Veidlapa Nr. M-3 (8)

Study Course Description

Treatment of Degenerative Diseases of the Spine I

Main Study Course Information

Course Code

RMK_014

Branch of Science

Clinical medicine

ECTS

25.00

Target Audience

Medicine

LQF

Level 8

Study Course Implementer

Course Supervisor

Jānis Osītis

Residency Speciality

Speciality

Vertebral surgeon

Supervisor of Medical Speciality

Jānis Osītis

Contacts

About Study Course

Objective

To ensure the acquisition and improvement of theoretical knowledge and practical skills in the diagnosis and operative treatment of the most common (degenerative) diseases of the spine with standard methods and approaches, in order to prepare the specialist for certification in the subspecialty of Spine Surgeon.

Learning Outcomes

Knowledge

1.The acquired knowledge is sufficient to advise a patient with a degenerative spinal disease, draw up a treatment plan and, if necessary, prepare the patient for surgery by filling in all the necessary pre- and post-operative medical documentation, prescribing the necessary examinations and medical treatment, informing the patient and nursing staff. Knows the standard surgical technique in cases of degenerative diseases, including degenerative scoliosis.

Skills

1.• Patient positioning and marking, equipment preparation for surgery. • Independently perform a dorsal approach to the thoracic and lumbar parts of the spine, implant transpedicular fixation screws. • Perform laminectomy, hemilaminectomy in the lumbar spine. • Create microdiscectomy approach, fenestration window, perform microdiscectomy under optical magnification. • To create an anterior approach to the middle part of the cervical spine, perform a discectomy of the cervical part up to the dorsal longitudinal ligament. Implant a disc substitute (Cage) and perform anterior fixation of the neck with a plate. • Can explain the development of degenerative spinal deformity, chronic spinal instability and imbalance, operative correction options, planning and surgical technique.

Competences

1.• Examination of a patient with spinal disease, interpretation of radiological findings. • Decision-making and justification of treatment tactics for degenerative spinal disease. • Documentation of the treatment episode.

Assessment

Individual work

Title	% from total grade	Grade
1. Individual work	-	-
The student prepares a report in PPT format on five of the seminar topics of the program.

Examination

Title	% from total grade	Grade
1. Examination	-	-
The evaluation of the course is the evaluation of the theoretical training, including the evaluation of the seminars, and the evaluation of the practical training on a scale of 10 points. Preparation for the seminar of the given course is discussed with the course leader, then the trainee prepares a written report using literature sources. The seminar takes place using a written report, the course leader evaluates it in a 10-point system.

Study Course Theme Plan

FULL-TIME

Part 1

Seminar

Modality	Location
-	-

Topics

History and development of spine surgery.

Seminar

Modality	Location
-	-

Topics

Anatomy and physiology of the spine and biomechanics of the spine. Topographic anatomy. Pathogenesis of degenerative diseases.

Seminar

Modality	Location
-	-

Topics

Physical and neurological examination of the patient.

Seminar

Modality	Location
-	-

Topics

Non-spinal diseases and conditions with similar complaints and symptoms.

Seminar

Modality	Location
-	-

Topics

Differential diagnosis of spinal surgical diseases. Radiological examinations.

Seminar

Modality	Location
-	-

Topics

Preoperative planning to reduce the risk of complications. Scheduled patient admission for spine treatment, preparation for surgery.

Seminar

Modality	Location
-	-

Topics

Positioning and marking of the patient, preparation of equipment for surgery. Work with operating microscope and microdiscectomy instruments.

Seminar

Modality	Location
-	-

Topics

The most common operative approaches. The dorsal approach involved the thoracic and lumbar spine. Anterior approaches to the cervical spine. Lumbar disc herniation, microdiscectomy midline, dorsolateral and percutaneous approaches.

Seminar

Modality	Location
-	-

Topics

Lumbar microdiscectomy.

Seminar

Modality	Location
-	-

Topics

Fixation of transpedicular screws in the lumbar part, creation of a fixing structure. Decompression of lumbar spinal stenosis.

Seminar

Modality	Location
-	-

Topics

Lumbar transarticular interbody spondylodesis and disc replacement implantation. Lumbar spondylodesis with autologous bone graft.

Seminar

Modality	Location
-	-

Topics

Cervical discectomy. Intercorpus spondylodesis in the neck with cage implantation. Fixation of the anterior cervical spine with a plate and screws.

Seminar

Modality	Location
-	-

Topics

Scoliosis in adults. Indications for operative treatment. Contraindications. Planning the operation. The importance of patient compliance and understanding of the intended operation.

Seminar

Modality	Location
-	-

Topics

Mechanical, implant-related complications. Adherent segment disease. Vague pain syndromes. Arachnoiditis. Psychosomatic disorders. Diagnostic infiltration. Stimulator implantation for pain relief.

Total ECTS (Creditpoints):

25.00

Number of Residency Seminars:

Length (weeks):

Final Examination:

Residency exam (Theory and practice)

Bibliography

Required Reading

Spine Surgery, Edward C. Benzel (ELSEVIER 2016.) 1-168.

Klinikleitfaden Orthopaedie Unfallchirurgie (Elsevier 2016.) Der operative Patient 149-194

Diagnostic Imaging Spine Elsevier 2015.

Surgical Anatomy & Techniques to the Spine. Daniel H. Kim (Elsevier 2006.) 106-113. 213.-226.; 45.-56.

Spine Surgery, Operative Techniques. Eli M. Baron (ELSEVIER 2018.) 54.-64.; 304.-310.; 387.-397.

Additional Reading

European Spine Journal indexed in PubMed/Medline