The Neurosurgical Spine Fellowship in the Department of Neurosurgery at Washington University School of Medicine is a one-year, intensive fellowship in the surgical treatment of disorders of the spine and spinal cord. Dr. Paul Santiago, MD, is the director of the Neurosurgical Spine Fellowship. Additional faculty include Ian Dorward, MD, Camilo Molina, MD, Brenton Pennicooke, MD and Wilson Z. Ray, MD.
The fellowship has three main concentrations:
- Clinical experience
Our complex spine surgeons have busy spine practices covering the entire range of disorders of the spine and spinal cord. Approximately 1,200 to 1,500 spine cases are performed annually within the Spine Division, with more than 1,300 new outpatient consults seen each year.
Disorders of the craniocervical, cervical, thoracic, lumbar and sacral spine are treated. Although the majority of the cases are degenerative in etiology, ample exposure is given to tumors of the spine and spinal cord, infection, congenital spinal disorders, trauma and inflammatory disorders. Because Washington University receives many tertiary referrals, fellows see ample rare pathology.
The neurosurgical spine fellow will become adept at all aspects of spinal surgery, including instrumentation of the craniocervical, cervical, thoracic and lumbosacral spine, from both anterior and posterior approaches. Because of the tertiary referrals seen at Washington University, the fellow will participate in a significant number of atlantoaxial cases. The spine fellow also will become comfortable with minimally invasive spine surgery, including diskectomies and fusions.
Inpatient clinical exposure is abundant and allows the fellow to interact with the neurosurgical residents. The fellow is expected to have complete knowledge of the inpatient spine census and determine proper management of these patients in conjunction with the attending spine surgeon and resident physicians. Consults arising from inpatient services or the emergency room will be seen by the spine fellow in conjunction with the neurosurgical residents.
Trauma call is shared with orthopedics on alternating weeks. This shared call applies only to emergency department consults. Neurosurgery is always on call for any other inpatient consult not arising from the emergency department.
Each spine surgeon has at least two days of outpatient clinic each week. All patients seen by the fellow are reviewed by the appropriate spine surgeon, with ample time allowed for discussion and teaching. A rotating schedule allows equal time in the operating room and clinic.
At the conclusion of the fellowship year, the fellow will have mastered patient selection for surgery, operative decision-making, the technical details of spine surgery including instrumentation and minimally invasive approaches, and care of the perioperative spine patient.
Research and Teaching Experience
Combined neurosurgical and orthopedic spine conferences are held routinely, and a spine fellow teaching seminar occurs once a week. Discussion and didactic lectures are provided to the fellows and spine residents to discuss complex cases and ongoing research. The Neurosurgery Department enjoys an excellent relationship with orthopedic spine faculty members, with shared fellow education.
The fellowship concentrates mostly on clinical research, although basic science research opportunities through the Washington University School of Medicine are ample. The fellow is encouraged to aid the residents in their research interests as well as teaching. A cadaveric anatomy lab is available for use by the fellow. The amount of time dedicated for research is flexible. The fellow is funded for any meetings in which research or data have been accepted for publication.
Each fellow is expected to submit several papers and/or chapters for publication during their fellowship year. Topics will be selected by the fellow and Drs. Santiago and Ray at the beginning of his or her training.
Eligibility Criteria and Contact
Applicants must have completed an ACGME-approved neurosurgery residency training program in the United States or Canada before the start of the fellowship program, or meet the criteria for an unrestricted (non-training) Missouri medical license. A personal visit to our department and an interview are required. Interested applicants should apply two years prior by sending a cover letter and curriculum vitae.