When is a Spine Fellowship Necessary?
Plans for the 15th Annual Meeting Solidify
Annual Meeting Symposia At-A-Glance
Spine Resources on N://OC®
Pedicle Screw Reclassified
Application for Membership
In This Issue…Plans for the 15th Annual Meeting Solidify (2), Annual Meeting Symposia At-A-Glance (3), Spine Resources on N://OC® (4), Pedicle Screw Reclassified (5), Coding Corner (7)
The answer depends upon who is being asked the question. In order to determine the need for spine fellowship training, the neurosurgical resident needs to assess his or her own career goals. For someone considering an academic neurosurgical spine career, a spine fellowship has essentially become a mandatory prerequisite. However, the debate surrounding neurosurgeons entering private practice still drags on. Is a formal fellowship necessary for these residents?
Presently, two-thirds of all neurosurgical cases in private practice are spine surgeries. These spine cases range from relatively routine decompressive surgeries to complex instrumented fusion procedures. The need for advanced training depends upon the resident’s degree of training, both didactic and hands on, during his or her residency. The level of comfort that a particular resident has acquired upon completion of his neurosurgical residency will greatly dictate the need for advanced training.
Over the past 40 years, spine surgery has changed dramatically. Surgical procedures on the spine have become significantly more complex. The increased awareness surrounding spinal stability, as well as the traditional concerns regarding adequate decompression of the neural elements, has provided neurosurgical residents with ample opportunity to gain experience with, and exposure to, complex spine surgery.
With the possible exception of spinal deformity, most major academic neurosurgi- When is a Spine Fellowship Necessary? cal programs now provide training in complex spinal surgery. As such, a fellowship is probably unnecessary for most graduating residents entering private practice.
In spite of the fact that most private practice neurosurgeons perform the majority of their surgeries on the spine, their formal didactic training during residency centers predominantly on the study of disorders related to cerebral pathology. Neurosurgical trainees, as such, need to increase their formal reading on spinal anatomy, biomechanical principles, and spine surgery techniques. Ideally, this should be completed during the neurosurgical residency; however, a spine fellowship offers the opportunity to expand on these principles.