Avicenna Society

02/03/2026

Congratulations to Jaime Gasco on his 300th OLLIF.

You have truly mastered this technique. With proper soft transition, 300 cases in your hands translate to five times that volume anywhere else. This 300th case exemplifies exactly what you have achieved, a two level fusion in under one hour with 40 cc of blood loss. That is real expertise, earned the hard way.

Well done, Jaime. I am proud to have you on the board of the Avicenna Society.

01/24/2026

Streets of Minneapolis today

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01/23/2026

Sharing an excellent surgical video by our colleague Dr. Gujar demonstrating percutaneous pedicle screw placement using a single C-arm.

Key points:
• Two C-arms clearly improve efficiency and workflow
• In many regions, a second C-arm is not available
• This video shows the down-the-barrel technique with one C-arm, practical, reproducible, and safe when done correctly
• Highly relevant for surgeons working in resource-limited environments
• A solid reminder that technique and spatial understanding matter more than equipment volume

Strongly recommended watch for anyone performing or learning MIS percutaneous fixation.

01/09/2026

Sacroiliac joint must be part of your differential diagnosis, period.
Up to 25 percent of first time low back pain originates from the SI joint, yet it is still routinely overlooked.
Imaging alone is not enough, history, provocation tests, and diagnostic injections matter.
Miss it, and you risk unnecessary spine surgery with persistent postoperative pain.

This was the core message of my talk at ASS India.
If you want to continue this discussion in person, visit us at the Global Spine Meeting this May in Istanbul.

Full talk here: https://youtu.be/Lv9h53r074k

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01/06/2026

A quick follow up and an important clinical lesson.

This patient had imaging that would tempt most spine surgeons to jump straight to L5-S1 fusion. We did not.

Careful history, asking the patient to stand and point to the pain, and systematic sacroiliac joint provocation tests localized symptoms to the SI joint. Multiple protocol-driven SI joint injections produced near-complete pain relief each time, confirming the diagnosis.

Treatment was bilateral sacroiliac joint fusion, not L5-S1 fusion. One year later, the patient is completely pain-free.

Key points:
• Imaging alone is not diagnosis
• SI joint must be part of the differential, even with obvious lumbar pathology
• About 25 percent of first-time low back pain originates from the sacroiliac joint
• About 75 percent is spinal, do not ignore the spine, but do not ignore the SI joint either
• Skipping proper differential diagnosis risks taking the wrong surgical path

Due diligence protects patients. Shortcuts cost them.

01/05/2026

Make a post
What is your favorite mode of treatment for this 80-year-old male for L5-S1? Would you as well treat L4-5?

01/01/2026

01/01/2026

ASML is the only company on earth that can build extreme ultraviolet lithography machines.

13.5 nanometers atomic precision. Near x ray optics. Every advanced chip in the 2020s and beyond depends on this.
This exists because a few physicists refused to accept that it was impossible.
They were laughed off stages. Funding was denied. The US walked away.

ASML did not.
Medicine is no different.

When gatekeepers reject ideas like turning a 4 to 5 hour spine surgery into 35 minutes, with better outcomes, 1/20 infection risk, and four times faster recovery, they are protecting inertia, and exporting our innovation.
Innovation never dies. It just moves elsewhere, thrives, and then gets reimported, like electric vehicles and endoscopy.
Max Planck said it best: Progress is driven by a few INSPIRED individuals, often working quietly in overlooked corners.

Hence, INSPIRED SPINE.
STAY INSPIRED MY FRIENDS

12/11/2025

It is a privilege and an honor to be in Dubai and present the OLLIF talk in a plenary session to colleagues from around the world, December 3, 2025.

Full talk: https://youtu.be/2NMHiAy_d3w

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12/11/2025

There is always a learning curve. TransKambin OLLIF is no different. Early on, our full setup took 30 to 40 minutes before we could even start the case. By protocolizing every step and eliminating inefficient actions, our setup time is now consistently under 3 to 5 minutes.

This video pair demonstrates the common C arm setup and the full draping process for the field.
Draping sequence: https://youtu.be/ViS7c3X9VQQ

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