Hospital das Clinicas—Sao Paulo, Brazil

Address:
Instituto de Ortopedia e Traumatologia - HCFMUSP 
Rua Ovidio Pires de Campos, 333.
CEP 05403-010 São Paulo
Brasil

Phone: +55 11 2661-6951
Email
Web

Spine Center Director:
Alexandre Fogaça

Team member:
Tarcisio Barros Filho
Raphael Marcon
Reginaldo Oliveira
Eduardo Von Uhlendorf
Roberto Basile Junior
Fernando Pedrosa


Center description

University of Sao Paulo (USP) is the biggest university in Brasil, with the higher number of peer-reviewed publications in the country. Our Orthopedic Department is located at the Hospital das Clinicas complex, a “city inside a city”. This complex has eight buildings, two thousand beds (expanding to 2500) and is a national and Latin America reference center for trauma, tumor, heart diseases, children and many others specialties, including spine surgery. One of the buildings is our department, with 250 beds, 10 UCI beds, MRI and CT-Scan just for orthopedic patients, 11 OR Surgical Center. There are other 8 MRI and 8 CT-scans in the complex.

Department of spine pathology

The spine unit has 25 beds, a multidisciplinary team for medullar lesion patients and a administrative area in the second floor including a fellow and resident room with internet, publications access and office (including locker) facilities. A meeting room (15 people) with wireless internet, presentation facilities are also available exclusively for the spine unit, as one administrative secretary and one research secretary. Our institution offers a statistics and research support. The head of the orthopedic department is a spine surgeon and also vice-director of the Medical School. Last year he was the president of the Brazilian Orthopedic Society. He will be our program director.

Most frequent pathologies

Trauma, Degenerative, Tumor.

Procedures

Approximately 700 procedures performed per year

  • Cervical deformity
    Adult cervical reconstruction 
    Basilar invagination reconstruction 
    Paediatric cervical reconstruction

approx. 2 per year
approx. 1 per year
approx. 2 per year

  • Cervical trauma 
    Cervical stabilization

approx. 2 per week
  • Cervical tumor 
    Cervical tumor surgery

approx. 2 per month
  • Degenerative cervical spine 
    Anterior foraminotomy
    Cervical stabilization
    Laminoplasty 
    Posterior foraminotomy
    Total disc replacement

approx. 1 per week
approx. 2 per week
approx. 2 per year
approx. 3 per year
approx. 1 per month
  • Degenerative lumbar spine 
    ALIF
    Microsurgical disc surgery
    Microsurgical spinal stenosis
    Open stabilization 
    Percutaneous stabilization
    TLIF
    Total disc replacement

approx. 2 per year
approx. 2 per year
approx. 1 per week
approx. 2 per week
approx. 2 per month
approx. 1 per month
approx. 1 per year
  • Osteoporotic spine 
    Kyphoplasty 
    Vertebroplasty

approx. 1 per month
approx. 1 per month
  • Rheumatoid cervical spine 
    C1/C2 stabilization 
    Craniocervical stabilization

approx. 1 per month
approx. 2 per year
  • Special procedures  
    Cervical laminoplasty
    Cervical pedicle screw procedures
    Congenital deformities
    High grade spondylolisthesis / spondyloptosis 
    Navigation procedures (CT-based, Fluoro ISO C)
approx. 1 per month
approx. 1 per month
approx. 3 per year
approx. 2 per year

approx. 2 per year

Fellowship types

Observerships, Short-term

Language requirements

English, Portuguese, Spanish

Vacancies per year:

Short Term: 1 per period/year

Fellowship Start

Short Term:  in January

Special requirements

No special requirements

Program Characteristic:

Objectives

At the end of our program the fellow should be able to:

  1. Recognize, classification and give directions to treatment of patients with spinal trauma.
  2. Complete a neurologic and orthopaedic exam in spinal trauma patients.
  3. Evaluate a spine MRI Scan and CT-scan in Spine.
  4. Recognize risks and possible complications in spine trauma surgery.
  5. Operate less complicated cases of lumbar and cervical trauma. ( posterior fixation with lumbar pedicle screws and cervical lateral mass screws).
  6. Participate in our studies.

Methodology

1. Offices:

Goals:

  • Evaluate and understand clinical and behaviour pathologies in spine diseases.
  • Indicate the best exam and indicate the appropriate treatment.
  • Recognize surgical pathologies.

The fellow will be allowed to participate in our appointments and discuss the treatment indication.

2. Spine unit patients

Goals:

  • Observe post-op patients, complications and evolution.
  • Participate in protocol registration and documentation.
  • Recognize clinical and surgical complications and understand the initial treatment directions

3. Operation rooms

Goals:

  • “Scrub in” fellowship
  • Assist simple and complex spine surgeries
  • Perform patient positioning and preparation
  • Perform less difficult instrumentation and surgeries.( under supervision and depending on demand and surgical skills)
  • Fill out protocols studies papers.
  • Indicate and sometimes perform surgical accesses.

Timetable

Full-time regime Monday to Friday 07.30 am to 19.30 pm. Saturday 08.00 am to 12.20pm Cadaver labs.

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