The Adult Spine Surgery Service provides comprehensive care for a wide range of afflictions involving all areas of the spinal column from the base of the skull to the coccyx. The goal of the program is to provide residents with the broadest possible experience in pathologic conditions related to the spine. The various disorders that are routinely treated include: fractures and dislocations, degenerative disease, spinal deformity, spinal stenosis, benign and malignant tumors, inflammatory spondyloarthropathy and metabolic conditions.

The spine service performs approximately 350 major surgical procedures each year. Both anterior and posterior surgical approaches to the spine are utilized. Anterior approaches are usually performed by the orthopaedic attending with the orthopaedic residents. This further enhances the residents’ experience. A wide variety of both posterior and anterior operative approaches and spinal instrumentation techniques are an integral part of the residency experience. Furthermore, the resident will have the opportunity to participate in microscopically as well as laparoscopically assisted "minimally invasive" surgical procedures.

Outpatient care is a crucial part of the resident experience. Residents take an active role in the clinic, performing initial and follow-up patient evaluations. A thorough understanding of indications for operative and non-operative care is developed. In addition, weekly preoperative indications conferences afford a forum for discussion of surgical indications and techniques. Residents are responsible for organizing this conference which consists of case history presentations along with a review of the pertinent imaging studies of all surgical cases for the following week. Residents also participate in the bi-monthly community spine forum where interesting spinal cases are presented by practitioners in the mid-state area.

Resident responsibility is graduated and progressive. During the PGY II year, the resident is primarily responsible for the inpatient management of the service. Experience is gained in fundamental operating techniques as first assistant/ primary surgeon on basic cases such as primary diskectomies and posterior lumbar fusions. The junior resident can expect to obtain hands-on experience with fundamental techniques such as bone graft harvest, exposure of the posterior spine and insertion of pedicle screws.

During the chief resident rotation, increasing responsibility is given in terms of coordinating and overseeing management of the inpatient service. The resident is provided the opportunity to participate as a first assistant on all complex cases and is given the opportunity to perform the primary portion of most procedures under the direct and constant supervision of the attending physician. By the end of the rotation, the resident will have a thorough understanding of most common orthopaedic spinal problems, be well versed in the alternative treatment choices and confident in an ability to perform a variety of orthopaedic spine procedures.

For more information regarding Penn State Orthopaedics' residency training program, please email the residency program coordinator at OrthoResidency@hmc.psu.edu.