Avicenna Society

07/27/2026

India 2026 🇮🇳

What an incredible journey.

Over the past two weeks, our team from Inspired Spine, Avicenna Hospital Spring, and Avicenna Technical University had the privilege of teaching across India through cadaver labs, live surgeries, keynote lectures, and medical school presentations.

From Bareilly to Karad to Chennai, we trained surgeons and inspired future physicians from across India, Bangladesh, Malaysia, Central Asia, and beyond. We shared our latest advances in OLLIF, minimally invasive sacroiliac joint fusion, MIS-DTIF, and MIS-OTIF, while building new friendships and academic partnerships.

One of the most rewarding moments was speaking to medical students about what it means to be a surgeon in the 21st century. They are the future of medicine, and investing in them is one of the greatest investments we can make.

We return home proud, grateful, and even more committed to our mission: to freely share knowledge, train the next generation of surgeons, and improve spine care for patients around the world.

My heartfelt thanks to all of our hosts, colleagues, organizers, and friends who made this unforgettable journey possible.

Together, we are building a global community of surgeons dedicated to better patient care.

07/25/2026

This is an interesting case courtesy of Dr Navneeth Kumar.
The patient has significant neural compression with a neurological deficit, including a foot drop that has been present for two weeks.

First, what operation would you choose? In my practice, I would perform the procedure I am most experienced with. A transforaminal approach is certainly a reasonable option, but I believe the best operation is the one that achieves an adequate decompression while maximizing safety in the surgeon’s hands. In my hand OLLIF

The second question is even more important. How urgently should this patient undergo surgery? With a motor deficit that has already been present for two weeks, how much does timing still influence neurological recovery? Is this a true emergency, or does the opportunity for meaningful recovery remain beyond the initial

At two weeks after the onset of foot drop, how quickly would you proceed with surgery?

07/11/2026

Dear Avicenna Society members,

In about 3 hours, at 10:00 AM Central Time (U.S.), we will hold our monthly case conference.

Our conference is normally scheduled for the first Saturday of each month, but because of the Independence Day holiday, we postponed it to this week.

If you have an interesting case you would like to present and discuss with colleagues, please contact me. We already have several excellent cases prepared, but we are always happy to include additional cases and hear the community’s opinions.

Please remember to ensure that all imaging and clinical materials are fully anonymized before submission.

We look forward to seeing you there.

Zoom is the leader in modern enterprise cloud communications.

07/10/2026

Interesting case that we probably all see but rarely discuss.

The discs are relatively well preserved, yet the patient has severe axial low back pain, 8 to 10 out of 10. MRI shows a severely arthritic, “hugging” facet with what appears to be an osteoporotic facet fracture, exactly corresponding to the patient’s pain.

Many of these patients have already undergone medial branch blocks, but the benefit is often temporary. What do you consider the most definitive treatment in cases like this? How often do you see facet fractures as the primary pain generator?

07/08/2026

Here’s the corrected version:

Great job, Dr. Gasco, on this insightful presentation on OLLIF for high-grade spondylolisthesis, now available on VuMedi. Thank you for sharing your expertise and advancing the field of minimally invasive spine surgery. Keep up the outstanding work!

A video from Jamie Gasco (as part of Dr Hamid Abbasi), posted on Apr 7, 2026.

07/08/2026

Mathematic is beautiful once you visualize it

Watch, follow, and discover more trending content.

07/07/2026

Paraphrasing my hero, Richard Feynman: journals that claim to publish only the very best often end up publishing the worst, because they favor consensus over originality. In the end, they become little more than a stream of mediocrity.

Three months of waiting for a desk rejection from World Neurosurgery journal. Apparently, the quality of a manuscript can now be judged by counting how many authors have “MD” after their name rather than evaluating the science. The editor in chief remarks dismissed the contributions of orthopedi...

07/06/2026

Interesting that I’m seeing the opposite scenario immediately after my last case.

This patient has a first episode of right L5 radiculopathy with a 10 week history. Pain improved from 8/10 to 3/10 after a single lumbar epidural steroid injection. The patient has not yet completed physical therapy.

Another surgeon from a highly reputable institution strongly recommended lumbar fusion. While the patient has bilateral pars defects, I do not see significant spondylolisthesis or advanced degenerative disc disease.

In my practice, I would have a difficult time recommending fusion at this stage, given the short symptom duration and meaningful improvement with conservative treatment.

I’m interested in the community’s approach.

Is a bilateral pars defect, by itself, an indication for fusion in your practice? If yes, what additional factors drive that decision? Or would you continue conservative management and reserve surgery for persistent symptoms or instability?

07/06/2026

Clinical decision-making can sometimes be contentious.

This patient has had 3 years of persistent pain, rated 6 to 8 out of 10, has failed extensive conservative treatment, is significantly functionally limited, and has a consistent right L4 radiculopathy. Despite this, another local surgeon advised that there is nothing wrong and that surgery is not indicated.

In my practice, I would generally offer surgery in this situation.

I’d like to hear the community’s opinion. If you had this patient, would you still recommend against surgery? If so, what would be your reasoning?

Please vote:
🔹 Yes, I would offer surgery.
🔹 No, I would continue nonoperative management.

I would also appreciate your comments on the factors that most influence your decision.

07/04/2026

I’ve incorporated your additional point into the response:

Thank you, Dr. Gujar, for sharing this very interesting, and not uncommon, clinical scenario.

These are some of the most challenging cases, where the patient has minimal or no clinical symptoms, yet the imaging demonstrates severe pathology. I continue to struggle with balancing two important principles. On one hand, I strongly believe we should treat the patient, not the MRI. On the other hand, severe cervical stenosis may represent impending disaster, with the potential for central cord syndrome or spinal cord contusion after even minor trauma.

Before making a definitive treatment recommendation, I would also perform a thorough diagnostic workup, including a contrast enhanced MRI and, if indicated, advanced imaging such as MR spectroscopy, along with any additional studies necessary to exclude other underlying pathologies, including neoplasm, inflammatory, or autoimmune disorders.

I would be very interested to hear how others approach these patients. At what point do you recommend prophylactic ACDF despite minimal symptoms? In selected cases like this, I may recommend surgery to reduce the risk of a catastrophic neurological injury.