... with the help of a few well-wishers I was able to arrange a training programme in Spine Surgery at the Group Hospital Pellegrin, Bordeaux, France under Prof. Jean Marc Vital. I would like to thank the International Group for Advancement of Spine Surgery (IGASS) for its help in identifying this spinal centre for my fellowship training. My special thanks to Anke Huber-Jerome, Co-ordinator, IGASS for meticulously arranging the training programme.

I was able to observe the following spinal surgeries which were very useful in furthering my knowledge in spinal surgery

• Cervical disc replacement for cervical disc disease
  
• Surgical decompression for degenerative spinal stenosis,
  
• Lumbar micro discectomy,
  
• Transoral odantoid biopsy,
  
• Anterior cervical fusion,
  
• Lateral mass stabilization –cervical spine,
  
• Anterior deformity correction for scoliosis,
  
• Posterior deformity correction for dorsolumbar scoliosis.
  
• Spinal tumour surgeries.

In all my fellowship visit to Bordeaux, France was very memorable both academically and in experience.

Dr.Nalli.R.Uvaraj,
Associate Professor of Spine Surgery,
Madras Medical College, Chennai 600003, India.

... the offer through IGASS, to visit some of the reputed spine centers in Europe was irresistible. The final push to go ahead, came in the form of the wonderful organizational work and coordination by the IGASS office, to whom I am very grateful.

The work schedule during two weeks in Bordeaux with Prof. Jean-Marc Vital was quite busy and interesting. During this period, I had the opportunity to watch some interesting surgeries like odontoid fixation, C1-C2 posterior stabilization, revision for pseudoarthrosis in scoliosis and numerous cases of TLIF / PLF for degenerative disease of the LS spine. My surgical armamentarium has been enhanced by the exposure to Dr. Pointillart’s anterior approach to the cervico-thoracic junction, which I observe at this center.

At the Guy’s and St Thomas’s hospital in London, Mr. Khai Lam was an amazing host and he had stream-lined all aspects of my visit. He had arranged for me to spend time with the senior spine consultant Mr. Johnathan Lucas, with whom I attended a clinical meet at the Queens Park National Center for Neurology and Neurosurgery. I also was allowed to actively participate in Mr. Lucas’s Scoliosis clinic at the Evelina Children’s Hospital, where I could see the entire gamut of scoliosis cases – predominantly neuromuscular scoliosis.

…third leg of my trip was at the Charite Hospital, in Berlin, where I spent a week with Dr. Putzier and his team. I assisted in a wide variety of cases like: a 4 level ACDF without plating for a spondylotic Myelopathy; ALIF; and hemi-vertebrectomy for congenital scoliosis. An interesting learning experience at this center was the augmentation of a pedicle screw with PMMA in osteoporotic bone, about which I had read and heard about and Dr Putzier gave a very good demonstration of the technique.

… at the Institut Calot, in Berck-sur–Mer, France with Dr Daniel Chopin I got the opportunity to watch an in-situ fixation for a spondyloptosis L5-S1, with the addition of iliac screws, and another case of revision scoliosis.

On the whole, the entire programme was a very good learning experience for a young surgeon like me. It gave me a good exposure to the happenings outside my country, the work culture, and their thought processes. It also exposed me to the latest developments in technology in terms of instrumentation, the use of BMP and hospital infra-structure.

Dr. K. Narayana Acharya
Consultant Spine Specialist,
Dwaraka Institute of Spine Care, BMA Road, Gandhinagar,
Bellary – 583013 Karnataka, India

... fulfilled in the CHU of Bordeaux, I attended the Prof. Vital's activities, where I acquired interesting concepts of the dynamical stabilization for lumbar spine, cervical discopathies treated with disc prosthesis, and the new trans spinous approach for lumbar economic decompression, previously described for Japanese authors.
 
I am grateful for the Vital Prof and his team for his disposition to teach, and to the IGASS, specially Dr Chopin and the IGASS Coordinator Ms. Anke Huber, for the possibility of this fellowship.

Dr. Santiago Balderrama, Spine surgeon, Argentina