The CSRS Instructional Course Lecture is a full-day, case-based deep dive into cervical myelopathy, vascular injury, tumor, disc herniation, deformity, and trauma — featuring the field's most contemporary surgical strategies and expert panel discussion.
Degenerative Cervical Myelopathy
Surgical treatment of degenerative myelopathy can vary with the severity of the disease, patient and surgeon preference. Surgical treatment varies from anterior vs posterior approaches, fusion vs nonfusion technologies or hybrid combinations. This session will showcase the most contemporary surgical options as well as possible treatment modalities for the next generation.
Vertebral Artery Injury Complications
Vertebral artery injury remains one of the most feared complications in cervical spine surgery: rare enough that most surgeons will never manage one, catastrophic enough that hesitation in the first sixty seconds changes the outcome. This instructional course pairs a prevention-focused review of vascular anatomy, preoperative screening, and trajectory planning with a step-by-step walkthrough of intraoperative management once the artery is injured: tamponade and hemostatic control, the decision to abort versus proceed, and how the response differs between anterior and posterior approaches. We will also address the immediate postoperative pathway, including when to involve neurointerventional colleagues, antithrombotic decision-making for dissections, and follow-up imaging strategy. Attendees will leave with S.T.A.B.L.E. (Scan & Screen, Trajectory Planning, Anatomy Awareness, Bleeding Control, Limit Further Damage, Endovascular Backup), which is a framework built to function under pressure the way airway algorithms do. The closing discussion will focus on real-world scenarios, including management in the ambulatory surgery center setting where backup is not usually down the hall.
Cervical Tumor
Primary and metastatic tumors present unique treatment challenges due to patient and family expectations, need for multi-discipline collaboration, poor bone quality, wound healing issues and need for post-surgical procedures. Optimal outcome is often defined by patient expectations and not objective parameters we use for other cervical diagnoses. This session will discuss the specific details specific for cervical oncology and appropriate, reasonable outcome parameters.
Cervical Disc Herniation
A lateral soft cervical disc herniation is a common condition, but despite what is seemingly a straightforward pathology, there are numerous surgical treatment approaches with a wide range of invasiveness. Posterior open/tubular laminoforamionotomy and endoscopic foraminotomy both offer the ability to decompress and remove herniated disc material without the need for implants or fusion. Anterior cervical discectomy and fusion (ACDF) and total disc replacement (TDR) both provide for arguably a more complete decompression but require implants. The pros and cons of each procedure will be discussed and the audience polled at the conclusion of the session to assess for the favored treatment recommendation.
Cervical Deformity
Severe cervical kyphosis is a challenging deformity to surgically correct, especially in frail patients. This session will address several topics relevant to the treatment of this condition, including assessment of alignment and goals for realignment, surgical planning, and pedicle subtraction osteotomy indications and technique. In addition, the technique of placing subaxial cervical pedicle screws will be discussed as a means of enhancing correction maneuvers and mechanical stability.
Cervical Trauma
Optimal treatments for many traumatic conditions of the cervical spine remain debatable. In this session, representative cases for four relatively common cervical traumatic conditions will be presented and management approaches will be discussed by a panel of experts. Following panel discussion, the presenter for each case will show how the patient was managed in practice.