ASSI Newsletter

President's Message

Dear ASSI Members,

I feel honoured and humbled by trying to follow in the footsteps of Past Presidents of ASSI, who have been instrumental in the phenomenal growth of this organization in the last 3 decades. After assuming office, my priority was to revamp the committees to bring about a structured and professional functioning of ASSI.

ASSI remains committed to Education, Training and Research. Amidst these keywords, we find ourselves devoted to enhancing the quality of our fellowship programs and improving our research endeavours to match global standards. On an equally eloquent note, we need to express ourselves through the Indian Spine Journal (ISJ) and I would leave not a single stone unturned to make it comparable to international standards.

We are also focused upon giving you the best educational programs in ASSI conferences including ASSICON, ASSSI Live Surgical Course and ICS. Simultaneously, the ASSI Outreach Program will reach out to Tier 2 cities. We are on the process of making our website more informative and technologically up to the mark so that seamless viewing, downloading, and payments are possible and we are keen to amalgamate the ASSI Registry as well.

Advocacy is a crucial step for us and ASSI should evolve to be a voice to be reckoned with so that our recommendations make a substantial impact on policy makers and regulatory bodies. The newly set up Finance committee will address all related issues and will strive hard to achieve a robust financially sound ASSI which can deliver the best to all its members. Membership registration and implementation of the VAS membership will be a priority so that within a few years ASSI evolves to a standard of paid memberships only. Finally, the Nomination committee will ensure the smooth transition of leadership so that leaders of the future will propel ASSI to dizzy heights of excellence!

To this end I commit myself and seek your continuous cooperation and blessings.

Long live ASSI, Jai Hind!

Secretary's Message

Dear esteemed ASSI members,

With the mandate placed upon me to serve on ASSI's executive council as your Secretary, I eagerly anticipate your active engagement in ASSI operations. It is my intention to ensure that the secretariat operates efficiently, maintains transparency, and is readily available to all of us. In addition to growing our membership, we have achieved great strides in the past several years, and our organisation and its members' influence are now visible at major global events.

Journals, fellowship programs, seminars, and conferences are frequently viewed as indicators of a society's caliber, and I am glad to declare that we are among the finest. We are now developing short-term fellowships for surgeons who want to refresh their expertise in a certain surgical technique. More fellowship training centres are becoming certified, and the training process and procedures are being simplified.

A new editorial board has been appointed to the Indian Spine Journal, and we are inviting all of you to contribute papers to ensure the journal's success. The website is now being updated; we have a real-time database of our members, and all information is easily accessible. Accounts have been simplified, with a zero-rent office lease completed and a new net banking account formed, allowing for speedier payments.

However, it is my admission that much remains to be done: more efforts are required to expand membership to the district level, organise additional local courses and workshops modelled after outreach initiatives, and establish faculty development programs. We shall accomplish everything with your active involvement, senior members' assistance and direction, and their support.

Long live ASSI, Jai Hind!

Scoliosis Screening Sub-Committee

• Dr Ranjith Unnikrishnan (Chair)
• Dr Dhiraj Sonawane (Co-Chair)
• Dr Ujjwal Debnath
• Dr Montu Jain
• Dr Varun Aggarwal
• Dr Ayush Sharma
• Dr Suresh Pillai

ASSI Membership Sub-Committee

• Dr Abrar Ahmed (Chair)
• Dr Neeraj Gupta (Co Chair)
• Dr Ashish Jaiswal
• Dr Charanjit Singh Dhillon
• Dr Niraj B Vasavada

E-LearnSpine.org Sub-committee

The comprehensive e-learning resource will comprise of 10 professionals and 7 consumers modules.

Modules already launched - during ASSI Virtual Conference 2020 in September 2020 are Professional Modules (Basic Sciences, Degenerative Disorders of Cervical Spine, Degenerative Disorders of the Thoraco-Lumbar Spine, Spinal Trauma and Fractures)

Modules which we are planning to launch in ASSICON 2024 are Professional Modules (Deformities in Adults and spondylolisthesis, Deformity and Malformation in Children and Adolescents) and Consumer Modules (Pain procedures, Surgical treatments).

Modules which we are planning to launch in ICS 2024 are Professional Modules (Spinal Tumours, Infection, Inflammation and Metabolic Disease, Complications and Revisions) and Consumer Modules (Non-surgical treatments, Know your ‘healers’).

During the Editorial Committee Meeting held on 28th February 2020, it has been decided to include module on “Surgical steps and Video Library.” Experts has been finalised and requested to prepare surgical videos on:

1. Cervical, 2. Posterior cervical, 3. Ant thoracic, 4. Posterior thoracic, 5. Deformity, 6. Osteoporosis, 7. TL junction approach, 8. Lumbar, 9. Posterior lumbar fusion, 10. Lumbo-sacro-pelvic, 11. Pain procedures

Case Connect Sub-committee

Over the preceding year, the ASSI has achieved some notable milestones in the development of our spine surgery case discussion app ASSI CONNECT. Now we have a membership exceeding 700 approved participants. The platform serves as an indispensable educational resource for both trainees and seasoned surgeons. Diligent efforts to rectify technical glitches over the last year have led to the optimization of the user experience. Additionally, the introduction of a web version (compatible with the Chrome browser) allows for access on personal computers.

Over the last few months, we have seen a vibrant engagement, evidenced by the consistent discussion of numerous cases. We invite all the ASSI members to actively participate in case discussions on the app or the website version.

1. Expert Case Discussions: Engage in insightful case discussions with fellow ASSI members, sharing diverse perspectives and advanced techniques. Benefit from the collective wisdom of renowned spine surgeons, enhancing your understanding of complex cases.
2. Peer Networking: Connect with a community of passionate spine surgery professionals. Build meaningful relationships, exchange ideas, and collaborate on research projects, thereby expanding your professional network.
3. Educational Resources: Access educational materials, including surgical videos, research papers, and articles. Stay updated with the latest advancements in spine surgery, ensuring your knowledge remains at the forefront of the field.
4. Secure and Confidential: Rest easy knowing that ASSI Connect prioritizes data security and confidentiality. Your discussions and shared content are safeguarded, providing a safe space for open dialogue among members.

With Revamped Editorial Board....

ASSI Outreach Program Sub-committee

The idea of the spine outreach is for the national ASSI faculty to go through tier-2 cities in India and to impart knowledge on the basics of spine surgery. The course involves lectures, along with hands-on workshops on models and covers topics which are important in day to day practice.

The programs planned for this year are as follows:

• 9th December 2023: Udaipur, Rajasthan
  (Local Host Dr Chirayu Pamecha).
• 25th February 2024: Hubli, Karnataka
  (Local Host Hubli-Dharwad Orthopaedic Association, Secy. Dr Vinay Pawar).
• May 2024: Guwahati, Assam
  (Local Host Dr Jaideep Ghosh).
• July/ August 2024: AIIMS Bathinda/ AIIMS Bilaspur
  (Local Host yet to be decided).
• November/ December 2024: Karnal, Haryana
  (Local Host yet to be decided).

Scoliosis Screening Sub-committee

The scoliosis task force has made important decisions regarding the implementation of a scoliosis screening program. Here's a summary of the key recommendations:

Division of Responsibilities: The task force decided to divide national responsibilities based on regions, creating five zones: East, West, North, South, and Central. Each zone will be subdivided into states, and responsibility for each zone will be assigned to a senior and young scoliosis surgeon interested in conducting a scoliosis screening program. Zone Incharges: Provisional recruitment of incharges for each zone has been completed. Call for Participation: Individuals interested in contributing to the scoliosis screening program are invited to contact the Chairman/Co-chairman. Use of Scoliosis App: The task force suggests utilizing the Assi Scoliosis App for the screening program. Specifically, the recommendation is to include only children with diagnosed scoliosis or suspected scoliosis in the app. These recommendations indicate a structured approach to address scoliosis on national level, with a focus on regional divisions, incharges, and the utilization of Expertise & manpower for screening purposes.

Spine Registry Sub-committee

On behalf of the registry committee of the ASSI, I am happy to announce that version 3 of the ASSI registry is now up and running. The links for entering details of cases into the registry have been shared with the participating centres. In order to make this initiative of the ASSI a success, it is imperative that every centre contribute earnestly towards ensuring a complete and comprehensive registry of cases operated in our country.

An exhaustive database of patients operated for spine pathologies can help the ASSI understand the various aspects of spine problems unique to our country and practice setting in order to better address any lacunae. Also, such a database can provide valuable data that can aid researchers in performing multicentric studies with ease. Moving forward, the registry committee will be focussing on evaluation of the accumulated data and on follow-up data retrieval systems.

Moving towards this goal, the registry committee has been meeting regularly with faculty and fellows from participating centres to identify difficulties faced with data entry. It has also decided to regularly audit the number of registry entries made by each participating centre on a regular/monthly basis. Details on joining the registry for centres that are not participating currently will be announced on the ASSI website in order to encourage wider participation.'

ASSI Membership Sub-committee

Dear Sir,

I have been given charge of requesting the ASSI members to upgrade their membership to Value Added Subscription (VAS) membership and correction of address details.

Request regarding same has already been sent on the available phone numbers and addresses for upgradation and address correction.

There will be monthly follow up and reminders through available e mail addresses, SMS messages and WhatsApp messages and we are expecting a significant improvement in members opting for Value Added Subscription (VAS) membership and correction of membership details including phone numbers and addresses.

Thanks, and regards

Chair VAS Subcommittee

I, Dr Sri Krishna Chaitanya Kondety, Spine Surgeon in KIMS Hospitals, Hyderabad, was a part of the ASSI travelling fellowship 2021. I was privileged to be awarded with this fellowship. It was a wonderful experience to spend time with great surgeons all over india and to be a part of their academic and surgical work. I really thank ASSI for presenting me with this award.

My fellowship journey started with my arrival in New Delhi, it was a very warm welcome in Faculty Club AIIMS New Delhi, I met the other co fellows in the faculty club. We were taken around the Outpatient departments and wards of AIIMS New Delhi by our mentor Dr Bhavuk Garg. it was an amazing experience to see so many patients with wide spectrum of ailments, we were exposed to around 25 cares including Pre op, post op and follow up patients. Later in the day we visited AIIMS OPD which has many scoliosis patients coming from all over the country. We had an intense discussion over various deformities and clinical evaluation. After a good academic session with our mentor, we also observed many ongoing research activities in the department, we had 2 Operating days in our one-week journey and scrubbed for around 5 cases every day which included wide variety of surgeries from degenerative spine and trauma to most complex deformities. There was a very good demonstration of ROBOT by Dr Bhavuk for one of the deformity cases. Fortunately, we were a part of the AIIMS deformity course organised and observed some live surgeries during that time.

I thank ASSI for awarding me with the fellowship. This is one of the best leading experiences in my life. I am also fortunate to visit such high-volume centre and meeting different surgeons around the world and sharing our experiences. I also thank my mentors for spending time to share their experience with us and teach us whenever possible in their busy schedule. Thank you ASSI.

I, Dr Jwalant Patel, from Ahmedabad, feel an extreme honor and privileged to write this report that I had been selected for the prestigious ASSI travelling fellowship for the year 2021. It has been a wonderful journey of extraordinary experience full of academics and learning points. It started at the reputed Stavya Spine Center, Ahmedabad under the mentorship of respected Dr Bharat Dave where we have spent 7 days. We had an amazing experience and great time with all the consultants here including Dr Ajay Krishnan and others. We have seen almost all kinds of spine surgeries including endoscopy, navigation guided, O arm guided and minimally invasive spine surgeries etc. Not only surgical skills but also value-added lessons from the mentors have helped us to be the best spine surgeon.

Next center was the great AIIMS, Delhi under the mentorship of young and so much research-oriented Dr Bhavuk Garg. We had also an advantage to attend the first AIIMS spine deformity conference, have seen robotics and other spine deformity surgeries, chance to visit the cadaveric lab of the AIIMS and dedicated lab for the foot and spine biomechanics which was unique and first of its kind in India.

The third center of the fellowship was Indian Spinal Injuries Center. We had the most amazing opportunity to take the advantage of one of the best spine surgeon and mentor of all time respected Dr H S Chhabra and many other consultant spine surgeons working at the center. Dr Gururaj, Dr Vikas Tandon, Dr Ankur Nanda, Dr Kalidutta Das, Dr Niraj Gupta were the chief spine surgeons there. We had chance to witness almost all kinds of spine surgeries including robotic spine surgeries. We were thrilled to get a chance to witness the great rehabilitation center which was unique with extra ordinary facilities and yes with human touch covering all the aspects of rehabilitation including social influence and workers.

Long live ASSI…………With lots of respect and salutes…!!!

My travelling fellowship started with the Instructional Course Spine (ICS) held in Bhubaneshwar in November 2022. After initial 3 days of intense academic feast that discussed various facets of cervical spine diseases and complications, we proceeded to Kolkata, the city of Joy. The program here was planned for 1 week in the spine unit of Kothari hospital, headed by Dr. Saumyajit Basu. His co-ordination of the program through mail communications became evident soon after we had received the fellowship confirmation mail from the ASSI. Before describing the actual learning experience over there, we must mention about Dr. Basu and his team’s hospitality. He is an excellent host. That week, we got to scrub in for a spectrum of cases including high grade listhesis, lumbar fusions, cervical and thoracic OPLL, cervical laminectomy, scoliosis etc. Observing the adjunctive techniques such as transforaminal root blocks were also useful. Despite his busy OPD schedule, Dr. Basu took active interest to discuss his cases and management plans. His patience and energy during surgeries was inspiring. Over the week, we had healthy discussions over spine related and other topics. His meticulous way of record keeping was another take home.

After completing the Kolkata trip, we then moved to Sancheti Hospital, Pune. We were attached to Dr. Shailesh Hadgaonkar who is heading his spine unit. He is an agile, energetic personality and could multitasking at ease. We also had the opportunity to interact and learn from his other spine colleagues Dr. Ajay, Dr. Pramod and Dr. Siddharth. The academic morning meet discussing all the preoperative and postoperative cases is one of the very good practices in this hospital. This forum serves as a good opportunity for the residents to learn and discuss the management plans. Here, a variety of degenerative spinal pathologies were operated. We were involved in planning and assisting the deformity cases. It is one of the few centers which performs O-arm/ navigation assisted surgeries, and the overall experience was good.

The third center was Nanawati Hospital, Mumbai where the spine unit was headed by Dr. Mihir Bapat. Being from an institute, we had a different exposure to observe the spine practice in the corporate set up. We learned the intricacies of how to deal and interact with patients in a private set up. Here, we had the opportunity to observe hybrid technique of lumbar TLIF and other MIS surgeries. Overall, the travelling fellowship (along with my colleague Dr. Nishank) was an enriching and joyful experience, and we would like to thank ASSI for the wonderful learning opportunity.

I was selected for the ASSI Travelling Fellowship, which commenced with ICS 2022, held at Bhubaneshwar, following which we visited three leading spine centres between November 06-26, 2022. The first centre we visited was Kothari Medical Centre, Kolkata, where we spent a week with the spine team led by Dr Saumyajit Basu. The warm hospitality and the inclusive learning environment aside, we could see the entire gamut of spine surgery cases in the operation theatre within a short span of one week. The noteworthy cases which stoked our attention included an adolescent with severe, rigid idiopathic scoliosis who underwent deformity correction and posterior spinal fusion, a young adult with an osteoblastoma located in the sacrum and a 3-year-old kid with early-onset scoliosis treated by serial casting. We also attended a special OPD for scoliosis patients with spinal muscular atrophy. It was a joy and an inspiration alike to see Dr Basu’s humane and sympathetic approach to dealing with patients in OPD – patiently answering all their queries and allaying their fear and anxiety with his reassuring demeanor.

From Kolkata, we moved to Pune – where we spent a week mentored by Dr Shailesh Hadgaonkar at Sancheti Institute for Orthopaedics and Rehabilitation. Even in a short span of one week, we saw more than 25 spine surgeries and interventional procedures performed by Dr Hadgaonkar, Dr Ajay Kothari and Dr Siddharth Aiyer. In particular, we could get a first-hand experience of seeing pedicle screws being inserted under the guidance of O-arm navigation. Dr Hadgaonkar shared the nitty-gritties and nuances of the technique based on his vast experience of using O-arm guided navigation and addressed all our questions related to the topic. On 19-20 November, we also had a chance to attend MISSABCON 2022.

Our last week of the Fellowship was spent under Dr Mihir Bapat at the Max-Nanavati Hospital, Mumbai. Dr Bapat showed us his unique technique of performing a minimally-invasive transforaminal lumbar interbody fusion based on C-arm guided percutaneous screws and mini-incision decompression under microscope-assistance through a midline skin incision. Spending time with him in the out-patient department also taught us how to deal tactfully with the prototype degenerative spinal disorder patient, who populates the bulk of our clinical practice.

The lessons I learnt from the Travelling Fellowship went well beyond the domain of spine surgery – the art of effective communication with the patient, discipline and perseverance in the operating room, managing time and priorities in a busy, competitive surgical practice and inculcating ethics as a strong moral compass.