We invite you to join us for the 8th Annual Safety in Spine Surgery Summit. We are returning to an in-person meeting this April in New York for a one-day CME-accredited course. Safety in Spine Surgery Month will also feature video content and promotion to raise awareness and highlight S3P work and resources.

Check back soon for registration, lodging, abstract submission, and more!

Program Highlights:

  • The Latest Best Practices for Safety in Spine Surgery
    • Intraoperative Neuro Monitoring
    • Optimization of the Pediatric Neuromuscular Patient
    • Optimization of the Adult Deformity Patient
  • Calling in Reinforcements to Manage “High Risk:” Surgeons and Staff
  • Risk Stratification and the Development of Predictive Calculators
  • Cognitive load in the operating room: how it can affect your performance
  • Expert Panel | Safety Challenges that Changed my Practice
  • Perspectives Across a Career Focused on Neurological Safety | Lawrence G. Lenke, MD
  • Keynote | Sharpening Your Scalpel: Optimizing Performance in and Out of the OR | Christopher Ahmad, MD

Invited Faculty:

  • Michael Vitale, MD MPH
  • Christopher Ahmad, MD
  • Todd J. Albert, MD
  • Brandon Carlson, MD, MPH
  • Dean Chou, MD
  • Roger Hartl, MD
  • Han Jo Kim, MD
  • Lawrence G. Lenke, MD
  • Firoz Miyanji, MD FRCSC
  • Frank J. Schwab, MD
  • Rajiv Sethi, MD
  • Eeric Truumees, MD

Faculty Subject to Change

As part of the 2nd Annual Safety in Spine Surgery Month, we invite you to join us at two live webinars on April 14 and April 21, 2022. These events will be hosted and moderated by the Safety Month Chair Michael Vitale, MD and Co-Chairs John Flynn, MD; Roger Härtl, MD; Larry Lenke, MD; and Rajiv Sethi, MD.

The April 14 webinar will take place at 7:00 pm Eastern Time and will focus on Best Practice Guidelines. It will feature the publication of several checklists and protocols by the Safety in Spine Surgery Project as well as lectures and panel discussions with our esteemed chairs and faculty. In addition, 5 of the award winners of Best New Methodologies and Techniques to Enhance Safety in Spine Surgery will present their papers. This webinar will be CME-accredited. Click here for the full program.


The April 21 webinar will also take place at 7:00 pm Eastern Time. It will focus on Robotics and Navigation and specifically its use across generations of US spine surgeons. The other 5 of this year’s award winners will present at this webinar, plus faculty lectures, discussions, and technology updates from our corporate partners. Click here for the full program.


We hope you’ll join us for these two events and get involved with Safety Month on social media! Post your questions and contributions with the hashtags #safetyinspinesurgery and #s3p. Follow us on Twitter, Facebook, Linkedin, and Instagram for daily posts of Best Practice Guidelines and further resources.

We are looking forward to an exciting month of collaboration!

Thank you for participating in Safety in Spine Surgery Month! We closed out the month with an excellent April 29 webinar on Leveraging the Team to Make Spine Surgery Safer. The replay will be available on our website next week.

Our last week of safety videos included some outstanding content & practical tips. We heard from:

  • Dr. Nicholas Fletcher on Mean Arterial Pressure Parameters
  • Dr. Sumeet Garg on Getting the Team on the Same Page
  • Dr. Jean-Pierre Mobasser on the Risks of K Wires and Guidewires in Spine Procedures
  • Dr. Michael Glotzbecker on Overcommunication
  • Dr. Massimo Balsano on his safety tips
  • Dr. Suken Shah on the Surgeon Performance Program
  • Dr. David Skaggs on Setting up Systems
  • Dr. Roger Härtl and Dr. Jacob Goldberg on Emergency Workflow Training

As always, you can review all these videos, plus our library of past talks, for free on the website.

We want to thank this week’s contributors, as well as this week’s partner organizations: SMISS, ISASS, SRS, Setting Scoliosis Straight Foundation, and POSNA.

We hope you’ll join us for next year’s Safety in Spine Surgery Summit (Spring 2022 in New York).

View all this week’s videos here.

Welcome to the Safety in Spine Surgery Month, Week 1! This week we reached over 2,000 unique visitors across our social media channels with the message of safety in spine surgery. We saw some excellent and diverse perspectives on what safety means to surgeons, industry, and our partners. Highlights included:

  • Dr. Vitale reminded us, “If you’re the smartest person in the room, you’re probably in the wrong room,” in his video on Calling in the Reinforcements.
  • Dr. Yazici spoke about the safe management of complex neuromuscular deformities.
  • Dr. Lenke showed us the process of using 3D models to study anatomical landmarks prior to surgery and during surgery.
  • Dr. Sponseller talked us through the why & how of using an IVAC to reduce infection risk in neuromuscular patients following PSF.
  • David Bailey of OrthoPediatrics shared about their support of the Safety month.
  • Dr. Flynn talked about the impact dedicated spine teams have had – he calls them “the greatest safety measure that I’ve seen in my 25 year career”
  • And finally, Dr. Radcliff explained three ways the operative microscope affects safety in spine surgery.

We heard from followers on social media, too—Dr. Vitale commented about 3D Models—“Great way to ‘navigate’ before you get into the OR—much like an athlete visualizes performance prior to the event.” Dr. Sumeet Garg commented on what he’s found effective for improving safety—“Working with plastic surgeons on closure for cases to pelvis. Navigation speeds up placement of sacral and pelvic fixation and aids in maximizing screw diameter.”

We want to thank this week’s contributors, as well as this week’s partner organizations: The Scoliosis Research Society, The Setting Scoliosis Straight Foundation, OrthoPediatrics, and the International Society for the Advancement of Spine Surgery.

We want to hear from you, too! Join us on social media with your own safety tips or questions. Tag us, and you might win a $100 gift card!

View all this week’s videos here.

The Safety in Spine Surgery Project (S3P) is pleased to announce the 10 winners of the Safety in Spine Surgery Month Call for Abstracts / Call for Projects. The winning submissions for Best New Methodologies and Techniques to Enhance Safety in Spine Surgery will present their work during two live webinars for Safety in Spine Surgery Month. The free webinars will be held on April 15 and April 29. Registration and further details are available at the link below.

April 15 Webinar

Checklists and Guidelines which Make Spine Surgery Safer
  • Spine Surgery Checklist: A Step towards Perfection through Protocols
    Jwalant Patel, MS, FASSI; Arvind Kulkarni, MS
  • Establishing a Standardized Protocol for Identifying Patients at High Risk for DVT/PE Following Spine Surgery
    Zeeshan Sardar, MD, MSc; Kristen Mitchell, PA; Rick Leung, PA; Derek Mazique, MD
  • Surgical Site Infection Following Neuromuscular Posterior Spinal Fusion Fell 72% After Adopting the 2013 Best Practice Guidelines
    Stephen R. Stephan, MD; Kenneth D. Illingworth, MD; Kavish Gupta, MD; Lindsay M. Andras, MD; David L. Skaggs, MD MMM
    Cedars-Sinai Medical Center & Children’s Hospital Los Angeles
  • Learning from Air Travel: Utilizing a Checklist Prior to Closing (Landing) in Pediatric Spine Surgery
    Jessica H. Heyer, MD; Patrick J. Cahill, MD; John M. Flynn, MD; Jason B. Anari, MD
    Children’s Hospital of Philadelphia
    @CHOPorthofellowship

April 29 Webinar

Leveraging the Team to Make Spine Surgery Safer
  • Reduction of Facial Pressure Injuries after Prone Positioning in Spine Surgery: A Multi-Disciplinary Approach
    Mindy Stites, MSN, APRN; Brandon B. Carlson, MD MPH; Linda Brookman, RN; Jake Kessen, CRNA; David Pennington, CRNA; Jacob Birlingmair, MD; Kabir A. Torres, BA; Douglas C. Burton, MD
    University of Kansas Health System
  • Design and Implementation of an Enhanced Recovery After Surgery (ERAS) Protocol in Elective Lumbar Spine Fusion by Posterior Approach: A Retrospective, Comparative Study
    Bhavuk Garg, MS, MRCS; Nishank Mehta, MS; Tungish Bansal; Shubhankar Shekhar; Puneet Khanna; Dalim Vaidya
    All India Institute of Medical Sciences
  • Comparison of Procedural Utilization Rates and Timeline to Care in Multidisciplinary versus Unidisciplinary Spine Clinic Models
    Joshua Benton, BA; Vijay Yanamadala, MD, MBA, MS; Brandon T. Weiss BS; Wenzhu B. Mowrey, PhD; Michael Longo, BA; Rafael De La Garza Ramos, MD; Yaroslav Gelfand, MD; Phillip Cezayirli, MD; Erida Castro-Rivas, MS; Mark Headlam, BS; Adaobi Udemba, NP; Lavinia Williams, RN; Merritt D. Kinon, MD; Andrew I. Gitkind, MD, MHA; Reza Yassari, MD, MS
  • Multidisciplinary Conference for Complex Surgery Leads to Improved Quality and Safety
    Zoe Norris, BFA; Michelle Zabat, BA; Hershil Patel, BS; Nicole Mottole, BS; Kimberly Ashayeri, MD; Eaman Balouch, MD PhD; Constance Maglaras, PhD; Themistocles Protopsaltis, MD; Aaron Buckland, MBBS FRACS; Charla Fischer, MD
    NYU Langone Health & NYU Langone Orthopedic Hospital
  • Innovative Technology System to Prevent Wrong Site Surgery and Capture Near Misses: A Multi-center Review of 487 Cases
    David Gloystein, MD; John Devine, MD; Bradley Heiges, MD; David Schwartz, MD; Deborah Spratt, MPA BSN RN CNOR
  • The Effect of a Transdisciplinary Spine Conference on Quality and Safety for Adult Spinal Deformity Surgery
    Gregory Mundis Jr., MD; Fernando Rios, MD; Hani Malone, MD; Bahar Shahidi, PhD; Tina Iannacone, BSN; Shae Galli, BS; Robert Eastlack, MD

The Safety in Spine Surgery Project is pleased to announce the First Annual Safety in Spine Surgery month, taking place in April of 2021. The goal of this project is to improve safety in spine surgery by sharing guidelines, techniques, and protocols that make care better, and to share lessons learned from participants who have developed specific, successful safety protocols. This event will feature 2 live webinars and an industry-wide social media campaign throughout April.

Under the leadership of Michael G. Vitale, MD, MPH and co-chairmen John Flynn, MD; Roger Härtl, MD; Larry Lenke, MD; Rajiv Sethi, MD, S3P is partnering with surgeons, allied health care providers, organizations, hospitals, and medical device companies in this effort. It is the belief of the program directors that all major healthcare stakeholders are obligated to invest their expertise and funds to enhance patient safety.

Submission of abstracts and projects summaries is underway for Best New Methodologies and Techniques to Enhance Safety in Spine Surgery. The 10 best submissions will each be awarded $1000 and be featured during one of the live webinars. We encourage our colleagues to submit not only scientific papers, but also any project that has made a difference in spine surgery quality, safety, or value. Submissions are due to Kate Laney by February 19, 2021.

Registration is open for two live webinars, taking place April 15 and April 29. The first will focus on predictive analytics, enabling technology, and innovative techniques to make the OR safer. The second will highlight checklists, guidelines, and tricks to avoid complications and improve neurological safety. Registration is free and can be accessed at this link.

We encourage you to get involved in this effort by submitting abstracts, attending the webinars, and getting active on social media during the month of April. Post your successes and difficulties with the hashtags #safetyinspinesurgery and #s3p. Follow us on Twitter, Facebook, Linkedin, and Instagram for further information.

If your practice, organization, or medical device company would like to partner with us, please contact Kate Laney.

We are looking forward to an exciting month of collaboration!

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Less than 2 weeks before the 5th Annual Safety in Spine Surgery Summit on March 13, NewYork-Presbyterian Hospital received its first COVID patient. These were the early days of an unprecedented strain on the city’s healthcare system. NYC is still fighting a hard battle every day and continues to rise to the challenge.

Despite taking the necessary step to cancel the live Safety Summit in March, we were still committed to providing top-tier educational resources to the spine surgery community. Our local faculty gathered for discussion and our long-distance faculty recorded their own presentations. In the words of Dr. Flynn & Dr. Vitale, it’s more a mission than a course. Thanks to our faculty and supporters, we’re now pleased to present these to you as a free Safety Summit Online CME video series.

Surgeons, PAs, and Nurses can earn 4.2 hours of CME/CE credit by viewing this series of lectures and panel discussions. Learn from experts in spine surgery, neuromonitoring, medical device approval, malpractice, and more. Plus, gain invaluable insight from Stephen Harden of LifeWings, a leader in transforming patient safety programs around the country. We’ve also provided the full text of the outstanding abstracts submitted for this meeting. In addition, you can review the E-Poster presentations, representing some of the best new research in our field. This CME-accredited course is available through February 2021.

We hope you’ll take advantage of this year’s on-demand learning experience. We look forward to joining together in person again for the 6th Annual Safety Summit in Spring 2021. Until then—stay healthy. Stay safe.

Click here for more information.

Less than 2 weeks before the 5th Annual Safety in Spine Surgery Summit on March 13, NewYork-Presbyterian Hospital received its first COVID patient. These were the early days of an unprecedented strain on the city’s healthcare system. NYC is still fighting a hard battle every day and continues to rise to the challenge.

Despite taking the necessary step to cancel the live Safety Summit in March, we were still committed to providing top-tier educational resources to the spine surgery community. Our local faculty gathered for discussion and our long-distance faculty recorded their own presentations. In the words of Dr. Flynn & Dr. Vitale, it’s more a mission than a course. Thanks to our faculty and supporters, we’re now pleased to present these to you as a free Safety Summit Online CME video series.

Surgeons, PAs, and Nurses can earn 4.2 hours of CME/CE credit by viewing this series of lectures and panel discussions. Learn from experts in spine surgery, neuromonitoring, medical device approval, malpractice, and more. Plus, gain invaluable insight from Stephen Harden of LifeWings, a leader in transforming patient safety programs around the country. We’ve also provided the full text of the outstanding abstracts submitted for this meeting. In addition, you can review the E-Poster presentations, representing some of the best new research in our field. This CME-accredited course is available through February 2021.

We hope you’ll take advantage of this year’s on-demand learning experience. We look forward to joining together in person again for the 6th Annual Safety Summit in Spring 2021. Until then—stay healthy. Stay safe.

Click here for more information.

Without doubt, the impact of complications like surgical site infection (SSI) can have a tremendous burden on patients, their families, surgeons, hospitals, and society as a whole. As with most complications in healthcare, SSI should be thought of as the result of a combination of host, technique, systems and culture challenges. When multiple defects accumulate, SSI overwhelms the various countermeasures and a clinical infection ensures.

When the defects all align, it allows for these factors to allow passage through the “Swiss cheese” of host, perioperative, and systems defenses. Our role in making care better extends far beyond the time in the operating room. Our highest performance can only come from the ability to develop a high functioning team with unique and synergistic inputs across the entire care continuum, starting well ahead of surgery to include culture and involvement of multiple stakeholders all working towards a shared goal with everyone understanding the importance of the role they play. The greatest opportunity to improve quality, safety, and value lies in the period before the skin incision and long after it is closed. Increasingly, it’s not just the surgeon’s role in acting as the captain of the ship but understanding the importance of “slowing the machine” to consider the full spectrum and extent of potential surgical risk and working with the team to attempt to optimize preoperative care and potentially alter the characteristics of the surgical approach for a given patient.

Work at S3P is dedicated to exploring the role of the multidisciplinary team in minimizing the possibility of complications after spine surgery. Interventions and risks are being explored as efforts to affect the host, surgical technique, culture and systems of care. As with all quality improvement efforts, these must adapt over time to create sustained and iterative improvements in care. Our team began this journey several years ago and we look forward to involving you in this as well.

How Lessons from Cycling Can Inform Efforts at Continuous Improvement

A recent conversation with an avid cycler helped me draw interesting parallels between how sport and the pursuit of skill so often intersects with our mission to make care better in healthcare. Britain’s national efforts in cycling provide such an interesting case study, taking a program who had never won a single gold medal in its 76 year history to winning seven out of 10 gold medals in two consecutive Olympics and applying the same discipline to lead one of the most successful professional cycling teams ever.

Sir Dave Brailsford, the coach responsible for these efforts, took the principles of the Toyota Production System, also called lean, to infuse the team with the spirit of Kaizen, or continuous improvement. He thought that if the team broke down everything they could think of that went into competing better on a bike, and then improved each element by 1%, then these marginal gains could achieve a significant aggregated increase in performance. This came from everything to the traditional areas of experimenting in wind tunnels for aerodynamic, to applying 5S techniques to the mechanics team truck and painting the floor white to prevent slips from grease, to teaching athletes about proper hand hygiene from a surgeon. This even went as far as requiring all athletes to sleep on team provided mattresses and pillows so athletes could sleep in the same posture with the same support every night. Taken together, they felt that it gave a competitive advantage.

These principles of looking at strategy, human performance, and continuous improvement have the same applications to how surgery is performed. For strategy, so much cognitive effort needs to be spent on understanding patient’s unique attributes, understanding plans for surgery, and involving the team. This can also involve slowing down the machine and working with a multidisciplinary team to understand the approach. With S3P efforts, this include recommending using multidisciplinary indications conferences with anesthesia, medicine, and nursing to fully discuss a patient’s treatment plans.

For human performance, this truly involves a surgeon treating themselves as athletes, caring for their physical conditions and optimizing their movements. But this also involves attention to behavioral psychology and creating an environment for optimum performance. This may involve routines the evening and morning before surgery to cognitively rehearse the procedures but also can include preventing heuristic biases from affecting decision making. At S3P, this involves the development of formal risk stratification scores to formalize the requirements and opportunities for “slowing the machine” and optimizing patients’ modifiable risk factors.

The final aspect of continuous improvement plays heavily into Sir Dave’s efforts at finding marginal gains. The same principles are applied within my own OR. For the past year, we have been using the comprehensive unit-based safety program to work with my operative team to fully map out the steps involved in preparing a patient for surgery to incision. From there, we brainstormed ways to drive more efficiencies. Things included marking with tape the position of the table and posting laminated photos of the way the lights should be set up. While each step would only save several minutes at most, as we found more and more opportunities for efficiencies, this began to increase our time to set up by up to 20%. Today, we are applying this across the entire continuum.

Identifying these principles as critical success factors and ensuring they are in place can allow everyone to focus on improvements and reach an optimal place to improve quality, safety, value, throughput and efficiency.