Schulich school of Medicine and Dentistry logo Clinical Neurological Sciences Schulich School of Medicine & Dentistry

Spine

Description

The spine group is a multidisciplinary team of experts with experience ranging from minimally invasive techniques and complex surgical interventions with instrumentation to non-surgical management of spinal disorders. Neurosurgeons work as part of a team, collaborating with their colleagues in various disciplines including neurology, radiology, anesthesiology, physiatry, and physical medicine to optimize expertise. The result is a superior spine program that offers new surgical and diagnostic technologies and methods to improve the health and productivity of individuals with spinal disorders.

A leader in spinal surgery, London Health Sciences Centre was the first to successfully perform an artificial disc replacement in Canada in 2002.

Training Opportunities

Residents

Neurosurgery residents will graduate with a the following proceedural skills:

  • Patient positioning, prepping, and draping for anterior and posterior spine surgery
  • Proficiency in applying external fixation devices for cervical traction.
  • Bone graft harvesting techniques
  • Posterior spinal approaches
  • Recognize and manage common post-operative complications and initiate treatment

Neurosurgery Residents will also be able to:

  • Recognize emergency conditions (specifically acute cauda equina syndrome, acute
    neurological deterioration, acute traumatic spinal cord injury) with accurate prioritization
  • Recognize the significance of injury in high-risk spinal conditions such as osteoporosis,
    inflammatory arthropathies, DISH and ankylosing spondylitis.
  • Record a complete, accurate, well-organized history specific for disorders involving the
    spinal column and associated neurological conditions with an emphasis on understanding
    the patient’s context and preferences. In addition, appreciate the impact of the spinal
    disorder on the patient's quality of life, and function.
  • Perform a specific and complete physical exam for the entire spinal column and
    associated neurological structures with an emphasis on the assessment of deformity and
    dysfunction for the individual patient.
  • Develop an effective differential diagnosis based on information gathered on history and
    physical examination.
  • Understand and advise patients regarding non-surgical treatment options.
  • Formulate a management plan including appropriate frequency and goals of outpatient
    follow-up for patients managed surgically and non-surgically.
  • Participate in pre-operative planning for patients scheduled for surgery.
  • Understand the indications for spine surgery relative to the affecting pathophysiology.
  • Understand the risks, complications and expected outcomes of common spine procedures.

Neurology residents will develop an approach to the assessment, investigation, and emergency management of patients presenting with:

  • Back pain
  • Orthopedic trauma
  • Spinal cord injury

Learn more about CNS Residency programs.

Post graduate, Graduate, Undergraduate

Dr. Duggal and Dr. Ng both supervise undergraduate medical students, graduate students, residents and fellows in each of their areas of research. CNS offers training opportunities for residents in spine and peripheral research. Opportunities for MSc, PhD, and Postdoctoral candidates are also available upon request. Most recently, Dr. Duggal has acted as a primary supervisor to a resident conducting research on DTI of spinal cord compression and to a PhD candidate conducting research on spinal cord compression using fMRI.

Research Opportunities

If you are interested in conducting spine research or are interested in assisting in ongoing research by our faculty, visit their bio pages for information on their specific research interests and how to get in touch.

Recent Spine Publications

Bierer J, Wolf A, Lee DH, Rotenberg BW, Duggal N. Bilateral caudate nucleus infarcts: A case report of a rare complication following endoscopic resection of a tuberculum sellae meningioma. Surg Neurol Int. 2017 Sep 26;8:235. doi: 10.4103/sni.sni_192_16. eCollection 2017. PubMed PMID: 29026671; PubMed Central PMCID: PMC5629865.

Aleksanderek I, Stevens TK, Goncalves S, Bartha R, Duggal N. Metabolite and functional profile of patients with cervical spondylotic myelopathy. J Neurosurg Spine. 2017 May;26(5):547-553. doi: 10.3171/2016.9.SPINE151507. Epub 2017 Feb 3. PubMed PMID: 28156205.

Aleksanderek I, McGregor SM, Stevens TK, Goncalves S, Bartha R, Duggal N. Cervical Spondylotic Myelopathy: Metabolite Changes in the Primary Motor Cortex after Surgery. Radiology. 2017 Mar;282(3):817-825. doi: 10.1148/radiol.2016152083. Epub 2016 Sep 30. PubMed PMID: 27689923.

Radovanovic I, Urquhart JC, Rasoulinejad P, Gurr KR, Siddiqi F, Bailey CS. Patterns of C-2 fracture in the elderly: comparison of etiology, treatment, and mortality among specific fracture types. J Neurosurg Spine. 2017 Aug 18:1-7. doi: 10.3171/2017.3.SPINE161176. [Epub ahead of print] PubMed PMID: 28820364.

Cushnie D, Urquhart JC, Gurr KR, Siddiqi F, Bailey CS. Obesity and spinal epidural lipomatosis in cauda equina syndrome. Spine J. 2017 Jul 26. pii: S1529-9430(17)30498-9. doi: 10.1016/j.spinee.2017.07.177. [Epub ahead of print] PubMed PMID: 28756300.

Staudt MD, Bailey CS, Siddiqi F. Charcot spinal arthropathy in patients with congenital insensitivity to pain: a report of two cases and review of the literature. Neurosurg Rev. 2017 Jan 26. doi: 10.1007/s10143-017-0814-3. [Epub ahead of print] Review. PMID:28124176

Faculty

Neurosurgeons