The site of the 2009 WENMISS meeting is the Sutera Harbor Resort, Kota Kinabalu, Malaysia.
Courtesy of Sutera Harbor Resort

AAOS Now

Published 6/1/2008
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Dennis McGowan, MD, MSc; Katherine Sale, MPH

A report from WENMISS

International program focuses on spine technologies

The World Society for Endoscopic Navigated and Minimal Invasive Spine Surgery (WENMISS) is a forum where surgeons, scientists, engineers, and others can discuss these rapidly evolving technologies and their impact on patients. This year’s WENMISS Congress, held in London Jan. 12-14, 2008, attracted approximately 150 participants from countries as diverse as Austria, India, Pakistan, Russia, Malaysia, the United Kingdom, and the United States.

Under the theme “Improving the accuracy and safety of surgery,” the conference included a premeeting course for residents and registrar-level surgeons. AAOS member Dennis McGowan, MD, comoderated a workshop on navigation and presented a lecture on navigated pedicle screw insertion. The invited guest lectures included presentations from Dr. McGowan, Sanford Emery, MD, and many international participants. Of particular interest to many clinicians was the research series presented by Vijay Goel, PhD, who spoke on navigated disk replacement from a biomechanical perspective.

Papers address multiple issues
Topics discussed included new biomaterials, tissue engineering of the intervertebral disk, motion-preserving technology, navigation, and robotic-assisted surgery. In total, 80 papers were presented, addressing the following issues, as well as many others:

  • Fixation when bone density is below normal: The data presented showed that cement augmentation using either a fenestrated screw technique or a vertebroplasty technique improved screw fixation strength equally. In addition, both techniques were superior to cement augmentation using a balloon-void creating technique.
  • Robot-assisted surgery: Clinical experience demonstrated real potential for using a robot in the operating room to assist with vertebroplasty.
  • Revision surgery: Data demonstrated that navigated pedicle screw placement did not reduce the rate of revision surgery.
  • Complications: A comprehensive paper was presented on complications of vertebroplasty and kyphoplasty seen in practice.

Other papers expanded on the indications for using vertebral augmentation with osteoconductive cements and temporary spanning fixation in patients with traumatic fractures and in skeletally immature patients.

A unique opportunity
Given the international scope of the Congress, many of the papers reported on devices that have not been approved for use in the United States by the U.S. Food and Drug Administration. WENMISS affords U.S. orthopaedic spine surgeons and neurosurgeons the unique opportunity to discuss these innovative techniques with their inventors and evaluate the results and complications before the devices are introduced in the United States.

WENMISS is committed to being a truly international organization and plans to make special efforts to include the surgeons from Russia and the former Soviet federation republics. Collaborations with Russian-speaking surgeons are underway to improve access to the Web sites (www.wenmiss.com and www.wenmiss.org) and to encourage participation in future meetings by increasing the content available in those languages.

Dennis McGowan, MD, MSc, is a member of the AAOS Biomedical Engineering Committee and first vice-president of WENMISS. He can be contacted at dmcgowan49@hotmail.com

Katherine Sale is manager of biomedical research and regulation in the AAOS research department. She can be reached at sale@aaos.org

What is WENMISS?
During the 14th Triennial Congress of the Asia Pacific Orthopaedic Association (APOA) (September 2004), a group of eminent spine surgeons and scientists agreed that rapid advances in minimally invasive and computer-aided spine surgery required a forum for discussion on new technology and its effects on patient care. Thus was born the World Society for Endoscopic Navigated and Minimal Invasive Spine Surgery (WENMISS).

The society brings together leaders from multiple fields—including spine surgery, computer science, biomedical engineering, physics, medical imaging, endoscopy, cybernetics, information technology, and related industries—at an annual meeting. The goal of the meeting is to promote research and accelerate awareness and acquisition of expertise in this field.

Peer-reviewed papers are presented and workshops to help train surgeons are held. The meeting format enables vendors and computer scientists to describe their technologies to surgeons and allows surgeons to describe their needs and problems. Research into developing and standardizing the best terminology for these expanding technologies are also addressed.

WENMISS seeks to partner with spine and neurosurgeons to provide global access to programs that will increase the safe use of new technology and provide the best and most efficient care to patients. As an international organization, WENMISS has the added advantage of bringing clinicians and researchers together in locations around the globe. The next WENMISS Congress—May 21-23, 2009—will convene in Malaysia at the Sutera Harbor Resort at Kota Kinabalu, and the society hopes to welcome many new members then.