Dr. Wong, as Past President of the North American Spine Society (NASS), recently co-chaired the 29th Annual Brussels International Spine Symposium (BISS) in Brussels, Belgium.

The theme of the meeting was “The Aged Spine.” The program had 51 talks on various aspects of the evaluation and treatment of spine pathology in the older patient. The diverse faculty was from Belgium, France, Italy, Spain, Germany, Switzerland, the UK and Ireland, as well as the USA.

Dr. Wong gave talks on recognizing and controlling surgical risk factors, epidural lipomatosis related to age, herniated lumbar discs in the elderly, the graying of our population, and implications for spine care and evidence analysis of the New England Journal of Medicine papers on decompression alone vs. decompression and fusion for spinal stenosis.

The 250 attendees benefitted from the high-quality presentations as well as interactive discussions between the faculty and the audience. Anticipation is already high for the 30th anniversary 2024 BISS meeting with “Patient Safety” as the theme.

Jan is a very self-sufficient 78-year-old from Ogallala, Nebraska, and she was NOT ready to “roll over and accept” her worsening health. After breaking her arm in August of 2023 and then suffering a stroke that affected her arm and leg, Jan made a full recovery. But then she was dismayed when she started having back and leg pain and an MRI showed severe spinal stenosis. 

The pain in her back and leg progressively became worse. Jan tried injections, physical therapy, and even ketamine, with no relief. The pain meds she was forced to take “made me puffy and aged me,” she says. Over the next year the pain worsened; getting dressed and getting in and out of her car was a challenge and she had to use a cane or a walker. She had a lift installed on her stairs so she could remain in her home, and her son even installed a lift on the stairs in his home, so that his mom could continue to work for him in his home office. 

But Jan refused to accept her worsening pain and the possibility of a wheelchair in her future, so she started looking for doctors in Denver, a larger market than Ogallala. Fusion surgery was recommended, but Jan was worried about the recovery from such a big surgery. She went to see Dr. Chris Johnson for another opinion and immediately knew he was different. “Dr. Johnson spent a long time with me,” Jan says, “he told me we should only do what was necessary.” Dr. Johnson said a microdecompression surgery would be less invasive and provide a shorter recovery period than a fusion surgery - and it would still get rid of Jan’s pain. Jan liked Dr. Johnson’s fresh, conservative approach and underwent an L5-S1 microdecompression surgery in November of 2023.

Jan woke up from surgery and was amazed when she could dress herself with no pain. “I didn’t need to spend even one night in the hospital,” so her son drove her back to her home that same day. “Dr. Johnson gave me detailed post-surgical instructions and I have followed them to a T,” Jan says, “including exercises to strengthen my core and improve my balance so I will remain independent in the future.”

Jan was thrilled when she could put away her cane and her walker. She “hops” into her car, and her stair lift only carries groceries now. She is back on her elliptical machine, works with a trainer, and best of all, she has more energy to devote to her job working part-time with her son.

Jan has no more back pain to this day. She has already recommended Dr. Johnson to others and thanks him for her “new lease on life.” She credits her “amazing recovery” to being proactive; “ask questions, find the right people, don’t settle when it comes to your body,” she says, “Dr. Johnson thinks differently and so do I.” 

It seems AI is everywhere these days, and it was a topic at the Annual Brussels International Spine Symposium that Dr. Wong Co-Chaired recently. 

The keynote symposium speaker, Dr. John Finkenberg, 2023 President of NASS, titled his address: “Will Artificial Intelligence Allow Us to Practice the Art of Medicine and Better Customize Surgery for the Aging Spine.” Several medical instances of AI already in use were given. For example, AI has enhanced the early detection of breast cancer. The human eye of the radiologist can discern about 13 shades of grey on a diagnostic mammogram, whereas AI can distinguish over 20. It is hoped that similar advances in AI imaging of the spine will answer lingering questions. For example, AI could help determine whether the posterior longitudinal ligament (PLL) has been broached by a disc herniation leading to a “free” disc fragment loose in the canal vs. a “contained” disc herniation under an intact PLL.

Dr. Finkenberg also pointed out some of the problems already facing us with AI in the medical field. For instance, AI machine learning algorithms are set up to take note of words and phrases within a certain distance of a keyword in textbooks or journal publications, so phrases like “spinal stenosis” can lead to completely unrelated associations and therefore wrong or false conclusions.

Another concern with AI is authorship. Schools, colleges, and medical schools are already dealing with whether a student or AI is the author of term papers and theses. Dr. Gunsburg in his role as Editor in Chief of the European Spine Journal (the fourth-highest impact musculoskeletal journal in the Index Medicus), and Dr. Wong, as Past Associate Editor of the Journal of Bone and Joint Surgery (the top impact musculoskeletal journal in the Index Medicus) were able to confirm that these journals are already dealing with similar issues.

Colorado Spine Partners

Dr. David Wong, Dr. Sanjay Jatana, Dr. Gary Ghiselli, Dr. Chris Johnson

145 Inverness Drive East, suite 100

Englewood, CO 80112

303-MY-SPINE

www.coloradospinepartners.com

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