منشور Dr. med. Samir Smajic

In which area of spine surgery do you specialize? Degenerative conditions? Tumors? Scoliosis? Endoscopic procedures? Minimally Invasive Surgery (MIS)? NSpine offers a comprehensive range of topics, and we highly recommend attending the main conference in London this July! Engage in insightful discussions with globally renowned surgeons and scientists, establish connections, and immerse yourself in the latest advancements in surgical techniques. I am truly humbled and honored to be chairing the session on Minimally Invasive Spine Surgery and Endoscopy alongside Dr. Vincent Hagel. Our session promises to be a gathering of exceptional spine surgeons, innovators and educators, such as Junseok Bae or Ricardo Casal Grau, featuring talks on cutting-edge medicine. Delve into the discussions led by outstanding surgeons Pedro Berjano, Dennis E. DOMINGUEZ, MD and Andrew Young on the optimal approach to lateral surgery: Single-position lateral vs. single-position prone vs. two-staged approach What would persuade you?

The 20-minute retraction time rule in transpsoas lateral lumbar interbody fusion is a generally accepted guideline in spinal surgery. However, does it also apply to prone LLIF? Ashish Patel recently conducted a retrospective review and concluded that the "20-minute Rule" had low sensitivity for predicting injury (50%) and a high false positive rate (95%). Hence, it can be inferred that: • Injuries are not solely predicated on time and are likely multifactorial. • Retraction time is an unreliable predictor of post-operative injury. • Time may be a confounding factor. Mike Selby, in response to Ashish Patel's study, confirmed that he hadn't encountered significant issues with longer retraction times in prone lateral surgery. My evaluation of 59 prone lateral cases corroborates this study and Mike's observation. I only noted one transient L3/4 palsy 3/5 in a complex revision case, and my average retraction time was 31 minutes. While reflecting on the potential reasons, I came across a study by Juan Uribe, MD, that utilized MRI to describe the anatomy of the psoas muscle in prone, lateral decubitus, and supine positions. I was intrigued to find that the psoas muscle, as visualised on MRI images, appears quite similar in prone and supine positions. In contrast, in the lateral decubitus position, the muscle is markedly thicker (less stretched), suggesting that due to the increased thickness and relaxation, the plexus may shift away from the position we anticipate based on supine MRI scans of the psoas/plexus anatomy. Consequently, we must bear in mind that the "movable" anatomy visible in supine MRI scans may vary in the lateral decubitus position. Anatomical positional changes in the lateral lumbar interbody fusion SV Gandhi et al. Eur Spine J. 2022 Sep;31(9):2220-2226 Conclusion: The MRI anatomical evaluation shows that the psoas, and therefore lumbar plexus, and vasculature move significantly with changes in positioning. How Prone Position Affects the Anatomy of Lumbar Nerve Roots and Psoas Morphology for Prone Transpsoas Lumbar Interbody Fusion W Yingsakmongkol  et al. World Neurosurg. 2022 Apr:160:e628-e635 Conclusions: Lumbar nerve roots, psoas morphology, and great vessel position were not affected by the prone position compared with the supine position.

Sa oduševljenjem i velikom radošću, kao predsjednik udruženja bosansko-hercegovačkih ljekara u Njemačkoj, zvanično pozivam sve ljekare koji imaju želju da doprinesu boljem zdravstvu u Bosni i Hercegovini i radi umrežavanja, kao i sve zdravstvene radnike, da se pridruže prvom kongresu. Molim sve ljekare i ostale zdravstvene radnike da s oduševljenjem lajkuju ovaj post i dijele ovaj poziv. Istovremeno, sa velikom radosti pozivam ljekare iz Austrije, Švicarske, Nizozemske, Belgije, Luksemburga, Francuske i skandinavskih zemalja da se povežemo i stvorimo evropsko društvo ljekara iz Bosne i Hercegovine. Hajde da preuzmemo budućnost našu i naše djece u naše ruke!

Revision Case! The efficacy of anterior surgery is impressively demonstrated in revision cases. A 67-year-old patient with a history of six prior surgeries (three decompressions and three fusions) presents with severe back pain rated 10/10 persisting since the most recent surgery one year ago. Furthermore, the patient experienced severe S1 pain attributable to screw loosening and a broken screw in S1, along with multiple unsuccessful attempts at re-instrumentation of S1. Session 1: Anterior Lumbar Interbody Fusion (XALIF) at the L5/S1 level, removal of Peek cages, insertion of a hyperlordotic cage at 20°, supplemented with iliac crest spongiosa grafting. Oblique Lumbar Interbody Fusion (OLIF) at the L4/5 level, removal of Peek cages, insertion of an expandable cage at 15°, supplemented with iliac crest spongiosa grafting. OLIF at the L3/4 level, removal of Peek cages, insertion of an expandable cage at 10°, supplemented with iliac crest spongiosa grafting. Due to challenging anatomy, OLIF was performed, encountering a configuration resembling Mickey Mouse at L4/5, transversing of the iliac vein at L4/5, and atypical plexus anatomy at L3/4. Session 2: Minimally Invasive Surgery (MIS) screw revision from L3 to S1, resection of the facets from L3 to S1, MIS re-decompression of L4/5, with additional stabilization at L3/4 using an iliac bone graft, followed by dorsolateral fusion. One day after the second surgery, the patient showed significant improvement, walking without the need for crutches and experiencing relief from leg pain.

Son and Father I was deeply moved and filled with an indescribable sense of pride. The moment arrived sooner than I could have ever imagined. It was the first time my son joined me in the operating room for a student internship. He has a keen interest in medicine, particularly surgery (I wonder where he got that from?), and specifically requested to intern at my hospital. With great pride, I showcased my favorite surgical technique (XALIF L5/S1) to my son in the operating room. As he observed me in action, he remarked on how truly cool my job is and how much of an art form surgery truly is. What an incredibly heartwarming and fulfilling moment in life!

Excited to share that I had the opportunity to test the Olympus EMEA Orbeye for prone position single-position surgery at IRCAD in Strasbourg during the NSpine Cadaver and Live Tissue Complication Course. Thanks to Ernst Jonscher for providing the technology! Ricardo Rodrigues-Pinto, MD PhD FEBOT, had a positive experience with his first steps into prone XLIF revision surgery. We're looking forward to integrating modern surgical techniques into our daily practice. Compared to Viseon Inc., I found the 3D visualization of the Orbeye impressive, and its flexibility in usage stands out. It's particularly effective in minimally invasive approaches like MAS and MIS TLIF, XLIF, and XALIF.

The NSpine Cadaveric and Live Tissue Masterclass is much more than just an educational institution; it is a temple of learning and teaching that offers an unparalleled experience with each visit. The immense impact it has on both the faculty and the delegates is undeniable and is manifested in the way it enriches and expands knowledge and experiences. Each visit is like a journey into a universe full of possibilities, where I arrive with high expectations and leave with a wealth of enhanced experiences and newly acquired knowledge. The experience is not only educational but also uplifting, as it allows us to elevate our skills and knowledge to the next level. But what truly sets this Masterclass apart is the relationships forged during the shared learning time. It is a genuine joy to form new friendships from all over the world that go beyond the confines of the classroom. It is a sense of community that emerges from the shared pursuit of knowledge and excellence. The NSpine Cadaveric and Live Tissue Masterclass is not just an institution; it is a community of people who are passionately dedicated to their field and are ready to share their knowledge and experiences. It is a place where each visit is a unique and enriching experience. It is a place where I arrive with high expectations and leave with strengthened experiences and new friendships from all over the world.

What happens when Prof. Dr. Kamil Cagri Kose meets Dr. med. Samir Smajic ? Bilateral inspiring, outstanding surgery skills battle and beautiful outcome! The key was an asymmetrical pedicle subtraction osteotomy at L1 left side, closing the wedge to correct both the scoliosis and the kyphosis! The sushi, I believe, was well deserved afterwards.

Obasjani uzbuđenjem, pozivamo vas da se prijavite za ovaj historijski događaj! Pošaljite svoje prijave preko e-maila na kongres@bhaeg.de. Jedva čekamo da vas vidimo na 1. kongresu bosansko-hercegovačkih ljekara u Njemačkoj! Preplavljeni smo ponosom što imamo podršku od Tarika Filipovića! Pogledajte video! Tarik Filipović, dinamični bosansko-hrvatski televizijski voditelj i talentirani glumac, ostavio je neizbrisiv trag u svijetu scenskih umjetnosti. Sa impresivnim repertoarom od preko 800 kazališnih produkcija od svog debija 1985. godine, on je moćna figura u industriji. Iza scene, također je nastupao u brojnim filmovima i TV dramama, očaravajući publiku širom nekadašnjih jugoslavenskih regiona. Posebno je očarao gledatelje više od decenije kao karizmatični voditelj hrvatske verzije poznate emisije "Tko želi biti milijunaš?".

The integration of cutting-edge spinal implants through the utilization of contemporary surgical methods not only illuminates a path to remarkable patient outcomes and swift recoveries, but also instills an unparalleled sense of fulfillment and satisfaction in surgeons. #XALIF #XLIF #expandabaleCAGE #SynergyAdvanceTechnologyAndSkills