Thursday, 15th May 51st International Society for the Study of the Lumbar Spine Annual Meeting 2025

Three oral presentations will be followed by a 15-minute panel discussion.

• Incidence and Risk Factors of Lumbosacral Complications Following Long-Segment Spinal Fusion in Adult Degenerative Scoliosis - Yong Hai
• A comparison of postoperative outcomes in surgical treatment for spinal metastasis focused on the institutional function: Analysis of a nationwide administrative database in Japan - Kentaro Yamada
• Three-month postoperative psychosocial risk using the STarT Back Screening Tool is associated with 1-year disability, physical function, and pain after lumbar spine surgery - Rogelio A Coronado
• Classifying invasiveness of minimally invasive spine surgery (MISS) techniques: toward a standardized system  - Rachel Bratescu
• Adjacent level canal area changes up to 2 years after lumbar spinal stenosis decompressive surgery  - a secondary analysis of data from the NORDSTEN SST study - Helena Brisby
• Safety of combined anterior-posterior lumbar column fusion verses single column anterior or single column posterior lumbar fusion: analysis of Medicare data - Brook Martin

• Structural changes of muscle spindles in the multifidus muscle after intervertebral disk injury are resolved by targeted muscle activation - Paul W Hodges
• Cartilage End Plate Defects Precede and Initiate Bony End Plate Defects and Disc Degeneration – An ‘Integrated Total End Plate Score’ to Identify Preclinical Discs at Risk for Degeneration.   - S Rajasekaran
• A randomized trial on three different minimally invasive decompression techniques for lumbar spinal stenosis. Five years follow-up from the NORDSTEN-SST. - Erland Hermansen

Speakers:
Pierre Côté - Ontario Tech University, Canada
Conor O’Neill - University of California, San Francisco, US
Sara Jones Berkeley - University of North Carolina, Chapel Hill, US

Identifying cause and effect relationships is a core task of science.  For this reason, randomized controlled trials (RCT’s) stand at the apex of the scientific evidence pyramid. However, it may not be feasible to conduct RCT’s to answer all the important causal questions in spine research.  Of the 119 oral (podium and special poster) presentations that included clinical data at the ISSLS 2024 annual meeting only 3 were reports of RCT’s.  Of the 116 clinical studies based on observational data only one included a formal causal analysis.  While traditionally researchers have avoided making causal inferences when interpreting observational data, we argue that methodological advancements  challenge this practice and provide methods to investigate causal effects using observational designs.  Therefore, it is critical for scientists involved in spine research to use modern approaches to designing and analysing observational studies, by incorporating causal inference principles.  This symposium will feature four 12-minute presentations followed by discussion:

1. Introduction to counterfactual reasoning (O’Neill)
2. A principled approach to answering causal research questions using Directed Acyclic Graphs (Côté)
3. Solving applied problems in spine research with causal inference: Mediation Analysis (Sara Berkely Jones)
4. An innovative alternative to RCT’s: Target emulation trials (Côté)

Three oral presentations will be followed by a 15-minute panel discussion.

• Longitudinal progression of disc degeneration over 23 years from adolescence to adulthood - Teija Lund
• Screening System for Assessing Suitability of Cognitive Behavioral Therapy for Chronic Low Back Pain - Keisuke KS Shimizu
• A pre-, peri- and postoperative rehabilitation pathway for lumbar fusion surgery (REACT): a nonrandomized controlled clinical trial - Liedewij Bogaert
• Effects of sustained locomotion training-based outpatient rehabilitation on the global sagittal spinal alignment in locomotive syndrome: a 2-year prospective cohort study - Takashi Yurube
• Patient-reported outcomes in a community sample of individuals with chronic low back pain: Baseline behavioral-psychosocial features of the University of Pittsburgh’s Low Back Pain - Biological, Biomechanical, Behavioral Phenotypes (LB³P) project - Gwendolyn A Sowa
• Efficacy of cognitive functional therapy for pain intensity and disability in patients with chronic non-specific chronic low back pain: a randomized sham-controlled trial - Ney Armando NM de Mello Meziat Filho

Three oral presentations will be followed by a 15-minute panel discussion.

• Exploring paraspinal muscle single fibre contractile variability in adult spinal deformity patients - K. Josh Briar
• Quantifying paraspinal muscle fibre orientation (a)symmetry in adolescent idiopathic scoliosis - Phoebe Duncombe
• Clinical tests for lumbar instability demonstrate limited sensitivity and specificity but confer a high negative predictive value in patients with chronic low back pain - William Anderst
• Effects of running on intervertebral disc health in adults with chronic low back pain: the ASTEROID randomised control trial - Ulrike H Mitchell
• Dynamic trunk control is associated with post-operative mechanical risk in patients with adult spinal deformity - Jeannie F Bailey
• From waves to wellness: The effects of aquatic therapy on muscular and psychological health in patients with chronic low back pain - Chanelle Montpetit

Three oral presentations will be followed by a 15-minute panel discussion.

• Safety and Efficiency of Release-Controlled RNA Interference Targeting Raptor with Cationized Gelatin Nanospheres in Rat Intervertebral Disc Nucleus Pulposus Cells: a Development of New Drug Delivery System - Yoshiaki Hiranaka
• Biomarkers in Cerebrospinal Fluid of Persistent Neuropathic Pain after Lumbar Stenosis Surgery - Joonghyun Ahn
• Endplate structural defects: prevalence, distribution and association with age and body mass index in adult males - Aliyu Lawan
• Proteomic analysis identifies distinct signaling pathways in lumbar intervertebral disc degeneration between type-2 diabetic and non-diabetic patients - F M Moinuddin
• Gli1 loss causes congenital vertebral synostosis in a mouse model - Chitra L Dahia
• Intervertebral Disc State Fingerprint to classify degeneration and low back pain in the Northern Finland Birth Cohort 1966 - Estefano Muñoz-Moya

Speakers:
Xudong Joshua Li - University of Virginia, US
Zorica Busar - New York University, US
Gianluca Vadalà - Campus Bio-Medico University of Rome, Italy

This symposium will explore the latest advancements in the understanding and management of lumbar disc herniation, focusing on predicting disc reabsorption, identifying novel biomarkers, and utilizing AI for surgical decision-making. Experts will discuss the effectiveness of various surgical techniques, including discectomy vs sequestrectomy, and annulus fibrosus repair, in reducing recurrence rates. The emerging roles of endoscopy and unilateral biportal endoscopy (UBE) will be also discussed. The session aims to enhance knowledge on optimizing patient outcomes through personalized surgical approaches and cutting-edge technologies.

Learning Objectives:

1. Understand the natural course of disc herniation reabsorption and the potential for prediction using MRI.
2. Explore new biomarkers for lumbar disc herniation and their clinical relevance.
3. Assess the potential of artificial intelligence in predicting surgical outcomes and determining optimal timing for intervention.
4. Evaluate the effectiveness of current surgical techniques, including discectomy, sequestrectomy, and annulus fibrosus repair, in reducing recurrence rates.
5. Discuss the future role of endoscopic techniques and UBE in the treatment of lumbar disc herniation.

This symposium stems from the efforts of the AOSpine Knowledge Forum Degenerative initiative, aimed at driving innovation in the field of lumbar disc herniation management.

Join your fellow delegates in the Grand Overlook ballroom at the Atlanta History Centre for a night to remember.

The Gala Dinner is a social highlight of the ISSLS Scientific Meeting.

Enjoy a night of great food, drinks, company and dancing. Transportation included.