With the aim of providing the latest perk of knowledge and training to the aspiring neurosurgeons in Pakistan, the department of neurosurgery at Liaquat national hospital organized the Spinal Deformity Course from 15th– 16th September 2018, in collaboration with Middle East Spine Society, World Spinal Column Society, and Pakistan Society of Neurosurgeons. 

Prof Salman Sharif opened the course by highlighting the objectives and introducing the speakers of the course. The first session about the basic principles was started with Prof Michael Steinmetz (Cleveland Clinic, USA) via skype in which he systematically talked about neuromonitoring for deformities. Prof Douglas Orr (Cleveland Clinic, USA) then also joined via facetime and expertly taught us regarding when to operate on patients with congenital scoliosis. Subsequently, Prof Onur (Turkey), thoroughly discussed the preoperative clinical evaluation of deformities and growing rod techniques. A lecture on sagittal balance and deformity was given by Prof Salman Sharif (Pakistan), followed by Dr Mohsin Qadeer (Pakistan) talking on the radiological imaging of spinal deformities. Dr. Aman Ullah (Resident Neurosurgery) briefly showed the reduction techniques and maneuvers for adolescent idiopathic scoliosis. The session ended with Dr Sameer Irfan (Resident neurosurgery) presenting the case of adolescent idiopathic scoliosis, a case for live surgery. Prof Onur, Prof Salman Sharif and the team headed to theatre to perform the live surgery on an adolescent idiopathic scoliosis patient with a double curve progressive deformity. Prof Onur showed the free hand technique to apply pedicle screws and also to keep in perspective the size of the screw, while demonstrating how to calculate the diameter and angle of the screw from the CT scan. During surgery various techniques of rod adjustments, derotation, segmental derotation and compression with derotation were shown and taught. The participants also learned the benefits of neuromonitoring intraoperatively, which was the major component of this course.  After lunch break, the second live surgery of a patient of lipomyelomeningocele with tethered cord syndrome started under Neuromonitoring.  

The first day ended with a dinner by the sea in Kolachi Restaurant in which all participants and faculty enjoyed the sea breeze after a long day of learning.

Day 2 of the course kicked off with a session on Adolescent idiopathic scoliosis (AIS), in which Prof Doug Orr (via skype) talked about the preoperative clinical evaluation of AIS and its classification. Afterwards, Prof Onur talked about natural history and conservative management of AIS and continued to talk on when operate AIS and how. Following the coffee break a series of lectures were given on adult degenerative scoliosis (ADS). Prof Salman Sharif talked about the classification and sagittal balance in ADS. The techniques of osteotomies for ADS was taught by Prof Onur, after which he continued on prevention strategies for proximal junctional kyphosis. The second day ended with a live surgery on a patient with diastematomyelia and progressive scoliosis.