Spine Fellowship

Through a well-rounded and structured schedule, our program offers a balanced exposure to clinic, operating room, and research. Unique to our institution is the synergistic and integrated relationship between the orthopedic and neurosurgical spine surgeons, which allows exposure to the complete spectrum of spinal disorders including trauma, degenerative conditions, deformity, and tumors. Our fellows have ample opportunities to learn ‘bread and butter’ spine procedures as well as complex cases. Upon completion of the fellowship, graduates should be comfortable diagnosing and treating the complete spectrum of spinal problems from the occiput to the sacrum.

The Rothman Orthopaedic Institute/Thomas Jefferson University Spine Fellowship accepts 4 fellows: 3 clinical and 1 research/clinical (two-year track).

In addition to a robust spine surgery experience, fellows enjoy 3-4 social events hosted by the attendings in their homes. Fellows are also invited to participate in the annual Jefferson Spine Surgery Fellowship Alumni Symposium held in July in Newport, RI.

Alan S. Hilibrand, MD
925 Chestnut St, 5th Floor
Philadelphia PA 19107

Alexander R. Vaccaro, MD, PhD, MBA
925 Chestnut St, 5th Floor
Philadelphia PA 19107
 

Rotation Schedule

Case Breakdown (2014-2015 Fellows)

Indications Conference “aka Bone Board”
At 6:45am each morning the orthopaedic and neurosurgery spine services have a combined conference to review the consults and trauma cases from the previous day. During this conference indications and treatment plans are discussed. Additionally, elective cases for that day are reviewed and postoperative films from the previous day are evaluated.

Call
The orthopaedic and neurosurgery spine services work closely together to manage spine consults and trauma patients. The services alternate weeks of primary (vs. backup) spine call. Spine fellows are expected to take call and are the initial contact for the orthopaedic residents in managing these patients. The fellows coordinate the call schedule generally taking call a week at a time and dividing up primary call and backup call evenly.

The Rothman Orthopaedic Institute Spine Service has a strong tradition of academic excellence. A recent publication in The Spine Journal1 found that the Rothman Faculty published more research (161 articles, 26.8 per faculty member) with a higher h-index (8.2) than any other academic institution from 2011-2014.  Members of the faculty are members/leaders of national spine societies. Spine fellows are encouraged to become active members of the research team and are required to complete two original research projects. The Rothman Orthopaedic Institute has a robust research department with several research assistants, statisticians, database managers, clinical trial and IRB managers and staff dedicated to assisting with research projects.

The Rothman Orthopaedic Institute accepts one applicant into a two-year fellowship track. The first year is spent doing clinical and basic science research. The fellow leads the spine team working with the various resources in the research department. The second year is a standard clinical fellowship.

Weber H. Lumbar disc herniation. A controlled, prospective study with ten years of Observation Spine. 1983 Mar;8(2):131-40.

Fischgrund JS, Mackay M, Herkowitz HN, Brower R, Montgomery DM, Kurz LT. 1997 Volvo Award winner in clinical studies. Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective, randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation. Spine. 1997 Dec 15;22(24):2807-12.

Nurick S. The natural history and the results of surgical treatment of the spinal cord disorder associated with cervical spondylosis Brain. 1972;95(1):101-8.

Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH. Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am. 1999 Apr;81(4):519-28.

Lenke LG, Betz RR, Harms J, Bridwell KH, Clements DH, Lowe TG, Blanke K. Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am. 2001 Aug;83-A(8):1169-81.

Wiltse LL, Newman PH, Macnab I. Classification of spondylolisis and spondylolisthesis. Clin Orthop Relat Res. 1976 Jun;(117):23-9.

Hirabayashi K, Watanabe K, Wakano K, Suzuki N, Satomi K, Ishii Y. Expansive open-door laminoplasty for cervical spinal stenotic myelopathy. Spine. 1983 Oct;8(7):693-9.

Bracken MB, Shepard MJ, Holford TR, Leo-Summers L, Aldrich EF, Fazl M, Fehlings M, Herr DL, Hitchon PW, Marshall LF, Nockels RP, Pascale V, Perot PL Jr, Piepmeier J, Sonntag VK, Wagner F, Wilberger JE, Winn HR, Young W. Administration of methylprednisolone for 24 or 48 hours or tirilazad mesylate for 48 hours in the treatment of acute spinal cord injury. Results of the Third National Acute Spinal Cord Injury Randomized Controlled Trial. National Acute Spinal Cord Injury Study. JAMA. 1997 May 28;277(20):1597-604.

Kirkaldy-Willis WH, Wedge JH, Yong-Hing K, Reilly J. Pathology and pathogenesis of lumbar spondylosis and stenosis. Spine. 1978 Dec;3(4):319-28.

Ferguson RL, Allen BL Jr. A mechanistic classification of thoracolumbar spine fractures. Clin Orthop Relat Res. 1984 Oct;(189):77-88.

Boden SD, Dodge LD, Bohlman HH, Rechtine GR. Rheumatoid arthritis of the cervical spine. A long-term analysis with predictors of paralysis and recovery. J Bone Joint Surg Am. 1993 Sep;75(9):1282-97.

Waddell G, McCulloch JA, Kummel E, Venner RM. Nonorganic physical signs in low-back pain. Spine. 1980 Mar-Apr;5(2):117-25.

Denis F. The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine. 1983 Nov-Dec;8(8):817-31.

Weinstein JN, McLain RF. Primary tumors of the spine. Spine. 1987 Nov;12(9):843-51.

Fritzell P, Hagg O, Wessberg P, Nordwall A; Swedish Lumbar Spine Study Group. 2001 Volvo Award Winner in Clinical Studies: Lumbar fusion versus nonsurgical treatment for chronic low back pain: a multicenter randomized controlled trial from the Swedish Lumbar Spine Study Group. Spine. 2001 Dec 1;26(23):2521-32; discussion 2532-4.

Weinstein JN, Toseteson TD, Lurie J, Tosteson AN, Blodd E, Hanscom B, Herkowitz H, Cammisa F, Albert, T, Boden SD, Hilibrand A, Goldberg H, Berven S, An HS: Surgical versus nonsurgical therapy for lumbar spinal stenosis. N Eng J Med 358:794-810, 2008.

Weinstein, J. N.,Lurie, J. D.,Tosteson, T. D.,Hanscom, B.,Tosteson, A. N.,Blood, E. A., Birkmeyer, N. J.,Hilibrand, A. S.,Herkowitz, H.,Cammisa, F. P.,Albert, T. J.,Emery, S. E. Lenke, L. G.,Abdu, W. A.,Longley, M.,Errico, T. J.,Hu, S. S. Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis. N Eng J Med 356:2257-70, 2007.

Weinstein, J. N., Tosteson, T. D.,Lurie, J. D.,Tosteson, A. N.,Hanscom, B.,Skinner, J. S. Abdu, W. A.,Hilibrand, A. S.,Boden, S. D.,Deyo, R. A.: Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT): a randomized trial. JAMA 296: 2441-50, 2006.

Vaccaro AR, Kepler CK, Kopjar B, Chapman J, Shaffrey C, Arnold P, Gokaslan Z, Brodke D, France J, Dekutoski M, Sasso R, Yoon ST, Bono C, Harrop J,Fehlings MG.Functional and quality-of-life outcomes in geriatric patients with type-II dens fracture. J Bone Joint Surg Am. 2013 Apr 17;95(8):729-35.

Vaccaro AR, Lehman RA Jr, Hurlbert RJ, Anderson PA, Harris M, Hedlund R, Harrop J, Dvorak M, Wood K, Fehlings MG, Fisher C, Zeiller SC, Anderson DG,Bono CM, Stock GH, Brown AK, Kuklo T, Oner FC. A new classification 

of thoracolumbar injuries: the importance of injury morphology, the integrity of the posterior ligamentous complex, and neurologic status. Spine (Phila Pa 1976). 2005 Oct 15;30(20):2325-33.

For additional information or any questions, contact:

Kelly Quici
Resident, Fellowship and Medical Student Coordinator
Rothman Orthopaedic Institute
925 Chestnut Street, 5th Floor
Philadelphia, PA 19107 
Phone: 267-297-2440
kelly.quici@rothmanortho.com