James Chappuis, M.D., F.A.C.S., senior surgeon and CEO of SpineCenterAtlanta, along with his colleagues, were selected by the Orthopaedic Research Society (ORS) as having presented the best poster at this past 2016 annual meeting. SpineCenterAtlanta is one of the United States leading orthopedic practices and offers orthopedic and spine surgery, physical rehabilitation, physical and aquatic therapy, massage and acupuncture in an MRI imaging and ambulatory surgery center.
Chappuis, of SpineCenterAtlanta, Wins Poster Award
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ORS presented the award based on the poster “Biomechanics of Pedicle Screw Loosening in the Lumbar Spine.” In addition to Chappuis, the other study authors were Hope B. Pearson, Christopher J. Dobbs, Joel D. Boerckel and Eric Grantham.
Pedicle screw loosening is one of the recurrent issues in spine surgery. Do pedicle screws loosen in patients with recurrent back pain after spinal fusion surgery or will hardware removal ameliorate the secondary pain? And, of course, there is the issue of loose pedicle screws even after successful fusion in patients with recurring back pain. The poster authors found that the loosening was vertebra level-dependent and, as they wrote, “could suggest adjacent level issues.”
This award winning poster tackled all of these and other issue and for that and the manner in which they addressed these issues, Chappuis and his colleagues were recognized and won the best poster award at this past ORS.
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Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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