Controversies and Hot Topics Preview

James S. Harrop, MD, FACS

Due to the incredible success of the Controversy Sessions and Hot Topics at the 2014 CNS Annual Meeting, the Scientific Program Committee is pleased to continue these interactive and engaging discussions at the 2015 CNS Annual Meeting. The format will be similar to last year’s, with one Controversy Session and two Hot Topics presented each day Monday through Wednesday.

We aimed to cover a wide range of issues so that there would be no overlap, and this year’s topics were vetted through an extensive search and discussion with numerous members. Thanks to all those who helped in the process. We encourage CNS members to submit new ideas for upcoming meetings!

 

Monday, September 28

CONTROVERSY SESSION 1

ICH Management: Minimally Invasive to Decompressive Craniectomy Surgical Intervention

This panel will discuss the role for selected minimally invasive image-guided endoscopic management for deep-seated basal ganglionic ICH/IVH. Specifically, they will review the pathophysiology of spontaneous ICH and subsequent edema and neurologic deterioration. Further, they will clarify the dimensions of appropriately sized hemicraniectomy and differentiate timing and intervention between stroke and trauma patients.

Moderator: Rocco Armonda
Speakers: J D. Mocco, William J. Mack, Travis Michael Dumont

HOT TOPIC 1

Optimal Management for a Single Intracranial Metastasis: Radiation or Surgery?

This panel will explore the best treatment for a single intracranial metastasis based on anatomic location, tumor histology, and other concurrent treatments. Specifically the role for radiation versus surgical resection will be discussed.

Moderator: Mike McDermott
Speakers: Frederick F. Lang, Mark E. Linskey

HOT TOPIC 2

Cervical and Lumbar Adjacent Level Breakdown: Fusion or Not?

There is tremendous controversy regarding whether adjacent level disease exists and how to potentially avoid and treat it. This panel will explore the most beneficial strategies, and debate technology as well as advantages/ disadvantages of arthroplasty versus fusion in both the lumbar and cervical spine.

Moderator: Edward C. Benzel
Speakers: Regis W. Haid, William Welch, David O. Okonkwo, Domagoj Coric

Tuesday, September 29

CONTROVERSY SESSION 2

Spine Controversies: What To Do?

Due to the overwhelming controversies in spine care, we review two cases and discuss how to optimally manage them: First, what to do with a patient with persistent pain after lumbar laminectomy: SCS or redo surgery? Second, how to deal with treatment and timing of a spinal epidural abscess: medically treat and monitor or operate on the abscess now?

Moderators: Michael G. Fehlings, Ashwini Sharan
Speakers: Gerald E. Rodts, Daniel K. Resnick, Joshua M. Rosenow, Michael Y. Wang

HOT TOPIC 3

“Liquid Biopsy”: Advancements in Next-generation Personalized Care for Brain Cancer

This panel will explore the rapidly evolving field of non-invasive tumor categorization, specifically reviewing how these technologies can influence and impact your clinical practice and treatment algorithms.

Moderator: Ricardo Jorge Komotar
Speakers: Chetan Bettegowda, Brian V. Nahed

HOT TOPIC 4

The Role of LITT (Laser-Induced Thermal Therapy) in Epilepsy

There has been a rapid advancement in the use of laser technology in cranial surgery. This panel will define the varying roles of laser therapy in intracranial pathology.

Moderator: Robert E. Gross
Speakers: Nicholas M. Barbaro, Richard S. Zimmerman, Jason M. Schwalb

Wednesday, September 30

CONTROVERSY SESSION 3

Anticoagulation and Neurosurgery

Due to the explosion of anticoagulation therapies for stroke, DVT, and cardiovascular, the neurosurgeon is often placed in difficult situations about what this drug is and when to stop or start it. This session will define and have participants appreciate varying anticoagulation therapies in addition to reviewing surgical treatment options and strategies of correcting pharmacologically induced coagulopathies.

Moderators: Pascal Jabbour, Kenneth V. Snyder
Speakers: Issam A. Awad, R. Loch Macdonald, David M. Hasan

HOT TOPIC 5

Treatment for Facial Pain (Trigeminal Neuralgia)

Despite multimodality therapies, facial pain is a difficult disorder. These panelists will define the varying facial pain syndromes, review the pathophysiology of treatment modalities, and review the advantages/disadvantages of each approach.

Moderator: James J. Evans
Speakers: Kim J. Burchiel, Jeffrey A. Brown, Oren Sagher

HOT TOPIC 6

How to Stay Relevant Between Cost Pressure, Budgets and ACOs—A Stepwise Approach

This panel focuses on the present-day, evolving medical economics environment with a review of financial variables, cost, and expenses to neurosurgical practice. In addition, the government’s cost measures (i.e., PQRS) and other changes will be discussed.

Moderators: John K. Ratliff, Clemens M. Schirmer
Speakers: Erol Veznedaroglu, Steven A. Toms