Spine surgery training and competence of European Neurosurgical Trainees

Boszczyk, Bronek M.; Mooij, J.J.A.; Schmitt, N.; Rocco, Concezio Di; Fakouri, Baroum Baroum; Lindsay, Kenneth W.

doi:10.1007/s00701-009-0259-8

Cited by 22 publications

(18 citation statements)

References 14 publications

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“…In our opinion, performing between 25 and 30 cases with an experienced spinal surgeon would be reasonable for trainees to demonstrate competency and allow independent operating. We additionally perform fairly robust 6 monthly appraisals of all our fellows in performing these and other procedures [18]. With adequate training and judgment, spinal surgeons can safely perform such exposures, provided vascular surgical assistance is readily available if required.…”

Section: Discussionmentioning

confidence: 99%

Access related complications in anterior lumbar surgery performed by spinal surgeons

et al. 2012

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We report a very thorough and critical review of our anterior lumbar access surgeries performed mostly for DDD and spondylolisthesis at L4/5 and L5/S1 levels. Vascular problems of any type (24/304, 7.8 %) were the most common complication during this approach. The incidence of major venous injury requiring repair was 14/304 (4.6 %) and arterial injury 5/304 (1.6 %). The requirement for a vascular surgeon with the vascular injury was 9/304 (3 %; 5 arterial injuries; 4 venous injuries). This also suggests that the majority of the major venous injuries were repaired by the spinal surgeon (10/14, 71 %). Our results are comparable to other studies and support the notion that anterior access surgery to the lumbar spine can be performed safely by spinal surgeons. With adequate training, spinal surgeons are capable of performing this approach without direct vascular support, but they should be available if required.

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Section: Discussionmentioning

confidence: 99%

Access related complications in anterior lumbar surgery performed by spinal surgeons

et al. 2012

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“…The first consideration, if training is to involve the hardship of moving between multiple institutions, including interstate or international moves, is to ensure excellent training, including a superior experience for the trainee. There is little in the literature to guide the accreditation of neurosurgical units apart from specific considerations for subspecialty training such as endovascular/cerebrovas- cular surgery 2 or spine neurosurgery, 4 and there is little discussion of trainee welfare and satisfaction. The rigorous accreditation process outlined above appears to at least conform to best practice and is monitored through reaccreditation every 5 years as well as biannual trainee feedback, with scores across multiple years aggregated and released to the training unit to highlight deficiencies while maintaining trainee anonymity.…”

Section: Discussionmentioning

confidence: 99%

Challenges in the Australasian neurosurgery training program: who should be trained and where should they train?

Drummond

Hunn

McAlpine

et al. 2020

Neurosurgical Focus

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OBJECTIVENeurosurgical training poses particular challenges in Australia and New Zealand, given the large landmass, small population, and widely separated, often small, neurosurgical units. Such factors have necessitated a move away from autonomous, single-institution–based training to the selection of trainees by a centralized binational process. The success of this system is based on rigorous standardized evaluation of candidates’ academic achievements, anatomical knowledge, references, and interview performance. Similarly, the accreditation of hospitals to train successful candidates has been standardized. The authors review the evolution of trainee selection and the accreditation of training posts in Australia and New Zealand.METHODSThe records of the Neurosurgical Society of Australasia Surgical Education and Training Board were reviewed for documents pertaining to the selection of neurosurgical trainees and the accreditation of training posts. Application records and referee scores from 2014 to the present were reviewed to encompass process changes, in particular the change from written referee reports to standardized interviews of referees. Surgical logbook case numbers for 23 trainees completing training in 2016, 2017, and 2018 were collated and presented in an aggregated, de-identified form as a measure of adherence to accreditation standards. Written evaluations of the training experience were also sought from two trainees reflecting on the selection process, the quality of training posts, and training limitations.RESULTSWhile a time-consuming process, the method of obtaining referee reports by interview has resulted in a wider spread of scores, more able to separate high- and low-scoring applicants than other components of the selection process. Review of the training post accreditation records for the last 2 years showed that adherence to standards has resulted in loss of accreditation for one unit and shortened periods of review for units with more minor deficiencies. Two applications for accreditation have been denied. Examination of caseload data showed that trainees more than fulfill minimum requirements in accredited training posts, confirming the robust nature of this aspect of unit accreditation.CONCLUSIONSA key factor determining the success of neurosurgical training in Australia and New Zealand has been a willingness to evolve selection and other processes to overcome challenges as they become apparent. According to available analyses, the revised referee process and strict accreditation standards appear effective. The benefits and challenges of the current training system are discussed in the context of a paucity of international literature.

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“…The main application of implant or replacement discs are replacing injured intervertebral spine. With regards to some research, Spinal implant surgery is relatively new in the United States dating back to October 2001, while the spine surgery training has taken hold in Europe; European neurosurgical trainees during their residency, Boszczyk et al 2009. Even though spinal implants cannot function the same as the body's natural spine, they are still very beneficial. The goal of the implants is to provide, in addition to structural integrity, as much as possible the needed mobility in several planes, providing bending and torsion.…”

Section: A)mentioning

confidence: 99%

Connection of surface roughness to hysteresis loss in spine implants

Hodaei

Farhang

2015

JBSE

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To investigate roughness effect in spine implant, a contact model is offered in this paper. The contact surfaces are modeled macroscopically as semi-spherical containing micro-scale roughness. A minimum mean surface separation between two rough surfaces is defined and related to contact force. This is accomplished through a statistical account of elastic and plastic micro contact at the surface roughness scale and the subsequent integration of micron level events to obtain macro level expectation of force as a function of mean surface separation. Contact force-minimum separation relation facilitates the derivation of hysteretic energy loss during a load-unload event. It is found that the surface high plasticity index yields more energy per cycle. Using the force-minimum surface separation in a dynamic interaction of the implant, approximate leads to the prediction of contact natural frequencies and damping ratio of the implant. These characteristics along with energy loss in implant affect implant's performance and durability.

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Spine surgery training and competence of European Neurosurgical Trainees

Abstract: European neurosurgical trainees possess incomplete competence in dealing with spinal disorders. EANS trainees advocate the development of a postresidency spine subspecialty training program.

Cited by 22 publications

References 14 publications

Access related complications in anterior lumbar surgery performed by spinal surgeons

Access related complications in anterior lumbar surgery performed by spinal surgeons

Challenges in the Australasian neurosurgery training program: who should be trained and where should they train?

Connection of surface roughness to hysteresis loss in spine implants

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