• UCLA Health
  • myUCLAhealth
  • School of Medicine
UCLA Orthopaedic Surgery

UCLA Orthopaedic Surgery

UCLA Orthopaedic Surgery
  • About Us
    • Equity, Diversity & Inclusion
    • Ortho in the News
    • Research Publications
    • Make a Gift
    • Contact Us
  • Patient Resources
    • Request an Appointment
    • Billing and Insurance
    • Health Library
    • Insurances Accepted
    • New Patients
    • Preparing for Your Appointment
    • Preparing for Your Inpatient Surgery at UCLA Santa Monica Hospital
    • Interactive Procedure Videos
    • Maps / Directions
    • Webinars
    • Contact Us
  • Clinical Programs
    • After-Hours Clinic
    • Cerebral Palsy
    • Foot & Ankle Surgery
    • General Orthopaedics
    • Hand Surgery
    • Joint Replacement
    • Oncology
    • Pediatric Orthopaedics
    • Shoulder and Elbow Surgery
    • Spinal Disorders
    • Sports Medicine
    • Trauma
  • Our Locations
  • Research
    • Message from Vice Chair
    • Research Faculty
    • Billi Research Lab
    • UCLA Biomechanics Lab
    • International Skeletal Dysplasia Registry (ISDR)
    • Lyons Research Lab
    • Vitamin D Research Lab
    • Clinical Trials
    • Grants & Awards
    • Musculoskeletal Calendar
  • Education
    • Our Affiliates
    • Visiting MS4 Students
    • Residency Program
    • Fellowships
    • Post-Doctoral Research Training Programs
    • Grand Rounds
    • Alumni
  • Our Expert Team
    • Physicians
    • Physician Assistants & Nurse Practitioners
    • Research Faculty
  • UCLA Health
  • myUCLAhealth
  • School of Medicine

UCLA Orthopaedic Surgery

Spine Surgery Goals and Objectives

  1. Home
  2. Spine Surgery Goals and Objectives

Spine Surgery Goals and Objectives

Share this

Spine Surgery Rotation Educational Objectives 

MEDICAL STUDENTS


To perform a general spine and orthopedic screening exam.

To be able to perform a directed history and physical examination of each of the body areas pertinent to spine surgery with particular attention to the range of motion of the spine, gait, standard reflex, abnormal reflexes, muscle strength and sensory exam.

To demonstrate general understanding of various diagnostic modalities of the spine including xrays, MRI, CT scans.

To present a differential diagnosis of a patient with axial spine pain and/or radiculopathy. To devise a general treatment plan starting with non surgical management to type of surgical management appropriate for a specific spine condition.

 To be able to assess a patient with cauda equina syndrome and to understand spinal emergencies.

 

R-2 RESIDENTS


Medical Knowledge

To be able to differentiate the common spine conditions from each other, e.g. degenerative disc disease, facet arthropathy, neurogenic claudication, spondylolisthesis, and scoliosis.

To describe the various traumatic conditions of the spine. To differentiate the stable and unstable traumatic conditions of the spine.

To be able to devise general treatment modalities for various spinal disorders.

Patient Care and Operative Procedures

To be able to interpret and expand on the radiographic characteristics of the following conditions on plain films:

  • Cervical, thoracic, lumbar Spondylosis
  • Metastatic and infectious disease of spine
  • Fractures of the spine
  • Trauma c-spine series

To examine a spine patient:

Typical Exam Questions as an example outlined below:

Inspection

Disrobe patient, ROM spine, skin for: lipomata, café au lait, birth marks, Faun's Beard, pedunculated tumors, port wine marks. Pathology: spina bifida, neurofibromatosis, diastematomyelia. Posture: scoliosis, Gibbus deformity, excessive lumbar lordosis.

Bony Palpation

Posterior:Seated with patient standing, L4-L5 interspace, S2 spinous process, PSIS line), Coccydinia (Rectal exam), Iliac crests, ASIS, Greater trochanters, ischial tuberosities.

Anterior: Supine with knees flexed, L3-L4 (umbilicus and aortic division), Sacral promontory (most prominent),

Soft Tissue Palpation

Supraspinous ligaments (interspinous non-palpable)
Paraspinal muscles: extend back to relax fascia
Iliac Crest region: Gluteal muscles, cluneal nerves, fatty nodule under crest rim
Post superior iliac spine region: sacral triangle, sacrotuberous, sacrospinous
Sciatic area: midway between ischial tuberosity and greater trochanter
Anterior abdominal area and inguinal area

Range of Motion

Flexion: fingers to floor distance with knees straight
Extension: estimate extension; increased pain with spondylolisthesis
Lateral bending: coupled with rotation, note discrepancy between L and R
Rotation: stabilize pelvis with one hand and rotate patient with other hand

Neurologic Exam

Sensory, Motor and Reflex exam of the cervical and lumbar nerve roots.

As it relates to surgical procedures:

To be able to explain surgical indications based on history and exam findings. To be able to first assist in the surgical exposure of the cervical, thoracic and lumbar spine, understand bony and anatomic landmarks used in these exposures. To be able to obtain various types of autogenous bone graft from the iliac crest and to fashion various allograft bone samples for implantation, while minimizing operative time and blood loss. To be able to apply cervical spine stabilization (halo vest) with the supervision of the senior resident or the spine fellow.

 

R-4 RESIDENTS

Medical Knowledge

To construct a differential diagnosis of a spine patient and to order the tests appropriate to refine the diagnoses

Practice-Based Learning and Improvement

To articulate specific treatment approaches and their alternatives based on the strength of the literature evidence and applicability to a specific patient.

To elucidate current treatment concepts for the spine patients based on the diagnosis.

Systems-based Practice

To organize and manage the clinic environment

Develop an operative schedule in consultation with the Attending Surgeon and Fellows

Assess patient load and complexity

Evaluate the specific abilities of clinic staff and junior residents

Delegate responsibilities to junior team members based on their specific abilities.

Monitor and adjust work flow

Supervise patient care including chart reviews

Organize weekly academic conference

Practice-based Learning and Improvement

To participate in advanced diagnostic work ups

Perform and interpret xrays of the spine

Interpret complex MRI and CT studies

Discuss cases in relation to recent literature on the subject.

Interpersonal and Communication Skills

To be able to interact skillfully with the staff and community

Assess special equipment needs

Conduct equipment safety checks.

Patient Care and Operative Procedures

To be able to transcend what is published and create a surgical solution as required by specific circumstances.

To be able to first assist in complex procedures utilizing and directing assistants, while minimizing operative time and blood loss. Typical procedures would include:

  • Patient positioning and preparation for spinal surgery including application of Mayfield frame and Gardner-Wells tongs.
  • Posterior Cervical, Thoracic and Lumbar decompression including microdiscectomy and laminectomy (both open and minimally invasive techniques)
  • Cervical laminoplasty
  • Posterior Cervical, Thoracic and Lumbar fusion surgery with and without instrumentation
  • Spinal deformity surgery for scoliosis in children, adolescents and adults
  • Percutaneous pedicle screw placement
  • Anterior cervical, thoracic, lumbar discectomy and or corpectomy with grafting and instrumentation for treatment of degenerative disc disease, spondylosis, osteomyelitis, epidural abcesses or tumor metastasis
  • Posterior lumbar interbody fusion, PLIF or TLIF using both open and minimally invasive techniques
  • Spinal arthroplasty and disc replacement surgery
  • Surgical treatment of compression fractures using the minimally invasive vertebroplasty and kyphoplasty techniques.
  • Initial care, management and surgical treatment of various spinal trauma conditions.

 

Like Us on Facebook Follow Us on Twitter Subscribe to Our Videos on YouTube Follow us on Instagram Connect with Us on LinkedIn Follow us on Pinterest
UCLA Health hospitals ranked best hospitals by U.S. News & World Report
  • UCLA Health
  • Find a Doctor
  • School of Medicine
  • School of Nursing
  • UCLA Campus
  • Directory
  • Newsroom
  • Subscribe
  • Patient Stories
  • Giving
  • Careers
  • Volunteer
  • International Services
  • Privacy Practices
  • Nondiscrimination
  • Billing
  • Health Plans
  • Emergency
  • Report Broken Links
  • Terms of Use
  • 1-310-825-2631
  • Locations / Directions
  • Contact Us
  • Your Feedback
  • Report Misconduct
  • Get Social
  • Sitemap
Like Us on Facebook Follow Us on Twitter Subscribe to Our Videos on YouTube Follow us on Instagram Connect with Us on LinkedIn Follow us on Pinterest

Sign in to myUCLAhealth

Learn more about myUCLAhealth