Nancy Lamerigts, 24-03-2023

Lessons Learned; keynote lecture Professor Cumhur Öner

As an active sponsor at the Utrecht Spine Course on March 17th, the team of InSpine had the privilege of attending the keynote lecture by Cumhur Öner, Professor  Orthopedics at UMC Utrecht. His lecture titled “Lessons Learned” provided a comprehensive overview of his wealth of knowledge and experience gathered during his impressive career as a spine surgeon.

Chapter one of the lecture emphasized the importance of using algorithms to inform decision-making. According to Professor Öner, “experts are inferior to algorithms; whenever we can replace human judgement with a formula, we should at least consider it.” He also stressed the need to accept that there is always some level of uncertainty when making clinical decisions. For acute spinal patients, when in doubt, choose surgery. For patients with deformities or degenerative pathology without progressive neurological involvement, no surgery may be a good decision.

In chapter two, Professor Öner stressed that spine care is a team effort. The surgical team should consist of “spine surgeons” (not orthopedic, trauma or neurosurgeons) who have sufficient knowledge and expertise to make informed decisions. There should be enough room for disagreement and discussion among team members to ensure the best possible outcomes for patients.

Chapter three focused on patient selection. According to Professor Öner, it’s important to select indications, not patients. He advised looking at “hard clinical data” to determine whether surgery is indicated before considering the patient’s individual circumstances.

In chapter four, Professor Öner emphasized the need for a basic understanding of the anatomy and biomechanics of the spine from foramen magnum to trochanter minor to understand and manage spinal pathologies. He noted that all spinal sagittal issues are related to evolutionary development towards bipedality, knowledge that has been available since the 1970s.

Finally, chapter five stressed the importance of historical background and evolution in understanding surgical techniques. According to Professor Öner, “to understand a surgical technique, we need to know its historical context and evolution.”

Overall, the keynote lecture was a testament to Professor Öner’s expertise and his commitment to advancing the field of spine surgery. His insights provided a holistic view of spine surgery that was both informative and thought-provoking.

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