Spine Surgery is one of the rapidly developing Surgical Sub – Specialties of Orthopedic Surgery. With increase in the knowledge and diagnostic capabilities, the incidence of spinal disorders has increased tremendously in the recent past. The rise in the life expectancy of people has resulted in an increased diagnosis of elderly patients with degenerative disorders. Similarly the rise in road traffic accidents has contributed to an increase in spinal and spinal cord injuries. Many of these diseases and injuries, if diagnosed and treated appropriately in the early staged itself, can result in improved outcomes, thus preventing neurological insufficiency for the patients. However to treat spinal disorders efficiently with the best outcomes, it requires adequate training of surgeons in the field of spine surgery.
The aim of the training is to have safe and sensible spinal surgeons at the end who can use his knowledge, training, education, and surgical techniques acquired over for the best patient outcomes.
AIM OF THE PROGRAMME
The aim of this training program is to develop competence based spine fellowship curricula as a set of learning goals through expert consensus methodology in order to provide an educational tool for surgical educators and trainees. Secondarily, we aimed to determine potential differences among specialties in their rating of learning objectives to defined curriculum documents. Some keypoints are-
1. Develop a complete spine surgeon capable of critical thinking and recognizing and managing a broad variety of spinal conditions:
• Degenerative conditions
• Tumors and infections
• Adult and pediatric conditions
2. Obtain a detailed working understanding of cervical, thoracic, and lumbar anatomy as it pertains to normal anatomy, pathology, and the surgical and non-operative treatment of spinal disorders.
3. Become familiar and comfortable with the usage of operative techniques of the spine, usage of implants and tools specific to spine surgery, and in the placement of spinal instrumentation in the spine.
4. Be exposed to and become skilled in a broad range of surgical skills to treat the spectrum of spinal pathology.
5. Learn to completely assess the patient with spinal disorders, including spine specific history taking, physical exam, evaluation of radiographic findings, and an understanding of the results of treatment and diagnostic modalities.
OBJECTIVES OF THE PROGRAMME
• To acquire the skills necessary to assess and manage patients who present with spine-related complaints.
• To be able to easily classify patients into general categories after the initial history and physical examination. Such categories include normals, patients with underlying pathological processes, and symptom amplifiers.
• To understand and be able to implement the additional studies necessary to render an accurate diagnosis based on that combination of parameters which would include history, physical examination, plain radiographs, and other laboratory tests and imaging studies.
• To develop the patient management skills necessary to easily manage a wide range of pathological patient interactions. Skills necessary to be learned include those needed to defuse the situation encountered with a hostile patient, a manipulative patient, and a patient who is markedly depressed.
• To recognize when additional surgical care would be counterproductive to patient rehabilitation.
• To develop the skills necessary to plan and perform warranted surgical procedures involving anterior and posterior approaches to the cervical, thoracic, and lumbar spine.
• To develop the surgical expertise needed to perform specialized surgery using a variety of implants.
• To develop skills as an investigator by designing, implementing, completing, and interpreting retrospective or prospective clinical studies, and in selected situations, basic science research projects.
• To thoroughly understand the nature of professional liability involved in the management of patients with spine complaints.
• To thoroughly understand the importance of record documentation and risk management. • To exhibit professionalism at all times.
1. Posterior Lumbar discectomy
2. Anterior Cervical discectomy
3. Lumbar decompression +/- TLIF
4. Thoracic and Lumbar pedicle screw insertion
5. Lateral mass fixation
6. Cervical cage and plate
7. Cervical laminectomy
8. Thoracic laminectomy
9. Vertebral Cementing
10. Deformity correction (as first Assistant)
11. Osteotomy spine VCR/PSO/Ponte (as first assistant)
12. Minimally invasive screw placement lumbar/thoracic (as first assistant)
13. Anterior approaches thoracic/lumbar (as first assistant)
14. Management of spinal fractures through appropriate instrumentations.
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