Iberian Course Diploma 2019

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Iberian Course Diploma 2019
Madrid, Spain
12 - 16 November 2019

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Module 5: Tumours & Inflammatory Disease of the Spine



Dr. Antonio Martín Benlloch
Chairman:
Dr. Antonio Martín Benlloch. Spain
Dr. Manuel Tavares de Matos
Chairman:
Dr. Manuel Tavares de Matos. Portugal


Programme Module 5: Tumors, Infections & Systemic Diseases Programme Module 5: Tumours & Inflammatory Disease of the Spine

Module 5 Learning Outcomes



Session 1: VERTEBRAL OSTEOMYLETIS

ETIOLOGY, PATHOGENESIS, ROUTES OF SPREAD

  • Explain the aetiology of vertebral osteomyelitis including: bacterial, tuberculous, and fungal
  • Describe the pathogenesis including venous route, arterial inoculation and iatrogenic direct extension
  • Anticipate the routes of spread: vertebral body & intervertebral disc

SYMPTOMS & DIAGNOSIS

  • Recognise the signs and symptoms of vertebral osteolyelitis
  • Identify the risk factors (immunodeficiency etc)
  • Select appropriate investigations
  • Distinguish on MRl and x-ray the key features that define and contrast both pyogenic and tuberculous spinal lesions

CONSERVATIVE MANAGEMENT & INDICATIONS FOR SURGICAL TREATMENT

  • Evaluate options for conservative treatment
  • Compare absolute and relative indications for conservative treatment

SURGICAL MANAGEMENT OF SPINAL INFECTIONS

  • Formulate a plan for infection specific treatment
  • Anticipate complications
  • Plan appropriate management
  • Appraise current evidence concerned with spondylitis outcome and prognosis

CASE DISCUSSION



Session 2: METABOLIC BONE DISEASES

BONE DISORDERS

  • Paget's disease
  • Rickets
  • DISH (Forestier's disease)
  • Metabolic bone disease

OSTEOPOROSIS

  • Outline the etiology of osteoporosis
  • Diagnose osteoporosis using appropriate investigations

SURGICAL CONSIDERATIONS IN DISORDERS OF THE BONE

  • Evaluate treatment options.
  • Compare minimally invasive techniques including
    • vertebroplasty
    • kyphoplasty
    • vertebral body stenting

CASE DISCUSSION



Session 3: CADAVER LABS

POSTERIOR CERVICAL

  • Approach the posterior cervical spine
  • Identify anatomical landmarks of the occipito-cervical region
  • Anticipate risks and pitfalls
  • Perform lateral mass screw fixation
  • Perform lamina hook fixation
  • Perform C1-C2 screw osteosynthesis (Harms or Magerl)
  • Insert an occipital plate

VBR: VERTEBRAL BODY REPLACEMENT (THORACIC SPINE & THORACO-LUMBAR JUNCTION)

  • Approach to the anterior thoracic and thoraco-lumbar spine
  • Describe the relationship between large vessels and spine
  • Elevate diaphragm
  • Prepare rib for strut graft
  • Perform discectomy
  • Perform corpectomy
  • Place rib strut graft
  • Place corpectomy cage


Session 4: RHEUMATOID ARTHRITIS AND ANKYLOSING SPONDYLITIS

ETIOLOGY, PATHOGENESIS, SYMPTOMS, DIAGNOSIS

  • Explain the aetiology of rheumatoid disease
  • Describe the pathogenesis relating rheumatoid disease and joint changes
  • Recognise the signs and symptoms
  • Select and interpret appropriate investigations and imaging
  • Recognise signs of
    • the rheumatoid spine
    • ankylosing spondylitis

STABILIZING & CORRECTIVE SURGERY OF THE SPINE

  • Describe indications for corrective surgery for ankylosing spondylitis
  • Diagnose occipito-atlantoaxial complex and subaxial cervical spine
  • Differentiate between horizontal and vertical atlantoaxial instability

DIAGNOSIS & TREATMENT OF THE OCCIPITO-ATLANTOAXIAL COMPLEX

  • Identify the commonly used radiographic lines and measurements for the C0 to C2 complex.
  • Plan appropriate treatment for C0 to C2 and sub-axial rheumatic neck problems.
  • Appraise current evidence regarding outcome and prognosis

CASE DISCUSSION



Session 5: TUMOURS OF THE AXIAL SKELETON

PRIMARY BENIGN TUMOURS AND TUMOUR LIKE LESIONS; DIAGNOSIS AND MANAGEMENT

  • Explain the aetiology of tumours and tumour like lesions
  • Describe the pathogenesis relating to tumours and tumour like lesions
  • Differentiate between primary benign tumours and tumour like lesions
  • Select appropriate investigations, interpret results and stage tumour
  • Evaluate treatment options
  • Anticipate outcomes
  • Formulate a plan for long term monitoring

SECONDARY MALIGNANT TUMOURS; DIAGNOSIS AND MANAGEMENT

  • Justify the relative importance of combined tumour therapy including surgery, radiotherapy and chemotherapy.
  • Evaluate surgical options and results
  • Formulate a multidisciplinary management plan
  • Justify the risks, benefits and impact of radiotherapy and chemotherapy.
  • Evaluate surgical options
  • Anticipate complications

CASE DISCUSSION



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