- Email: [email protected]
Report from the 2014 Scoliosis Research Society Travelling Fellowship
Spine Deformity 3 (2015) 108e113 www.spine-deformity.org
Travelling Fellowship Report
Report from the 2014 Scoliosis Research Society Travelling Fellowship Nasir A. Quraishi, FRCSa,*, Meric Enercan, MDb, J. Naresh-Babu, MDc, D. Chopin, MDd a
Centre for Spinal Studies and Surgery, Queens Medical Centre Campus of Nottingham University Hospitals NHS Trust, Derby Road, Nottingham NG7 2UH, UK b Department of Orthopedics and Traumatology, Florence Nightingale Hospital, Istanbul Spine Center, Turkey c Mallika Spine Centre, Kothapet, Guntur, Andhra Pradesh, India d Neuro-Orthopedic Spine Unit, Lille University Hospital, France Received 15 October 2014; revised 9 January 2015; accepted 11 January 2015
Abstract The Scoliosis Research Society traveling fellowship was conceptualized in 1970, repeated in 1972, and, after a pause, restarted in 1993. International traveling fellows visiting North America first commenced in 2000 and have since alternated annually with the North American fellows. Although a senior fellow had always traveled with them, in 2012 the first senior international fellow traveled with the group. This year, the senior fellow was Daniel Chopin from the Neuro-Orthopedic Spine Unit, Lille University Hospital, France, and past Director of the Spine Center, Institut Calot Berck sur Mer (succeeding Dr. Cotrel). The junior fellows were Meric Enercan from the Florence Nightingale Hospital, Istanbul Spine Center, Turkey; J. Naresh-Babu from Mallika Spine Centre, Guntur, Andhra Pradesh, India; and Nasir A. Quraishi from the Centre for Spine Studies and Surgery, Queen’s Medical Centre, Nottingham, UK. The host centers were initially suggested by Dr. Chopin, the senior fellow; after some minor tweaking and extensive planning from the Scoliosis Research Society office, the itinerary was confirmed. The researchers were to visit 7 centers in just over 3 weeks. All of the international fellows were going to have an extraordinary adventure although they had not met each other previously. As it turned out, the trip was indeed sensationaldprofessionally stimulating and socially endearing. The following is a short report on this unforgettable experience. Ó 2015 Scoliosis Research Society. Keyword: Scoliosis Research Society Traveling Fellowship
Introduction The Scoliosis Research Society (SRS) traveling fellowship was conceptualized in 1970, repeated in 1972, and, after a pause, restarted in 1993. International traveling fellows visiting North America first commenced in 2000 and have since alternated annually with the North American fellows. Although a senior fellow had always traveled with them, in 2012 the first senior international fellow traveled with the group.
Author disclosures: NAQ (none); ME (none); JN (none); DC (none). *Corresponding author. Centre for Spinal Studies and Surgery, Queens Medical Centre Campus of Nottingham University Hospitals NHS Trust, West Block, D Floor, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, UK. Tel.: þ44 (0) 115 924 9924, ext. 65160/61713; fax þ44 (0) 115 970 9991. E-mail address: [email protected] (N.A. Quraishi). 2212-134X/$ - see front matter Ó 2015 Scoliosis Research Society. http://dx.doi.org/10.1016/j.jspd.2015.01.001
This year, the senior fellow was Daniel Chopin from the Neuro-Orthopedic Spine Unit, Lille University Hospital, France, and past Director of the Spine Center, Institut Calot Berck sur Mer (succeeding Dr. Cotrel). The junior fellows were Meric Enercan from the Florence Nightingale Hospital, Istanbul Spine Center, Turkey; J. Naresh-Babu from Mallika Spine Centre, Guntur, Andhra Pradesh, India; and Nasir A. Quraishi from the Centre for Spine Studies and Surgery, Queen’s Medical Centre, Nottingham, UK. The host centers were initially suggested by Dr. Chopin, the senior fellow; after some minor tweaking and extensive planning from the SRS office, the itinerary was confirmed. The researchers were to visit 7 centers in just over 3 weeks (Table). All of the international fellows were going to have an extraordinary adventure although they had not met each other previously. As it turned out, the trip was indeed sensationaldprofessionally stimulating and socially endearing. The following is a short report on this unforgettable experience.
N.A. Quraishi et al. / Spine Deformity 3 (2015) 108e113
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Table Scoliosis Research Society traveling fellows itinerary, 2014. Site
Dates
Hosts
New York Hospital for Joint Diseases Columbia Children’s Hospital St. Louis Barnes-Jewish Hospital, Washington University Medical Center Children’s Hospital San Diego Rady Children’s Hospital San Francisco University of CaliforniaeSan Francisco Anchorage Orthopaedic Physicians Anchorage
Monday, August 18 to Sunday, August 24
Frank Schwab, MD, Tom Errico, MD Michael Vitale, MD, David Roye, MD
Monday, August 25 to Thursday, August 28
Lawrence Lenke, MD
Thursday, 28 August to Sunday, August 31
Peter Newton, MD
Monday, September 1 to Sunday, September 7 Monday, September 8 to Tuesday, September 9
Sigurd Berven, MD Praveen Mummaneni, MD James Eule, MD
New York Dr. Chopin and Nasir arrived in New York on the weekend of August 16 to 17, 2014. On Monday, they were welcomed by their hosts at the New York University Hospital, Hospital for Joint Diseases (HJD), Dr. Frank Schwab and Dr. Tom Errico. They spent the day in the operating rooms and observed 2 skillfully performed pedicle subtraction osteotomies well planned on Surgimap (Nemaris Inc., NY). The evening dinner was at an elegant restaurant opposite Central Park, where the researchers were accompanied by the remaining spinal faculty staff. Later that evening, amid endless courses of exquisite seafood and accompanying wine, they were joined by the 2 remaining fellows, Meric and Naresh. The 4 colleagues remained close for the remaining 4 weeks and spent every evening (and most breakfasts and lunches) together (Fig. 1). The next day was also spent in the operating rooms at HJD. With 3 simultaneous operating rooms running, there was plenty for the visiting researchers to see. The following 2 days were spent at the Columbia Children’s Hospital with hosts Michael Vitale and David Roye. The sheer size of the campus was astounding and the facilities were first-rate. The researchers enjoyed spending time with Michael and David in the operating rooms and had great discussions about spine distraction systems, management of scoliosis, and quality improvement. Even better, most of the discussions were over delicious coffee and traditional New York bagels with cream cheese! On the last day there, the visitors gave presentations to the orthopedic department at the grand rounds conference. Meric gave an excellent talk about adult deformity corrections in Istanbul; in particular, it was interesting to hear about experiences with corrective techniques, additional rodebone graft strut supports, and a new position for iliac wing fixation. The conclusion was Dr. Chopin’s lecture on the management of high-grade spondylolisthesis. That evening, interesting case presentations followed, by fellows Dr. Mark Weidenbaum and Dr. Randall Betz, among others. Michael Vitale hosted the visitors at the excellent Italian restaurant Spina, in downtown New York.
The final academic day in New York was back at HJD. The traveling fellows again gave talks at the morning conference and then spent the day in the research laboratory under the supervision of Virginie Lafage. This was the most impressive research setup that the visitors had witnessed, in an impressive 5-story townhouse opposite the HJD campus. Virginie and the staff presented their projects; clearly, their list of research accomplishments was inspiring. However, at the end of the day, the visitors were a little deflated that the
Fig. 1. All SRS traveling fellows at the first site in New York (left to right: J. Naresh-Babu, Daniel Chopin, Meric Enercan, and Nasir Quraishi).
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accomplishments would be hard to reproduce in their home institutions. The final weekend in New York, the fellows spent visiting (and cycling) around some of the popular sites and on the last evening went to Broadway. There, they watched a performance of Mamma Mia. This was a fantastic experience, topped off by a tasty pizza from a local deli. New York was fantastic city to explore and walk around. In addition, the researchers had just tasted the first experience of their remarkable fellowship, learned much about sagittal balance as well as surgical planning, and witnessed perhaps one of the most impressive institutions in the world for research on spinal alignment and adult deformity. St. Louis When the researchers arrived in St. Louis, they were immediately struck by the heat and humidity. It was close to 100 F as they sat down for a nice dinner with Dr. Michael Kelly and dr. Jacob Buchowski. Dr. Lawrence Lenke was the host, and it was clear from the outset that he was used to receiving visiting surgeons. The setup in the operating rooms was first-rate, with large screens where surgeries could be observed from the head as well as overhead using light cameras. The surgeries included revision adult deformity corrections, pedicle subtraction osteotomy, posterior vertebral column resection, a Shilla procedure, and a cervical laminoplasty (the latter was performed by Dr. Dan Riew). The current authors cannot speak more highly of the surgical skills and techniques that they were privileged to see. They also had an opportunity to give presentations at the spinal conference that was attended by local faculty, nursing, and research staff (Fig. 2). The faculty team included Dr. Keith Bridwell; it was great to hear about his extensive experience. Naresh gave a nice talk about his experience
with 3-column osteotomies in children, performed without intraoperative monitoring. There are financial restraints limiting its use in Hyderabad, but his results have been excellent thus far. Preoperative planning was another useful conference in St. Louis that gave the newer faculty members a chance to receive preoperative advice from senior staff. The clinic arrangement with Dr. Lenke was fantastic; nearly all patients were listed for surgery after a considerable screening and triage program performed by his research associates and senior nursing staff. The visitors were impressed by the sheer number of patients attending the clinic, both nationally and internationally. In addition, Larry was a splendid host in the evenings. The culmination of the researchers’ stay was an excellent dinner hosted at Larry’s country club. Both he and Daniel gave closing speeches, and Larry was gracious in offering thanks to the visitors’ families for allowing them to be away from home for so long. The next day, the researchers departed for San Diego. San Diego The researchers arrived in the beautiful city of San Diego, and after some early confusion (on their part) regarding the correct hotel location, they were safely settled in and having dinner at a local Argentinean restaurant. Although the food was pretty good, the evening will be remembered for the 3-block walk along the highway to get thereda bit farther than they had expected. The host in San Diego was Dr. Peter Newton, and he was exceptional throughout. The first day in the children’s hospital, the researchers attended morning conference rounds followed by presentations. Dr. Chopin gave an excellent talk on the historical basis of sagittal balance and current concepts. Dr. Newton’s research team spoke about their work on rotational changes of the spine in scoliosis
Fig. 2. Scoliosis Research Society traveling fellows with Lawrence Lenke, MD (second from bottom right) and faculty.
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Fig. 3. Scoliosis Research Society traveling fellows and Dr. Peter Newton (right), enjoying fish and chips at San Diego Harbor.
and his work on the anterior tether technique. Dr. Behrooz Akbarnia also attended and gave a superb talk on growing rods, whereas his staff spoke about their experiences with minimally invasive correction for adult deformity. In the afternoon, the visitors were shown around the department by Dr. Burt Yaszay, who has an impressive clinic and EOS machine setup. That afternoon, the researchers watched Dr. Newton perform an impressive adolescent idiopathic scoliosis correction with his colleague, Dr. Salil Upsani. In the evening, the visitors were hosted for dinner with a stunning view of San Diego Bay. The researchers had a long weekend off in San Diego and Peter continued to be a perfect host (Fig. 3). They were taken to the Maritime Museum of San Diego, were given a Mexican dinner at Burt’s beautiful house, watched their first baseball game, and finished off the weekend with dinner at Peter’s beach house watching the sunset on the coast. San Francisco The researchers arrived in San Francisco the next day and were picked up by one of their hosts, Dr. Praveen Mummaneni, who was wearing his scrubs and was coming off work. Later that evening, Dr. Sigurd Berven, the other host, picked up the visitors from their hotel and took them to his home. They had a sushi dinner with some of the other local faculty, and his fellows had arranged for the researchers to view the week’s case presentation. They were in for a busy week with some fascinating cases.
Over the next 4 days, they saw 4 3-column osteotomies, 2 adolescent idiopathic scoliosis corrections (performed by Dr. Mohammad Diab using first-generation USS instrumentation developed in Nottingham), and minimally invasive 4-levels extreme lateral interbody fusion by Dr. Vedat Deviren. It was especially good to see the neurosurgeons and spinal orthopedic surgeons working jointly in the operating room: Dr. Chris Ames and Dr. Vedat combined to perform a nice cervicothoracic osteotomy. On presentation day (Fig. 4), the researchers gave talks: Nasir summarized his experience with primary versus revision 3-column osteotomies in adult patients; and Dr. Berven and his research staff showcased their impressive current projects. The visitors were hosted for dinner on a daily basis by local faculty, with whom they experienced the tremendous variety that San Francisco has to offer. A particular memory is their walk with the knowledgeable and world-wise Mohammad Diab along the Golden Gate Bridge and back, the culmination of which was all 4 people being squeezed into Mohammad’s mini and driven to the dinner venueda la sardines in a tin! A sailing trip organized by one of the newer faculty, boat captain Dr. Murat Parkezi, was simply stunning. On the last weekend, Praveen and Sig hosted the visitors in Napa Valley. They spent too much money at the downtown Apple Store and perhaps had their best steak at a nearby local steakhouse. On the final day, Praveen and his wife hosted the visitors for lunch on San Francisco Bay. The week had been amazingdfull of excellent cases and wonderful evening entertainment in which the researchers were able to spend
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Fig. 4. Scoliosis Research Society traveling fellows with Dr. Sigurd Berven (third from left) and Dr. Praveen Mummaneni (far left).
time with the faculty. Sig and Praveen had organized an excellent program for them. Anchorage The next day, the researchers arrived in Anchorage, Alaska, where they were picked up by Dr. James Eule, their local host, in his impressive Dodge truck. (Take note, Mohammad Diab!) At the dinner, they were hosted by local faculty at the top floor restaurant of the Hotel Captain Cook. This had an impressive view of the city, which the researchers were surprised to learn had a population of approximately 350,000 and another 400,000 who lived in the rest of the state. The hotel was comfortable. The next
day, the visitors attended a presentation conference with the spinal team. After 4 hours of case discussions and presentations, it was time to get some air (literally). James took the visitors on a wonderful adventure in his seaplane. They saw the most breathtaking Alaskan landscape, Naresh got a chance to fly the plane, and they landed on Lake Chitula (Fig. 5). There, they explored the local wilderness, pitched a tent, and had the most exquisite salmon that they had ever tasted. They remained entranced by local stories of moose and bear hunting and living in the bush. That evening, they were flown back to Anchorage and straight to the SRS conference. Stephanie Tesch had been instrumental in logistical and administrative support throughout the trip and was pleased to see the visitors all together safely back and in 1 piece. Scoliosis Research Society Meeting
Fig. 5. Scoliosis Research Society traveling fellows with James Eule, MD. James is in the background unloading the plane while the authors are posing for photos for Daniel.
The 49th SRS meeting in the 49th state was excellent. The researchers were invited to the reception, introduced in the SRS President’s welcome speech, and hosted at the farewell dinner, and Daniel and Nasir had a chance present their traveling fellowship to members at the business meeting. They are incredibly grateful to the SRS committee for giving them this once in a lifetime opportunity. The experience of this traveling fellowship has been invaluable. During that month, they made many wonderful friends and colleagues. They were able to refine their knowledge of surgical techniques and explored common areas of research for continuing collaboration in the future. Among the traveling fellows, they had created a strong bond that they are sure will continue long into the future.
N.A. Quraishi et al. / Spine Deformity 3 (2015) 108e113
Acknowledgment The authors are grateful to the SRS and their host sites programs for this exclusive opportunity to experience spine surgery in North America. In particular, they would like to thank: Frank Schwab and Tom Errico, HJD, New York University Hospital; Michael Vitale, David Roye, Mark Weidenbaum, and Charla Fischer, Columbia University Hospital;
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Lawrence Lenke, Keith Bridwell, Michael Kelly, Jacob Buchowski, and Ron Lehman, BarneseJewish Hospital, St. Louis; Peter Newton, Behrooz Akbarnia, and Salil Upsani, Rady Children’s Hospital, San Diego; and Sigurd Berven, Praveen Mummaneni, Mohammad Diab, Vedat Deviren, Chris Ames, Murat Parkezi, and Dean Chou, University of CaliforniaeSan Francisco.
Travelling Fellowship Report
Report from the 2014 Scoliosis Research Society Travelling Fellowship Nasir A. Quraishi, FRCSa,*, Meric Enercan, MDb, J. Naresh-Babu, MDc, D. Chopin, MDd a
Centre for Spinal Studies and Surgery, Queens Medical Centre Campus of Nottingham University Hospitals NHS Trust, Derby Road, Nottingham NG7 2UH, UK b Department of Orthopedics and Traumatology, Florence Nightingale Hospital, Istanbul Spine Center, Turkey c Mallika Spine Centre, Kothapet, Guntur, Andhra Pradesh, India d Neuro-Orthopedic Spine Unit, Lille University Hospital, France Received 15 October 2014; revised 9 January 2015; accepted 11 January 2015
Abstract The Scoliosis Research Society traveling fellowship was conceptualized in 1970, repeated in 1972, and, after a pause, restarted in 1993. International traveling fellows visiting North America first commenced in 2000 and have since alternated annually with the North American fellows. Although a senior fellow had always traveled with them, in 2012 the first senior international fellow traveled with the group. This year, the senior fellow was Daniel Chopin from the Neuro-Orthopedic Spine Unit, Lille University Hospital, France, and past Director of the Spine Center, Institut Calot Berck sur Mer (succeeding Dr. Cotrel). The junior fellows were Meric Enercan from the Florence Nightingale Hospital, Istanbul Spine Center, Turkey; J. Naresh-Babu from Mallika Spine Centre, Guntur, Andhra Pradesh, India; and Nasir A. Quraishi from the Centre for Spine Studies and Surgery, Queen’s Medical Centre, Nottingham, UK. The host centers were initially suggested by Dr. Chopin, the senior fellow; after some minor tweaking and extensive planning from the Scoliosis Research Society office, the itinerary was confirmed. The researchers were to visit 7 centers in just over 3 weeks. All of the international fellows were going to have an extraordinary adventure although they had not met each other previously. As it turned out, the trip was indeed sensationaldprofessionally stimulating and socially endearing. The following is a short report on this unforgettable experience. Ó 2015 Scoliosis Research Society. Keyword: Scoliosis Research Society Traveling Fellowship
Introduction The Scoliosis Research Society (SRS) traveling fellowship was conceptualized in 1970, repeated in 1972, and, after a pause, restarted in 1993. International traveling fellows visiting North America first commenced in 2000 and have since alternated annually with the North American fellows. Although a senior fellow had always traveled with them, in 2012 the first senior international fellow traveled with the group.
Author disclosures: NAQ (none); ME (none); JN (none); DC (none). *Corresponding author. Centre for Spinal Studies and Surgery, Queens Medical Centre Campus of Nottingham University Hospitals NHS Trust, West Block, D Floor, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, UK. Tel.: þ44 (0) 115 924 9924, ext. 65160/61713; fax þ44 (0) 115 970 9991. E-mail address: [email protected] (N.A. Quraishi). 2212-134X/$ - see front matter Ó 2015 Scoliosis Research Society. http://dx.doi.org/10.1016/j.jspd.2015.01.001
This year, the senior fellow was Daniel Chopin from the Neuro-Orthopedic Spine Unit, Lille University Hospital, France, and past Director of the Spine Center, Institut Calot Berck sur Mer (succeeding Dr. Cotrel). The junior fellows were Meric Enercan from the Florence Nightingale Hospital, Istanbul Spine Center, Turkey; J. Naresh-Babu from Mallika Spine Centre, Guntur, Andhra Pradesh, India; and Nasir A. Quraishi from the Centre for Spine Studies and Surgery, Queen’s Medical Centre, Nottingham, UK. The host centers were initially suggested by Dr. Chopin, the senior fellow; after some minor tweaking and extensive planning from the SRS office, the itinerary was confirmed. The researchers were to visit 7 centers in just over 3 weeks (Table). All of the international fellows were going to have an extraordinary adventure although they had not met each other previously. As it turned out, the trip was indeed sensationaldprofessionally stimulating and socially endearing. The following is a short report on this unforgettable experience.
N.A. Quraishi et al. / Spine Deformity 3 (2015) 108e113
109
Table Scoliosis Research Society traveling fellows itinerary, 2014. Site
Dates
Hosts
New York Hospital for Joint Diseases Columbia Children’s Hospital St. Louis Barnes-Jewish Hospital, Washington University Medical Center Children’s Hospital San Diego Rady Children’s Hospital San Francisco University of CaliforniaeSan Francisco Anchorage Orthopaedic Physicians Anchorage
Monday, August 18 to Sunday, August 24
Frank Schwab, MD, Tom Errico, MD Michael Vitale, MD, David Roye, MD
Monday, August 25 to Thursday, August 28
Lawrence Lenke, MD
Thursday, 28 August to Sunday, August 31
Peter Newton, MD
Monday, September 1 to Sunday, September 7 Monday, September 8 to Tuesday, September 9
Sigurd Berven, MD Praveen Mummaneni, MD James Eule, MD
New York Dr. Chopin and Nasir arrived in New York on the weekend of August 16 to 17, 2014. On Monday, they were welcomed by their hosts at the New York University Hospital, Hospital for Joint Diseases (HJD), Dr. Frank Schwab and Dr. Tom Errico. They spent the day in the operating rooms and observed 2 skillfully performed pedicle subtraction osteotomies well planned on Surgimap (Nemaris Inc., NY). The evening dinner was at an elegant restaurant opposite Central Park, where the researchers were accompanied by the remaining spinal faculty staff. Later that evening, amid endless courses of exquisite seafood and accompanying wine, they were joined by the 2 remaining fellows, Meric and Naresh. The 4 colleagues remained close for the remaining 4 weeks and spent every evening (and most breakfasts and lunches) together (Fig. 1). The next day was also spent in the operating rooms at HJD. With 3 simultaneous operating rooms running, there was plenty for the visiting researchers to see. The following 2 days were spent at the Columbia Children’s Hospital with hosts Michael Vitale and David Roye. The sheer size of the campus was astounding and the facilities were first-rate. The researchers enjoyed spending time with Michael and David in the operating rooms and had great discussions about spine distraction systems, management of scoliosis, and quality improvement. Even better, most of the discussions were over delicious coffee and traditional New York bagels with cream cheese! On the last day there, the visitors gave presentations to the orthopedic department at the grand rounds conference. Meric gave an excellent talk about adult deformity corrections in Istanbul; in particular, it was interesting to hear about experiences with corrective techniques, additional rodebone graft strut supports, and a new position for iliac wing fixation. The conclusion was Dr. Chopin’s lecture on the management of high-grade spondylolisthesis. That evening, interesting case presentations followed, by fellows Dr. Mark Weidenbaum and Dr. Randall Betz, among others. Michael Vitale hosted the visitors at the excellent Italian restaurant Spina, in downtown New York.
The final academic day in New York was back at HJD. The traveling fellows again gave talks at the morning conference and then spent the day in the research laboratory under the supervision of Virginie Lafage. This was the most impressive research setup that the visitors had witnessed, in an impressive 5-story townhouse opposite the HJD campus. Virginie and the staff presented their projects; clearly, their list of research accomplishments was inspiring. However, at the end of the day, the visitors were a little deflated that the
Fig. 1. All SRS traveling fellows at the first site in New York (left to right: J. Naresh-Babu, Daniel Chopin, Meric Enercan, and Nasir Quraishi).
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accomplishments would be hard to reproduce in their home institutions. The final weekend in New York, the fellows spent visiting (and cycling) around some of the popular sites and on the last evening went to Broadway. There, they watched a performance of Mamma Mia. This was a fantastic experience, topped off by a tasty pizza from a local deli. New York was fantastic city to explore and walk around. In addition, the researchers had just tasted the first experience of their remarkable fellowship, learned much about sagittal balance as well as surgical planning, and witnessed perhaps one of the most impressive institutions in the world for research on spinal alignment and adult deformity. St. Louis When the researchers arrived in St. Louis, they were immediately struck by the heat and humidity. It was close to 100 F as they sat down for a nice dinner with Dr. Michael Kelly and dr. Jacob Buchowski. Dr. Lawrence Lenke was the host, and it was clear from the outset that he was used to receiving visiting surgeons. The setup in the operating rooms was first-rate, with large screens where surgeries could be observed from the head as well as overhead using light cameras. The surgeries included revision adult deformity corrections, pedicle subtraction osteotomy, posterior vertebral column resection, a Shilla procedure, and a cervical laminoplasty (the latter was performed by Dr. Dan Riew). The current authors cannot speak more highly of the surgical skills and techniques that they were privileged to see. They also had an opportunity to give presentations at the spinal conference that was attended by local faculty, nursing, and research staff (Fig. 2). The faculty team included Dr. Keith Bridwell; it was great to hear about his extensive experience. Naresh gave a nice talk about his experience
with 3-column osteotomies in children, performed without intraoperative monitoring. There are financial restraints limiting its use in Hyderabad, but his results have been excellent thus far. Preoperative planning was another useful conference in St. Louis that gave the newer faculty members a chance to receive preoperative advice from senior staff. The clinic arrangement with Dr. Lenke was fantastic; nearly all patients were listed for surgery after a considerable screening and triage program performed by his research associates and senior nursing staff. The visitors were impressed by the sheer number of patients attending the clinic, both nationally and internationally. In addition, Larry was a splendid host in the evenings. The culmination of the researchers’ stay was an excellent dinner hosted at Larry’s country club. Both he and Daniel gave closing speeches, and Larry was gracious in offering thanks to the visitors’ families for allowing them to be away from home for so long. The next day, the researchers departed for San Diego. San Diego The researchers arrived in the beautiful city of San Diego, and after some early confusion (on their part) regarding the correct hotel location, they were safely settled in and having dinner at a local Argentinean restaurant. Although the food was pretty good, the evening will be remembered for the 3-block walk along the highway to get thereda bit farther than they had expected. The host in San Diego was Dr. Peter Newton, and he was exceptional throughout. The first day in the children’s hospital, the researchers attended morning conference rounds followed by presentations. Dr. Chopin gave an excellent talk on the historical basis of sagittal balance and current concepts. Dr. Newton’s research team spoke about their work on rotational changes of the spine in scoliosis
Fig. 2. Scoliosis Research Society traveling fellows with Lawrence Lenke, MD (second from bottom right) and faculty.
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Fig. 3. Scoliosis Research Society traveling fellows and Dr. Peter Newton (right), enjoying fish and chips at San Diego Harbor.
and his work on the anterior tether technique. Dr. Behrooz Akbarnia also attended and gave a superb talk on growing rods, whereas his staff spoke about their experiences with minimally invasive correction for adult deformity. In the afternoon, the visitors were shown around the department by Dr. Burt Yaszay, who has an impressive clinic and EOS machine setup. That afternoon, the researchers watched Dr. Newton perform an impressive adolescent idiopathic scoliosis correction with his colleague, Dr. Salil Upsani. In the evening, the visitors were hosted for dinner with a stunning view of San Diego Bay. The researchers had a long weekend off in San Diego and Peter continued to be a perfect host (Fig. 3). They were taken to the Maritime Museum of San Diego, were given a Mexican dinner at Burt’s beautiful house, watched their first baseball game, and finished off the weekend with dinner at Peter’s beach house watching the sunset on the coast. San Francisco The researchers arrived in San Francisco the next day and were picked up by one of their hosts, Dr. Praveen Mummaneni, who was wearing his scrubs and was coming off work. Later that evening, Dr. Sigurd Berven, the other host, picked up the visitors from their hotel and took them to his home. They had a sushi dinner with some of the other local faculty, and his fellows had arranged for the researchers to view the week’s case presentation. They were in for a busy week with some fascinating cases.
Over the next 4 days, they saw 4 3-column osteotomies, 2 adolescent idiopathic scoliosis corrections (performed by Dr. Mohammad Diab using first-generation USS instrumentation developed in Nottingham), and minimally invasive 4-levels extreme lateral interbody fusion by Dr. Vedat Deviren. It was especially good to see the neurosurgeons and spinal orthopedic surgeons working jointly in the operating room: Dr. Chris Ames and Dr. Vedat combined to perform a nice cervicothoracic osteotomy. On presentation day (Fig. 4), the researchers gave talks: Nasir summarized his experience with primary versus revision 3-column osteotomies in adult patients; and Dr. Berven and his research staff showcased their impressive current projects. The visitors were hosted for dinner on a daily basis by local faculty, with whom they experienced the tremendous variety that San Francisco has to offer. A particular memory is their walk with the knowledgeable and world-wise Mohammad Diab along the Golden Gate Bridge and back, the culmination of which was all 4 people being squeezed into Mohammad’s mini and driven to the dinner venueda la sardines in a tin! A sailing trip organized by one of the newer faculty, boat captain Dr. Murat Parkezi, was simply stunning. On the last weekend, Praveen and Sig hosted the visitors in Napa Valley. They spent too much money at the downtown Apple Store and perhaps had their best steak at a nearby local steakhouse. On the final day, Praveen and his wife hosted the visitors for lunch on San Francisco Bay. The week had been amazingdfull of excellent cases and wonderful evening entertainment in which the researchers were able to spend
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Fig. 4. Scoliosis Research Society traveling fellows with Dr. Sigurd Berven (third from left) and Dr. Praveen Mummaneni (far left).
time with the faculty. Sig and Praveen had organized an excellent program for them. Anchorage The next day, the researchers arrived in Anchorage, Alaska, where they were picked up by Dr. James Eule, their local host, in his impressive Dodge truck. (Take note, Mohammad Diab!) At the dinner, they were hosted by local faculty at the top floor restaurant of the Hotel Captain Cook. This had an impressive view of the city, which the researchers were surprised to learn had a population of approximately 350,000 and another 400,000 who lived in the rest of the state. The hotel was comfortable. The next
day, the visitors attended a presentation conference with the spinal team. After 4 hours of case discussions and presentations, it was time to get some air (literally). James took the visitors on a wonderful adventure in his seaplane. They saw the most breathtaking Alaskan landscape, Naresh got a chance to fly the plane, and they landed on Lake Chitula (Fig. 5). There, they explored the local wilderness, pitched a tent, and had the most exquisite salmon that they had ever tasted. They remained entranced by local stories of moose and bear hunting and living in the bush. That evening, they were flown back to Anchorage and straight to the SRS conference. Stephanie Tesch had been instrumental in logistical and administrative support throughout the trip and was pleased to see the visitors all together safely back and in 1 piece. Scoliosis Research Society Meeting
Fig. 5. Scoliosis Research Society traveling fellows with James Eule, MD. James is in the background unloading the plane while the authors are posing for photos for Daniel.
The 49th SRS meeting in the 49th state was excellent. The researchers were invited to the reception, introduced in the SRS President’s welcome speech, and hosted at the farewell dinner, and Daniel and Nasir had a chance present their traveling fellowship to members at the business meeting. They are incredibly grateful to the SRS committee for giving them this once in a lifetime opportunity. The experience of this traveling fellowship has been invaluable. During that month, they made many wonderful friends and colleagues. They were able to refine their knowledge of surgical techniques and explored common areas of research for continuing collaboration in the future. Among the traveling fellows, they had created a strong bond that they are sure will continue long into the future.
N.A. Quraishi et al. / Spine Deformity 3 (2015) 108e113
Acknowledgment The authors are grateful to the SRS and their host sites programs for this exclusive opportunity to experience spine surgery in North America. In particular, they would like to thank: Frank Schwab and Tom Errico, HJD, New York University Hospital; Michael Vitale, David Roye, Mark Weidenbaum, and Charla Fischer, Columbia University Hospital;
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Lawrence Lenke, Keith Bridwell, Michael Kelly, Jacob Buchowski, and Ron Lehman, BarneseJewish Hospital, St. Louis; Peter Newton, Behrooz Akbarnia, and Salil Upsani, Rady Children’s Hospital, San Diego; and Sigurd Berven, Praveen Mummaneni, Mohammad Diab, Vedat Deviren, Chris Ames, Murat Parkezi, and Dean Chou, University of CaliforniaeSan Francisco.