MESSAGE FROM THE CO-DIRECTORS

Mar 25, 2018

Colleagues,

This year the University of Toronto Department of Surgery Spine Program celebrates its 9th Annual Acedemic Day "SpineFEST". It has been a productive academic year as our program continues to foster important citywide collaborations within the university as well as participate and lead on several key regional and international initiatives. 

As a program, we benefit from the ongoing strong support of our University Department of Surgery, and Divisions of Neurosurgery and Orthopaedics.  We value the clinical, research and education expertise of our citywide faculty and trainees in support of our important Program Council, Research and Education Committee activities.  Key collaborators from spine community and industry also continue to help nurture growth in our academic program. 

In Fall 2016 the Program, in collaboration with the Krembil Neuroscience Centre, celebrated the 15th anniversary of the Tator-Turnbull Lectureship as we had an interesting and rather inspiring lecture by our visiting professor Dr Claes Hultling from the Karolinska Institute. Dr Hultling himself is a quadriplegic as well as an innovative rehabilitation physician and researcher. The Symposium was particular special with moving tribute to Barbara Turnbull and dedication of one of the spinal cord injury lab investigator offices, that belonging to Dr Charles Tator, in Barbara’s name. Dr Hultling also engaged us in stimulating discussions in our U of T GTA Spine Rounds as he shared with us his extraordinary passion for an extraordinary, yet a challenged life. This May, we have partnered the Ontario Neurotrauma Foundation, Canadian Spinal Cord and Ontario Spinal Cord Injury to conduct a successful combined meeting of Spinal cord injury and update about the clinical and preclinical spine research.

In education and teaching, we have had an active year which continues to focus on excellence in fellowship and resident education.  We held our third annual joint citywide Orthopaedics & Neurosurgery Royal College of Physician and Surgeon’s of Canada (RCPSC) Mock Oral Prep Course for senior university resident trainees.  In particular, we acknowledge the significant contributions to the success of this meeting by our citywide spine fellows, led by Drs Jean-Christophe Murray, Kyle Stampe, and Mario Ganau whose time in preparation of the cases as well as valuable practical tips were well received by the residents.  At the fellowship level, selective rotation/observership opportunities have been offered to incoming fellows over the past years, with some fellows choosing to pursue this added educational offering.  Our fellowship education working group has initiated a successful two-year fellowship pilot with a second year focused on subspecialty of spine surgery. This opportunity builds upon competencies that may be acquired during a general first fellowship year, followed by a second year catered to advanced/focused competencies. This is also complemented by our citywide fellow surgical case-log program that is also based upon our national training competencies.  Our Journal Club has been accredited by the Royal College of Physician and Surgeon of Canada. We are pleased with our citywide clinical fellows who have taken on important leadership roles in organizing and hosting the journal clubs throughout the year. Many thanks to our fellows for leading the journal clubs; Dr So Kato and JC Murray have discussed interesting papers and cases on Cervical Spine deformity, also Drs Amit Kern, Kyle Stampe, and Gary Rosenberg facilitated exciting discussions on two sides of a study “SLIP” and their controversial outcomes.

Special thanks to Dr Stephen Lewis for organizing an exceptional surgical skills course for our new citywide incoming fellows.  The course was followed by a welcome dinner combined with research update meeting to expose our new fellows to our current cityside spine research project. We thank Drs Carlo Ammendolia and Karl Zabjek for organizing such a successful meeting.

From a clinical research perspective, The Program continues to serve as an academic hub to foster collaborative efforts in facilitating international multi-centre clinical trials and data sharing agreement between the main hospitals. Among of which, the Riluzole in Spinal Cord Injury Study (RISICS) which is principally sponsored by AOSpine North America. RISCIS is launched to evaluate efficacy and safety of Riluzole in improving neurological motor outcomes of patients with acute spinal cord injury. The study is still accepting new centers worldwide and recruiting locally at TWH, SMH, and SHSC.  The INSPIRE Study: Probable Benefit of the Neuro- Spinal Scaffold for Treatment of AIS A Thoracic Acute Spinal Cord Injury is also currently recruiting  internationally,  and locally at TWH and SMH,  to evaluate whether the scaffold is safe demonstrates probable benefit for the treatment of complete T2-T12/L1 spinal Cord injury. We are also pleased with the success of the Lumbar Spinal Stenosis Study which has achieved the enrolment target. The study is to examine the improvement of walking in patients who undergone a comprehensive program including a twice-a-week therapy. On the side of Metastatic Tumor Research, the Epidemiology, Process and Outcomes of Spine Oncology (EPOSO), is set to determine the efficacy of surgery versus radiotherapy for the treatment of impending instability secondary to metastatic disease of the spine. SHSC and TWH have been high accruing centers for EPISO and recruitment is near closing.

In patient care advocacy and global efforts, Drs Albert Yee and Michael Fehlings are working with AO Spine North America to more broadly disseminate knowledge gained from our national competence based training education efforts. In similar perspective, the Program co-hosted an international annual meeting with the Cervical Spine Research Society (CSRS) in Nov/Dec last year in Toronto with excellent showcase and representations from our program and local spine community. In a productive platform on the side of CSRS meeting, we also partnered with AO Spine International and Rick Hansen Institute to put forward implementations of the Guidelines we have developed in the past couple of years for Acute Spinal Cord Injury (ASCI) and Cervical Spondylotic Myelopathy (CSM). This comes as an initiative to enhance quality of care by establishing clinical protocols for management of patients with ASCI, and aid clinicians in evidence-based decision making based on recommendations for important and controversial areas of ASCI management. Interestingly, our “Time is Spine” concept, in which we stress on early surgical decompression to improve outcomes from spinal cord injuries, has been highlighted by the Spine Summit and Spine Universe, supported as AOSpine guidelines, and is being considered for teaching as AO principle. Our program continues each year to draw the Scoliosis Research Society traveling fellows and award winners. This year we hosted Dr Tushar Rathod as he spent his SRS Globus Medical Fellowship at TWH and SickKids, we will also be hosting an additional SRS award winner this November. We are very excite about hosting the Neurotrauma2018 Symposium in Toronto August 11-16 2018  at the Westin Harbour Castle Hotel. We are also looking forward to host the 2019 Global Spine Congress in Toronto in Spring 2019; a vibrant international spine conference which is anticipated to attract over 1500 delegates.

On December 4, 2017 we will be conducting our Strategic Planning retreat and we are pleased to invite our program faculty and trainees to this meeting. The retreat will inform the strategic directions for our program over the next 3 years with focus on three themes which are central to the mission of the UofT Spine Program: fellowship and training; integration of clinical care and enhancement of clinical programs and inter-institutional translational research.

In closing, we would like to thank all our program members and partners for their support over the years. We are privileged to benefit from the diverse and specialized expertise of our program members. We also thank Ms. Nadia Jaber, our program coordinator that has been instrumental in moving forward our collaborative agenda.

We are very excited about our SpineFEST keynote speaker Professor Zoher Ghogawala from Tufts University School of Medicine. He is a world renowned neurosurgeon, researcher,  and an engaging speaker. We invite you all to join us in welcoming Dr Ghogwala and learn about “The search for Truth in Spinal Surgery”.

Sincerely,

Michael & Albert

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