Juan S. Uribe. MD, FAANS
@thejuansuribe
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Professor of Neurosurgery, Vice Chair, Chief of Spine @BarrowNeuro . Go-to #neurosurgeon for athletes + stars. #TheJuanYouWant4Spine
Phoenix, AZ
Joined November 2021
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“Know the anatomy and the rest will follow”
Below is our publication in last month’s Journal of Neurosurgery Spine.
If you are really interested in accessing the thoracolumbar junction of the spine, I recommend you read this manuscript👇🏻
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I'm proud and humbled to be elected president of the American Association of Neurological Surgeons/Congress of Neurological Surgeons: Section on Disorders of the Spine.
@spinesection
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Believe that you can and you will ✅. As a
#Neurosurgeon
always wanted to be part of the most selected and respected leading organization that focuses on promoting, sponsoring and mentoring laboratory, translational, and clinical
#research
in the neurological science.
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The stand alone TLIF case below was performed and posted to social media by a proceduralist who is not trained as a spine surgeon. The company that designed and commercialized the product’s used in the case’s response to the posting is also below👇🏻🚨
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I feel honored to have been elected as the Chair of the
@spinesection
Section on Disorders of the Spine and Peripheral Nerves and to be working alongside such a skilled and supportive team of professionals. I am confident that, together, we will achieve great things!
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Congratulations to our international Research fellow Dr. Giraldo and to our entire Clinical Sonntag Spine Center research team at the Barrow Neurological Institute! Such a prestigious accomplishment to be awarded the NASS Resident and Fellow Research Award 2023.
@NASSspine
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It is obvious but worth repeating that spine surgery must be performed by spine surgeons 🚨
Recently, nine surgical societies delivered a joint position statement about spinal fusions being performed by non-spine surgeons.
@AANSNeuro
@SRS_org
@spinesection
@CNS_Update
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5 things I hate about TLIF's:
1.Hard to technically standardize the procedure (too many different techniques/steps)
2.Size of the implant (too small)
ability to provide lordosis
4.Impossible to perform without instrumentation (standalone TLIF!! 🤡)
And….
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The power of
#indirect
decompression relies not only on regaining complete disc height but also anatomical reduction of the listheses. (Thread)👇🏻
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5 Things I Hate About LLIF:
1.Imminent risk of retroperitoneal structures injury
2.Potential for lumbar plexus injuries (Even in OLIFs/Pre-Psoas)
3.Relying on indirect decompression. Unless you make a second posterior approach for direct decompression👇🏻👇🏻
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When less is more…
#Neurosurgery
. Over the last few years incremental changes in surgical techniques and better understanding of the biomechanics have allowed us to deliver better clinical and surgical outcomes (a thread..) 👇🏻👇🏻👇🏻
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"Never, Never, Never give up"
This case is an example of the importance of patience and perseverance when executing our surgical plans. It was imperative to exercise both when removing this giant calcified thoracic disc last week.
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SUCCESS ISN'T JUST WHAT YOU ACCOMPLISH IN YOUR LIFE
IT'S ABOUT WHAT YOU INSPIRE OTHERS TO DO. This is from yesterday at the Uribe's fellows reunion. I'm so proud and humbled to have had the opportunity to train this talented spine surgeons.
Love you guys/gals !!!
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Three generations in one photo:
"A mentor is someone who sees more talent and potential than you see in yourself, and helps bring it out of you."
#SpineSurgery
#Neurosugery
#Mentorship
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I am proud of the BNI Clinical Research Machine. The team presented 19 abstracts and 4 of them were awarded. There is no better way to validate our surgical techniques and procedures than being critical of them! The
@spinesection
is the perfect platform. Feb 2025 in Tampa.
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Mini-open lateral retropleural approach in three symptomatic patients with type 1, 2 and 4 thoracic disc herniations (Farber et al. On press). These patients were treated last week and they all went home in time for Thanksgiving to be with their loved ones.
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Adaptability drives progress as we adopt new techniques.
The two-blade retractor for lateral retroperitoneal approach allows the surgeon to work in a versatile cone instead of a fixed cylinder, obviating the need for angled instruments. 👇🏻
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Simplicity is the ultimate form of sophistication
#Neurosurgery
Delivering excellent outcomes in complex spine surgical procedures comes from mastering basic surgical anatomical principles, common sense, operative efficiency, and having the right tools to accomplish your goals👇🏻
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“Cheers to the people working on their dreams, not working for their weekend”
What a successful weekend of teaching and learning during the OFFICIAL 2022 AANS/NREF Spine Fundamentals Cadaver Course for Residents and Fellows.
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Optimizing surgical management of back pain has been a long and arduous road. While we continue to make strides, we must decipher what are tried and true solutions for helping our patients versus marketing.
#spine
#Neurosurgery
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Witnessing the groundbreaking accomplishments and remarkable results of our latest research at
#VR
laboratory
#SonntagSpineCenter
was truly inspiring. It fills me with immense pride to see Laura Snyder MD and JP Giraldo MD presenting our work at
@AANSNeuro
.
#future
#spine
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I am proud to announce that our paper has won the World Neurosurgery editor’s choice award for September 2022. I am grateful of our BNI team and the opportunity provided by ISSG to put together such an impactful manuscript on a very interesting topic.
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Mark Your Calendars Now🗓✅
You don’t want to miss the most comprehensive spine meeting of the year. There is no better opportunity to interact with your colleagues, challenge yourself to become a better surgeon, and enjoy all of the fun the Magic city has to offer
#SpineSummit
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Congratulations to our outstanding Barrow Neurological Institute and Sonntag Spine Center clinical research team for earning 15 abstract acceptances at the upcoming
@spinesection
on Disorders of the Spine and Peripheral Nerves annual meeting in Miami and 4 Kuntz awards!
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“Trust but verify”
We are in an era where our outcomes are coming under increased scrutiny. We must take it upon ourselves to use all of the resources at our disposal to achieve and verify our surgical goals. In the case below, you see pre- and (a thread..) 👇🏻
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Tomorrow I will debate Dr. Chris Ames at the 2023 AANS/CNS Spine Section during the “Millennial Mayhem” session. I am expecting a fun and playful debate on a hot topic in spine surgery:
#MachineLearning
and
#AI
!
Come see this debate live while enjoying a drink.
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Reciprocal Changes
The two cases below demonstrate the concept of local compensatory “Reciprocal Changes” in the spine.
Both patients are in sagittal balance before and after L4/5 interbody fusions. However, there is a big difference between the two. Can you see it? a thread👇🏻
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What an amazing return. Full house !!
Lateral Approaches to Spine Symposium @ Congress of Neurological Surgeons (CNS)
Great discussions, a lot of learning points from highly experencied faculty.
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“The difference between something good and something great is attention to detail.”
How do you know where your entry point is into the psoas when performing the lateral transpsoas approach?
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Worthwhile to repost- I’m proud and honored to work with such a talented group of residents and fellows. Their dedication and effort is what makes the Sonntag Spine Center and the Barrow Neurological Institute a global powerhouse for spinal care and neurosurgical training
#Miami
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Tomorrow, March 22nd, at the Sonntag Spine Symposium (AKA The Academic Spine Awards), we will host 50+ leaders in the spine field and the C suite executives of more than 80% of worlds spine market in one room. We will be discussing and exploring the most up to date topics
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I can't even begin to describe the amazing time I had in Tampa! Going back to my alma mater as a visiting professor was such a thrilling experience. I got to reconnect with my mentors, old friends, and meet so many talented residents and fellows. It was truly a trip to remember!
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Tip of the iceberg….. Preservation of the end plates is a central tenet of lateral lumbar interbody fusion to achieve indirect decompression. Preoperative optimization of bone and a surgical technique are indispensable to prevent subsidence.
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I hope this is an isolated event. We as spine surgeons need and our industry partners need to collectively stand against such breaches in practice scope by unqualified individuals.🚨
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The Sonntag Spine Symposium also known as “The Academy Awards of Spine” is just 4 weeks away. Don't miss it! 👏🏻
-In one day all of most influential people in all
#spinesurgery
be together to share the latest innovations/trends and research in the field
#Neurosurgery
@BarrowNeuro
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PJK/PJF Proximal Junctional Kyphosis (PJK) and Failure (PJF) is one of our biggest challenges in adult spinal deformity surgery. At the Sonntag Spine Center Biomechanics Laboratory, we are using our robotic-assisted mounting apparatus to test strain and stress using (DIC).
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With the right tools and techniques, the Lateral Transpsoas procedure at the TRANSITIONAL level (L4/5) can be successfully performed, provided that the vascular structures are not obstructing the way. Directional EMG and SEEP's can serve as an excellent platform.
#Neurosurgery
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It was an honor to interview Martin Eberhard, founder of Tesla today at the
@CNS_Update
Being able to learn from someone with such a disruptive mind was a total positive experience. Nothing good comes easy. Hard work, persistency and curiosity go a long way!!!
@spinesection
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Last week at the 2023 Annual
#AANS
/CNS
#SpineSummit
, I had the great privilege of debating Christopher Ames MD. While the crowd voted me as the winner, I am a very firm believer in AI and machine learning. Chris did a great job of presenting the cutting edge research 👇🏻
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Social Media Clinical Showcase, a thread 👇🏻
These are good technical demonstrations of the lateral approach, posted to various social media platforms. While these techniques are a great part of our armamentarium and require a very high level of skill to perform..👇🏻
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PROGRESS IS BORN OF DOUBT AND INQUIRY.
We have been retracting the lumbar plexus for 20 years. Despite all of our technical and scientific progress, lumbar plexus injuries are still our number one complication regardless of which lateral trajectory you choose to approach 👇🏻
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Tell me and I will forget, teach me and I may remember, involve me and I will learn”What a great experience in our 13th Annual Residents and Fellows Spine Course at the Seattle Science Foundation. In the picture our two BNI fellows Dr. Harrison Farber and Dr. Nima Alan teaching
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Multi-level cervical arthroplasty
Last week we asked if multi-level lumbar total disc replacement is an oasis or a mirage. This week I ask the same question in a different context: multi-level cervical arthroplasty in patient with cervical spondylotic myelopathy 👇🏻
#Neurosurgery
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The 2nd Annual Sonntag Spine Symposium aka the "Academy of Spine Awards" was an overwhelming
#success
. Thank you to all invited faculty, industry partners, and attendees that helped make this event so special!
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A long and intensive training is necessary to become a spine surgeon. It requires a gradual accumulation of knowledge and technical skills to diagnose, treat, and manage patients with spine pathologies.🚨
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It was a great pleasure to meet with my long time friends at the
#ISSG
. We held our first course for residents and fellows, sponsored by Medtronic. I am proud that the legacy is not only to perform high quality research in adult spinal deformity, but to train the next generations
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THE HARD PART IS IMPLEMENTING THE DECISION, NOT MAKING IT"
When losing weight is not an option in morbid obese patients and the symptoms are refractory to conservative measures, the surgical approaches are challenging.
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When dealing with deformities, designing shorter constructs is often difficult. While it's tempting to opt for larger constructs like a T10-Pelvis, are they always necessary? Is it possible to achieve equally good or better outcomes with smaller constructs? 👇🏻
#SMISS
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As an immigrant I came to this beautiful country full of dreams and expectations. While those have changed and adapted over time, today I am fulfilling one of them that has been a constant.
#Neurosurgery
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In just one week, the Sonntag Spine Center at BNI will be recognizing today's leaders in the field of spine surgery. The "Oscars of Spine" will feature panel-style debates led by these leaders, focusing on thought-provoking, hot topics encountered by spine surgeons worldwide 👇🏻
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It was was an honor for us to host Dr. Robert Eastlack, as a visiting professor for Grand Rounds at the
@BarrowNeuro
last Friday. He offered invaluable insight on principles, indications and applications on spinal deformity.
#neurosurgery
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Simple execution of implant placement is NOT the answer for the complex challenges that our patients face.
Even the company that designed the products used on that procedure, respect and support the appropriate training and education required to perform these procedures. 🚨
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This week was truly fantastic as I had the opportunity to visit Saint Louis and serve as a visiting professor at the Washington University Neurosurgery. During my time there, I had the privilege of sharing insights on the fascinating topic of Social Media and its influence.
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Thanks to my family, friends, mentors, and industry partners for being instrumental in achieving my dreams. The best is yet to come, we are only getting started, and as always:
"Never, Never, Never Give up."
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"Develop a passion for learning. If you do, you will never cease to grow."
I always enjoy teaching our next generation of Spine Surgeons. This weekend in the 14th Annual Residents and fellows Spine course at the Seattle Science Foundation. Superb Faculty and amazing participants.
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Improvement of patient safety and surgical reproducibility without compromising outcomes. Our
#VR
/AR lab team at the
#BNISonntag
Spine center collaborating with our 3D printing innovation center, in an effort to develop our next generation MIXED REALITY modulus
@BarrowNeuro
👇🏻
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The ACR (Anterior Column Release) procedure has the power to be as efficient and less morbid for our patients as traditional posterior column osteotomies at restoring patient lordosis. (thread) 👇🏻
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Congratulations to the 2022
#SMISStravelingFellows
it is a privilege to host you at
@BarrowNeuro
#MISspineSurgery
#Neurosurgery
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It was an outstanding celebration marked by engaging discussions on the latest trends in Spine.
The high-level interaction among field Leaders was truly remarkable. The involvement of industry C-suite executives offered a unique perspective on the current state of spine care
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Last weekend I took a break from the routine. I had a great time with my family and witnessed the release of the new~exotic
#Hypercars
in
#TheQuall
Motorsports Gathering during the
#montereycarweek
. Innovation can be achieved through
#hobbies
and family.
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Always great to be back to my home country. This time at Cartagena (La Heroica). Participating at the XVII Colombian Orthopedic Spine Society(SCCOT). Great opportunity to continue promoting the indications of Spine MIS for Deformity and MIS single Position Surgery.
#Networking
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The Thoracic Lateral Retropleural approach for the giant calcified disc seen here was successful using dedicated long micro-surgical instruments
Perfection is not attainable, but if we chase perfection we can catch excellence.
#MedTwitter
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“Ambition is the path to success. Persistence is the vehicle you arrive in.” Today is the last day of the biggest
@AANSNeuro
. Effective networking and sharing of ideas isn't a result of luck, it requires hard work and persistence.
#Neurosurgery
.
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Five things I hate about Navigation in spine 👇🏻
1.Real-time imaging gaps.
2."Blind spots" of the camera while tracking instruments.
3.Cost 🤑💰💸💲🤑
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Give an opportunity to a
#Colombian
and you will never regret it! Thanks to all my spine industry friends, peers and mentors, especially Drs. Levi, Green, Vanloveren, Vale, Shaffrey and Haid.
#Neurosurgery
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11 days… You don’t want to miss “the Oscars of
#Spine
”. Don’t miss the opportunity to witness the most influential KOL on Spine in one single event. It’s free, and the seats are limited. Come and experience lively debates and panels related to controversial topics
#Neurosurgery
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Opening the 2023 academic season in the Rocky mountains in Vail, CO at the Base to Summit meeting this weekend.
Great time and lively debates with all faculty and participants. Our pioneering concept of reciprocal changes in lumbar spine after fusions was well received
@SRS_org
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It's the 13th annual SSF spine residents & fellows course. Make sure to attend the live webinars on the Seattle science foundation and YouTube!
#SpineSurgery
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It was a very humbling experience to be part of the most sophisticated spine deformity meeting (THE MASTERS IN SPINE SURGERY SEMINARS: ADVANCED SPINAL DEFORMITY) this weekend in Vail CO.
The quality of discussions, open format and lively interaction with the participants 👇🏻
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Be sure to sign up for the 2024 Sonntag Spine Symposium, the "Oscars of Spine," hosted by the Sonntag Spine Center at Barrow Neurological Institute on March 22nd, 2024!
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Honored once again to have BNI participate at the SSF Journal Club.
Our amazing fellows Drs. Zhao, Alan, Farber and faculty Dr. Turner shared our experience in “Complication Avoidance in MIS Surgery”, followed by lively discussion with our colleagues in Texas Back Institute.
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"Repetition is the mother of learning, the father of action, which makes it the architect of accomplishment"
This weekend I have the honor to participate as invited professor at the ISASS Asia/Pacific annual meeting in Seoul, Korea. Never stop, always learning & sharing Knowledge
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In less than 2 months, distinguished Spine leaders will convene to engage in profound discussions and shed light on the most thought-provoking and impactful topics. This unparalleled gathering presents a unique and invaluable opportunity for professionals like you 👇🏻
#MedTwitter
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Thanks to all of my
#mentors
and colleagues that make it this happened.
Chris Shaffrey
Michael Lawton
Alan Levi
Jaques Morcos
Praveen Mumanneni
James Marquet
Justin Smith
Ziya Gokaslan
Zoher Ghogawala
Daniel Resnick
Mark Hadley
Nino Chiocca
Nader Sanai
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5.Not practical in cases where more than 3 levels of interbody fusion is an option (scoliosis)
#Neurosurgery
#Spine
#LLIF
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In a few weeks, we will recognize the most prominent, published, and talented
#spine
surgeons here in Phoenix at the Sonntag Spine Center
@BarrowNeuro
. Come and join us. Our first highlighted star is Dr. Lawrence Lenke.
#Neurosurgery
#SpineSurgery
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calcified disc adherent to the dura to prevent CSF leak while releasing all its surrounding attachments to the PLL and annulus for a safe removal without having a Dura rent and a CSF Leak.
#Neurosurgery
#SpineSurgery
#OrthoSpine
#ThoracicDiscHerniation
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-You will be interacting with the surgeons that
#pioneered
and disrupted spine surgery.
Today we feature
#DrLenke
. He will be presenting: “Adult Spinal Deformity: How did we get here, and where are we going next?”
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There were multiple times I was ready to give up in order to avoid complications (mainly a CSF leak), but safely and persistently staying within the safety zone eventually allowed us to achieve all of our goals. Thank you to all of our referral partners, trusting in our expertise
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One of my most cherished career highlights was being trained by Dr. Allan Levi, who is a former fellow of my current mentor, Dr. Volker Sonntag. It is my duty as a leader to continue the legacy of mentorship that was passed down from these titans of spine surgery.
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3) Compensating for loss of lordosis at the index level requires constant activation of the paraspinal muscles and structural ligaments to maintain spinal balance.👇🏻
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It’s time we make a systematic effort to understand this phenomenon from the ground up. Here you see our animal model at the BNI to study the lumbar plexus. Through these efforts, we hope to further our knowledge on the mechanisms that cause these injuries.
#Neurosurgery
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In my opinion, indirect decompression via MIS lateral inter-body fusion and instrumentation is the optimal surgical choice in this patient population.
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In just 24 days (Feb 17th), the 2nd Annual Sonntag Spine Symposium will be live. We are proud to announce that Dr. Luiz Pimenta, a pioneer in spine surgery; who developed the revolutionary technique (LLIF). Will be presenting. 👉🏻Registration link:
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Experienced surgeons must accept the responsibility of mentoring the next generation as the future of our profession will rest on their shoulders.
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access to L5/S1 😫
5.Need for meticulous discectomy and endplate preparation to prevent the number one enemy: Subsidance.
#Neurosurgery
#SpineSurgery
#LLIF
#orthopedics
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From my experience, intraoperative CT in the PRONE position provides real-time information necessary to plan the optimal entry point into the psoas.
Don’t forget the psoas muscle is invisible to X-RAYS and if you Navigate a preoperative CT that you might have innacurate position!
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The Sonntag Spine Symposium at the Barrow Neurological Institue (BNI), AKA “The Spine Oscars” is finally here. Registration is FREE.
This is your opportunity to interact with the most influential spine surgeons in the world.
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This week (Feb 17, 2023) who-is-who of
#spinesurgery
will be in one place at the Sonntag Spine Symposium (AKA Spine Oscars). Star-studded panels will discuss hot topics in lively
#debates
with the audience from all over the world. Come and participate in this incredible event!
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with persistent symptoms. Should motion-preservation, or neural element decompression, be the primary goal of surgery?
#medtwitter
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4) Conversely, proper restoration of lordosis at the surgical level allows the adjacent segments to relax, thus reducing strain in the spine and soft tissue structures.
What do you think about this concept?👇🏻
#Neurosurgery
#Spinesurgery
#BNI
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1) In this case, (C2 panus causing cervical myelopathy), we performed C1 laminectomy and C1-2 posterior instrumented fusion. The intrafacet device at C1-2 allows fusion despite laminectomy.
#OrthoSpine
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We are
#grateful
of them, their family and the referring physicians for entrusting their care in our hands! Happy holidays!
Stay tuned for operative videos.
#Neurosurgery
#Spinesurgery
#orthopedics
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2) Further, with atlantoaxial stabilization and arthrodesis, abnormal motion that was the harbinger of pannus formation in the first place is removed without the need for trans oral/nasal odontoidectomy.
#Spinesurgery
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