Veidlapa Nr. M-3 (8)
Study Course Description
Children's Spine Diseases, Surgical and Conservative Treatment
Course Code
RMK_006
Branch of Science
Clinical medicine
ECTS
8.00
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
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About Study Course
Objective
Provide in-depth structured training in children's spine surgery, both by systematically examining groups of children's spine diseases, including congenital, acquired and as complications of other diseases, spinal injuries in childhood, creating detailed knowledge of the symptoms of these diseases, the clinical picture, diagnostic examinations and their interpretation, conservative and surgical treatment including participation in operations and training in relevant surgical techniques to prepare the physician for certification in the subspecialty of Spine Surgeon.
Learning Outcomes
Knowledge
1.The acquired knowledge is sufficient to advise a pediatric patient with 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.
Skills
1.• Patient positioning and marking, equipment preparation for surgery. • Independently perform a posterior approach to the thoracic and lumbar parts of the spine, implant transpedicular fixation screws in a curved and rotated spine, including monoaxial ones, perform deformation correction using the implant structure. • Perform an anterolateral approach to the thoracic spine, opening of the pleura and disc annulus, discectomy, spondylodesis with rib-derived bone grafts. • Correction of spondylolisthesis with a posterior or combined approach.
Competences
1.• Examination of a pediatric patient with spinal disease, interpretation of radiological findings. • Making decisions and justifying treatment tactics for a pediatric patient with spinal disease. • Completion of documentation for an episode of acute or planned treatment.
Assessment
Individual work
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Title
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% from total grade
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Grade
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1.
Individual work |
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-
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The student prepares a report in PPT format on two of the program topics.
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Examination
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Title
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% from total grade
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Grade
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|---|---|---|
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1.
Examination |
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-
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Assessment of practical skills in a 10-point system at the end of the course, conducted by the lecturer from whom the resident received practical training.
Assessment of theoretical knowledge in a 10-point system for the written review presented within the seminar.
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Study Course Theme Plan
FULL-TIME
Part 1
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Seminar
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Modality
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Location
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Topics
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Spine development and clinical features at different stages of development. Vertebrate embryogenesis. Formation and ossification of the cartilaginous spine, ossification centers and growth zones. Anatomical and biomechanical features of the child's spine. Neurological and radiological examination methods in the diagnosis of children's spine diseases, their data interpretation. Vertebral segmentation disorders, half vertebrae, butterfly vertebrae. Congenital lumbar stenosis.
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Seminar
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Modality
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Location
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-
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Topics
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Clinical and preoperative evaluation of spinal diseases in children. Operative treatment methods, their indications, benefits and losses, growth potential were discussed with the child. Lenkie classification of scoliosis. Idiopathic scoliosis. Choice of intervention levels and indirect correction. Functional radiological examinations.
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Seminar
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Modality
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Location
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Topics
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Spinal deformities and their treatment options for children. Congenital scoliosis. Congenital kyphosis. Secondary spinal deformities due to dysplasia, neuromuscular diseases. Early onset scoliosis, scoliosis in infancy. Surgical and conservative methods of treatment of spinal deformities, preoperative assessment, planning of surgery. Peculiarities of treatment of spondylolisthesis and kyphosis in children. Correction of sagittal imbalance of the spine. Indications for corrective surgery.
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Seminar
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Modality
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Location
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Topics
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Preparing the child for spinal surgery. Positioning, providing access, anesthetic features, indications for intraoperative neuromonitoring. Wake up test. Post-operative care, rehabilitation.
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Seminar
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Modality
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Location
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Topics
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The child suffered from oncological diseases. Pathological fracture. Langerhans histiocytosis. Aneurysmal vertebral cyst, hemangioma. Osteoma, osteoblastoma. Chordoma, osteosarcoma, Ewning sarcoma, lymphoma, metastases. Indications for biopsy, indications for operative therapy.
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Seminar
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Modality
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Location
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Topics
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Spinal injuries in children. Thoracolumbar and neck. Spinal cord injury. Conservative treatment and indications for surgical treatment. Secondary surgical treatment for post-traumatic deformities.
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Total ECTS (Creditpoints):
8.00
Number of Residency Seminars:
6
Length (weeks):
6
Final Examination:
Residency exam (Theory and practice)
Bibliography
Required Reading
1.
Daniel H. Kim, Randal R. Betz, Stephen L Huhn , Peter O. Newton, editors. Surgery of the Pediatric Spine. Germany: Thieme Medical Publishers; 2008.
2.
Akbarnia B, Yazici M, Thompson GH, editors. The growing spine-management of spinal disorders in young children. Berlin: Springer; 2016.
Additional Reading
1.
Children’s spinal disorders and fractures, Michael Benson,John Fixen, Klaus Parsch, Malcolm Macnicol, Springer 2011.
2.
Pathogenesis of idiopathic scoliosis M. Machida, S weinstein, J. Dubousset 2018.
3.
Wirbelsaeule kompakt Reinhold, Eicher, Schleicher, Schmidt Schattauer 2018.
4.
Surgical management of Spinal Deformities. Thomas Errico Elsevier 2008.
5.
Adult and Pediatric Spine trauma, an Issue. Douglas Borckmeyer 2017.
6.
Benzel’s spine Surgery Michael Steinmetz 2016
7.
Diagnostic Imaging: Spine, 3RD Edition. Jeffrey S. Ross, Kevin R. Moore 2015.
8.
Journal of Children Orthopaedics indexed in PubMed/Medline