Surgery Reference

The AOSpine Surgery Reference

Written by leading spine surgeons from all over the world, the Surgery Reference is an online manual outlining spinal surgeries from assessment to aftercare.

It fulfills the functions of :

• a website with hundreds of surgical procedures using detailed text and illustrations

• an app for iPhones, iPads, tablets, and Android technology

• a portal for AO course videos and previously published material

Read an interview with Prof Kenneth Cheung, Executive Editor, about the challenges he and his team faced while creating the AOSpine Surgery Reference module.

Do you deal with patients suffering from a Lenke Deformities Type 1–6? Would you like to know more about the Lenke classification of deformities, the patient examination, and the selection of the fusion levels? If so, then the new AOSpine online referencing module is for you.

Larry Lenke and Kenneth Cheung would like to introduce you to the most comprehensive and practical online reference for colleagues exposed to deformity cases consisting of:

• Curve type (1–6)

• Lumbar spine modifier (A, B, C)

• Sagittal thoracic modifier (–, N, +)

Dr Larry Lenke, co-executive editor of the deformity module launched on AO Surgery Reference, published the Lenke Classification System for Scoliosis (AIS) in 2001. Based on this classification system, the AO Surgery Reference offers users a simple pathway through every surgical step from diagnosis to aftercare. The ease of access and the quality of information available make this tool unique and invaluable. It offers you everything you've ever needed, including:

• Diagnosis

• Decision

• Surgical approach

• Treatment

• Aftercare

Additional materials include: the insights on the Lenke classification; helpful information on patient examination; and helpful considerations when selecting the fusion levels. All this information is now available at your fingertips with clear illustrations. The AO Surgery Reference is consulted every day by over 4'300 of your colleagues, mainly in preoperative planning. Get an insight and download the app like more than 120'000 others worldwide or use it online at www.aosurgery.org.

Keep a lookout for the next module on spinal trauma which will be launched in December 2014.

AO Surgery Reference—stay tuned, stay focused!

Dr Larry Lenke, co-editor of the deformity module for the AOSpine Surgery Reference, published the Lenke Classification System for Scoliosis (AIS) in 2001. Based on this classification system, the Surgery Reference offers users a simple pathway through every surgical step from diagnosis to aftercare.

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Charting success

Since its launch in December 2013, AOSpine has tracked daily, non-bouncing visits to the AOSpine Surgery Reference website on deformities. The charts show usage levels, the countries from where the site is accessed, and the devices being used.

Popular in Latin America

The information tracked from the website goes beyond just daily visits. Users from the various AO regions are also tracked, and while it is not a surprise that European visitors lead the pack, Linda Domeisen, Project Manager AO Surgery Reference, says it was a surprise to see more traffic from Latin American users than they received from North America when comarping Surgery Reference usage on mobile devices.

No hard numerical goals have been set, but Domeisen says a user-friendliness test had been conducted in the past for other Surgery Reference modules, and another one is planned with an external company for the entire AO Surgery Reference project.

“Certainly Faculty can use it to teach their junior doctors.”

Faculty Focus spoke to Prof Kenneth Cheung, Executive Editor of the AOSpine Surgery Reference about some of the challenges his team faced during its creation. He asks for input from readers to identify areas requiring clarification and improvement, as well as in the submission of new techniques and approaches.

Professor Cheung, what is your role in the Surgery Reference and who did you work with?

Larry Lenke and I are the two main editors, responsible for editing the whole of the AOSpine Surgery Reference. The authors were Marinus de Kleuver, Keith Luk, and Han Jo Kim. Together with Larry Lenke and myself, we all wrote some part of the module.

AOTrauma has been developing their Surgery Reference modules for some years; was there a perceived need to develop an AOSpine Surgery Reference?

With the interest that the AO Surgery Reference has generated for long bones, it seemed natural that we should be doing something for spine too. The reason deformities was chosen as the first topic for spine is because there’s already an existing classification for deformity, for scoliosis—the Lenke Classification. With an existing classification, it was relatively easy to base the whole Surgery Reference module on this.

What were the challenges with such a huge project?

First of all, the timeline was very tight. We created the deformity module from start to finish in less than 1 year. The second challenge was the table of content itself. There are many different ways to skin a cat, and it’s the same for scoliosis surgery--there are many different ways to do a particular curved pattern. We had to make some decisions about how to standardize the module because there isn’t necessarily a universal agreement. If there were really five different approaches that are equally popular, we tried to put all of them in. If there seemed to be 1 that’s more popular and more appropriate, then we chose that 1 and not the other 4. The Surgery Reference has our opinion in terms of how we would propose to manage patients. It’s not necessarily something everybody would agree with, but it is something we, as a group, feel is the best way to do it.

Who is the Surgery Reference meant for?

This tool is really designed to be used by less experienced surgeons who really need the help and the guidance. Certainly, faculty can use it to teach their junior doctors in terms of curve patterns and general management of scoliosis, and they may find some of the illustrations useful. If you go to the website, it seems very simple, but there’s a huge amount of work that’s gone in to it.

Where do you see room for improvement?

Because this is written in a web-based manner, it’s a little difficult to proofread, so we’d love to have feedback from users about where they think clarification is needed. We also want to introduce additional techniques. Because of the timeframe, we stayed with mainstream techniques, but I think there’s always room for new techniques.

Where do you see the Surgery Reference going in the future?

I feel that AO Foundation and AOSpine have really pioneered a new way of learning for doctors-in-training. It is no longer a textbook they hold in their hand. Textbooks are always written in a very standard format, like an introduction, a main chapter, and then you have to search through it for the information you want. But with this site, it is really magical. You start with the problem and just follow the clicks and it leads you down that problem and you go through solutions.