B C D E

André Van Ooji, MD communicated clearly and effectively A B C D E

William C. Welch, MD communicated clearly and effectively A B C D E

3. The level to which this general session met my expectations was: A B C D E

4. The opportunity for questions and discussion was: A B C D E

5. The applicability of the information presented to my practice was: A B C D E

6. The overall rating of this general session was: A B C D E

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON 148 DISORDERS OF THE SPINE AND PERIPHERAL NERVES

7. What did you learn in this general session that you will apply to your practice?

8. Overall, how could this general session by improved (i.e. topics covered, speakers, audio/visual)?

9. Did you perceive any type of commercial bias during this program? Yes No If yes, please explain:

10. What other topics and/or speakers would you like to see presented at future Annual Meetings?

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 149

SCIENTIFIC SESSION IV – PAIN AND THE SPINE SURGEON

Name Member ID

Your comments to the following questions are needed to assist RATING SCALE the Annual Meeting Committee in developing future programs. Excellent Average Poor Your time and effort in completing this evaluation form is appreciated. ABCDE

1. Because of this general session I am able to:

Review appropriate narcotic weaning regimens for patients A B C D E undergoing spinal surgery

Describe the current pharmacological options available for caring A B C D E for these patients

Recognize indications for surgical pain management with neural A B C D E augmentations and stimulation

2. John C. Oakley, MD communicated clearly and effectively A B C D E

Giancarlo Barolat, MD communicated clearly and effectively A B C D E

Richard K. Osenbach, MD communicated clearly and effectively A B C D E

David S. Sinclair, MD communicated clearly and effectively A B C D E

John J. Moossy, MD communicated clearly and effectively A B C D E

3. The level to which this general session met my expectations was: A B C D E

4. The opportunity for questions and discussion was: A B C D E

5. The applicability of the information presented to my practice was: A B C D E

6. The overall rating of this general session was: A B C D E

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON 150 DISORDERS OF THE SPINE AND PERIPHERAL NERVES

7. What did you learn in this general session that you will apply to your practice?

8. Overall, how could this general session by improved (i.e. topics covered, speakers, audio/visual)?

9. Did you perceive any type of commercial bias during this program? Yes No If yes, please explain:

10. What other topics and/or speakers would you like to see presented at future Annual Meetings?

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 151

SCIENTIFIC SESSION V – YOUR ENVIRONMENT: THE SPINE PLAYING FIELD

Name Member ID

Your comments to the following questions are needed to assist RATING SCALE the Annual Meeting Committee in developing future programs. Excellent Average Poor Your time and effort in completing this evaluation form is appreciated. ABCDE

1. Because of this general session I am able to:

Outline the current infrastructure that exists with regards A B C D E to Medical politics

Recognize the competing factors and compelling reasons to implement A B C D E a concerted effort to unify and align our society’s interests with other spine lobby organizations

2. Mark R. McLaughlin, MD communicated clearly and effectively A B C D E

Christopher I. Shaffrey, MD communicated clearly and effectively A B C D E

James Bean, MD communicated clearly and effectively A B C D E

Paul B. Nelson, MD communicated clearly and effectively A B C D E

Katie Orrico, JD communicated clearly and effectively A B C D E

Troy M. Tippett, MD communicated clearly and effectively A B C D E

Paul Starr, PhD communicated clearly and effectively A B C D E

3. The level to which this general session met my expectations was: A B C D E

4. The opportunity for questions and discussion was: A B C D E

5. The applicability of the information presented to my practice was: A B C D E

7. The overall rating of this general session was: A B C D E

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON 152 DISORDERS OF THE SPINE AND PERIPHERAL NERVES

8. What did you learn in this general session that you will apply to your practice?

9. Overall, how could this general session by improved (i.e. topics covered, speakers, audio/visual)?

10. Did you perceive any type of commercial bias during this program? Yes No If yes, please explain:

11. What other topics and/or speakers would you like to see presented at future Annual Meetings?

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 153

SPECIAL COURSE VI– BOARD REVIEW FOR SPINE SURGERY AND PERIPHERAL NERVE

Name Member ID

Your comments to the following questions are needed to assist RATING SCALE the Annual Meeting Committee in developing future programs. Excellent Average Poor Your time and effort in completing this evaluation form is appreciated. ABCDE

1. Because of this special course I am able to:

Summarize the most common peripheral nerve cases that might be A B C D E presented on an oral board examination

Review common spine case scenarios that might be presented A B C D E

Discuss incorporating an alga rhythm format in creating a systematic A B C D E approach to the answering oral examination questions

2. Ehud Mendel, MD, FACS communicated clearly and effectively A B C D E

Daniel K. Resnick, MD communicated clearly and effectively A B C D E

Allen H. Maniker, MD communicated clearly and effectively A B C D E

Alan Levi, MD, PhD, FRCS communicated clearly and effectively A B C D E

3. The level to which this special course met my expectations was: A B C D E

4. The opportunity for questions and discussion was: A B C D E

5. The applicability of the information presented to my practice was: A B C D E

6. The overall rating of this special course was: A B C D E

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON 154 DISORDERS OF THE SPINE AND PERIPHERAL NERVES

8. What did you learn in this general session that you will apply to your practice?

9. Overall, how could this general session by improved (i.e. topics covered, speakers, audio/visual)?

10. Did you perceive any type of commercial bias during this program? Yes No If yes, please explain:

11. What other topics and/or speakers would you like to see presented at future Annual Meetings?

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 155

OVERALL MEETING EVALUATION

Name Member ID

Your comments to the following questions are needed to assist RATING SCALE the Annual Meeting Committee in developing future programs. Excellent Average Poor Your time and effort in completing this evaluation form is appreciated. ABCDE

ABSTRACT PRESENTATIONS 1. Balanced selection of papers: A B C D E

2. Originality of the papers presented: A B C D E

3. Content relevant to my practice: A B C D E

4. Opportunity for questions/discussion: A B C D E

OVERALL PROGRAM 5. Overall impression of the meeting: A B C D E

6. Level to which the Annual Meeting met my expectations was: A B C D E

7. The duration of the meeting is: A B C A. Just Right B. Too Long C. Too Short

8. Quality of the audiovisual: A B C D E

9. Meeting location: A B C D E

10. Hotel accommodations and service staff met my expectations: A B C D E

11. Pricing of hotel/resort accommodations: A B C D E

12. The overall cost to attend the meeting is: A B C A. Reasonable B. Moderate C. Too Expensive

13. Did you perceive any commercial bias during this program? A B A. Yes B. No

If yes, please explain:

EXHIBIT AND E-POSTERS 14. The organization and content of the poster session was: A B C D E

15. How many hours have you spent in the exhibit hall so far? A B C D E A. Less than 1 hour B. 1–2 Hours C. 2–3 Hours D. More than 4 Hours E. None

16. The quality of the exhibit program is: A B C D E

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MARCH 15-18, 2006 • BUENA VISTA PALACE • LAKE BUENA VISTA, FLORIDA 22ND ANNUAL MEETING OF THE AANS/CNS SECTION ON 156 DISORDERS OF THE SPINE AND PERIPHERAL NERVES

17. What suggestions do you have for improving this meeting?

18. What suggestions do you have for improving the exhibit hall?

19. What other topics and/or speakers would you like to see presented at future Annual Meetings?

20. Is there a city or location you would like to see the AANS/CNS Section on Disorders of the Spine and Peripheral Nerves host a future Annual Meeting?

PLEASE TURN IN EVALUATION FORMS AT REGISTRATION

AANS/CNS SECTION ON DISORDERS OF THE SPINE AND PERIPHERAL NERVES 23rd23rd AnnualAnnual MeetingMeeting ofof thethe AANS/CNSAANS/CNS SectionSection onon DisordersDisorders ofof thethe SpineSpine andand PeripheralPeripheral NervesNerves PHOENIX 2007 SAVE THE DATE! March 7–11, 2007 JW Marriott Desert Ridge Resort & Spa Phoenix, Arizona

Jointly Sponsored by the AANS