Spine
SPINE Volume 39, Number t l , pp 858-860 ©20t4, LIppincott Williams & Wilkins
TRAVELING FELLOWSHIP
Report of the 2012 Globus International Clinical Traveling Fellowship of the International Society for the Study of the Lumbar Spine (ISSLS) Taopheeq Bamidele Rabiu, FWACS
INTRODUCTION From December 1, 2012 to February 28, 2013,1 underwent training under Prof. Wilco C. Peul at the Leids Universitair Medisch Centrum (LUMC), Leiden and the Medisch Centrum Haanglanden (MCH), The Hague, the Netherlands as the 2012 Globus International Clinical Traveling fellow of the International Society for the Study of the Lumbar Spine (ISSLS). This report gives details of the fellowship program.
APPLICATION AND SELECTION My first application for the Globus ISSLS fellowship was in 2011. The application was supported by Profs. Wilco Peul and S. Rajasekaran as well as my local trainers Drs. Augustine Adeolu and Amos Adeleye. The application was not successful. I was not deterred by the setback and in 2012,1 was glad to have secured the support of Prof. Peul in applying for the fellowship again. It was with great joy that I received the news of my selection as the 2012 fellow on June 4, 2012 via an e-mail from the ISSLS secretariat. That wonderful notice was accompanied by a note from Prof. Peul promising me the full support of his team for the fellowship.
PREPARATION FOR MY STAY IN LEIDEN Through the wonderful support of Yvon Vd Voort and Margot Vianen, both of the LUMC and Katarina Orlinder of the ISSLS secretariat, I was able to secure accommodation in Leiden and make arrangements for my flights. Prof. Peul and Dr. Carmen Vleggeert-Lankamp (my cosupervisor) were also in touch with me to make preliminary arrangements for the training program. A prerequisite for my stay at the LUMC was a negative methicillin-resistant Staphylococcus Aureus (MRSA) test that was to be done prior to my arrival in Leiden
From the LAUTECH Teaching Hospital, Osogbo, Nigeria. Presented to the 2013 Annual Meetingof the ISSLS, Scottsdale, AZ; May 16, 2013. The manuscript submitted does not contain information about medical device(s)/drug(s). ISSLS funds were received in support of this work. No relevant financial activities outside the submitted work. Address correspondence and reprint requests to Taopheeq Bamidele Rabiu, FWACS, LAUTECH Teaching Hospital, Osogbo, Nigeria; E-mail: eshohealth® gmail.com DOI: 10.1097/BRS.0000000000000023 858
www.spinejournal.com
and then to be repeated there. My test in Nigeria was negative. As I was to learn later, the Netherlands has the strictest policy on MRSA control worldwide.
ARRIVAL AND INITIAL STAY IN LEIDEN On Saturday, December 1, 2012, I arrived in the beautiful and quiet city of Leiden and was happy with the warmth provided by my guest room in the Paviljoen at the Museum Volkekunde as the winter was starting. I reported at the neurosurgery department on the morning of Monday, December 3, 2012, and was personally received by Prof. Peul. We discussed the overview of my training at both the LUMC and the MCH. He arranged for me to be given a train ticket for commuting between the 2 cities (first class!). Thereafter, I had repeat swabs taken for the MRSA test. Later on that day, I accompanied Prof. Peul to the MCH where he introduced me to the staff and also showed me around the operating room (OR) complex. My first OR experience there was with Dr. Gourdard de Ruiter. My first experience with winter snow also occurred that same day. On the following day, I joined the clinical neurosurgery staff at the LUMC for the routine morning clinical reviews and later proceeded to the OR. In the afternoon, I was called out of the OR and informed that the preliminary reports of my MRSA tests were positive. That sad news was devastating, and its effect only best imagined. I learnt of the Dutch zero tolerance for MRSA and their "search and destroy" policy. I had to leave the hospital premises immediately! That marked the beginning of a tortuous journey over the next 4 weeks during which I was commenced on treatment for the MRSA carriage and had repeated swabs taken on weekly basis. I was only allowed to resume clinical activities on January 3, 2013 after 3 consecutive weekly negative swabs. During that difficult period, I had meetings (outside the hospital) with Prof. Peul and Dr. Vleggeert-Lankamp on a collaborative review of degenerative diseases of the lumbar spine in the Netherlands, a developed country, and Nigeria, a developing country. I spent that period researching into the status of degenerative diseases of the lumbar spine in Nigeria and the Netherlands. Our article on the subject, awaiting publication, discusses the differences in the management of degenerative diseases of the lumbar spine between the 2 countries as May 2014
Spine
TRAVELING FELLOWSHIP
well as the lessons that can be learnt from the differences. It was also during that waiting period that I moved to the apartment on Middelstegracht, Leiden, where I stayed till the end of the fellowship.
THE TRAINING PROGRAM Rotations My program was designed in such a way that I shuttled between the LUMC in Leiden and the MCH at The Hague. I attended the daily morning clinical reviews at the LUMC and then proceeded to the OR except for most Wednesdays that I went to the MCH. In addition, I also attended the routine neuroradiology meetings on Thursday mornings where difficult neurosurgical cases are reviewed with the radiologists as well as a neuropathology/tumor board meeting. I also had opportunities to observe some interventional neuroradiology procedures. To facilitate my full participation in the programs, the clinical reviews were conducted in English language for my benefit. The Staff Neurosurgeons I was privileged not only to work with Prof. Peul and Dr. Vleggeert-Lankamp whose primary interests were complex spine cases, but I also had the opportunities of working with their other exceptionally gifted and loving colleagues as follows:
Report of 2012 ISSLS Globus Fellowship • Rabiu
the thoracic spine for disc herniation and tumors, ACD±E (anterior cervical discectomy with/without fusion) with different cage systems, complex spinal instrumentations (lumbar, thoracic, cervical, and occipitocervical), and lumbar decompressive laminectomies for canal stenosis. Others included intracranial tumor excisions, clipping of aneurysms, brachial plexus surgical procedures, and facial reanimation procedures. I also had my first experience with neuronavigation for spinal and cranial surgical procedures and extended uses of C- and O-arm fluoroscopy.
RARE ERIENDSHIP AND PHILANTHROPY The fellowship afforded me the rare chance of not only making several friends in the Netherlands but also benefiting immensely from the warm philanthropy of Prof. Peul. His gift to me at the end of the fellowship was a pair of loupes that I have been using as "extra eyes" in several procedures after my return home. In a display of rare passion for the advancement of neurosurgical care in an underprivileged society, he is also working hard to have the LUMC and some of his associates support my center with equipments/instruments donations that would improve our spine and other neurosurgical services. A visit by him to Nigeria is also being planned for later this year. Apart from guiding me through complex neurosurgical procedures during his stay with us, he is also expected to share his knowledge with several Nigerian neurosurgeons and discuss future collaborations.
LUMC Dr. Radboud W. Koot Prof. Martijn J. A. Malessy Dr. Willem Poondaag Dr. Pieter J. Schutte Dr. Marco J. T. Verstegen Dr. Peter W A. Willems MCH Dr. Gourdard C.W. de Ruiter Dr. Jasper E C. Wolfs Dr. M. P. Arts
Neuro-oncology and skull base surgery Vestibular schwannomas and peripheral nerve surgery Complex spinal and peripheral nerve surgical procedures Complex spinal and pituitary surgical procedures Neuro-oncology and endoscopie pituitary surgery Vascular surgery
Complex spine and peripheral nerve surgical procedures Complex spine surgery Complex spine surgery
Other Members of Staff My stay in Leiden and The Hague was made memorable by the secretarial staff, resident doctors, physician assistants, and the OR nurses and anesthetists. They were all wonderful people. Clinical Exposure I had the wonderful opportunity of participating in and observing a wide variety of neurosurgical procedures. These included lumbar microdiscectomies, anterior approaches to Spine
MY RETURN HOME On Eebruary 28, 2013, I returned safely to Nigeria and resumed my work immediately. I have since deployed some of my new skills in improving patient care at my center.
APPRECIATION My profound gratitude goes to the executive council and all members of the ISSLS for awarding the 2012 fellowship to me. The fellowship is a laudable project that would help to improve spine care in less-privileged societies world over. Katarina Orlinder of the ISSLS administrative secretariat provided the 24/7 wonderful logistic support that helped me all through and after the fellowship period. I am very grateful to her. Wilco and Carmen are truly wonderful people. They surpassed my expectations from the fellowship and guided and supported me all through and after the program. I remain eternally grateful for their friendships and support for my career developmetit and improved care for my people. The attending neurosurgeons at the LUMC and the MCH were all wonderful friends and received me with open hands. They all made my stay memorable and worthwhile, and I owe them a debt of gratitude. Yvon and Nathalie provided round the clock administrative support and logistic planning without hitches. I thank them and all their colleagues. My friends and colleagues, the trainees, were wonderful. Erom the various clinical meetings to the OR and several social outings, Janneke, Hans, Justus, Sarita, Erances, and all www.spinejournal.com
859
TRAVFIINC FEI I owsHip
their colleagues were friends in the true sense of it. I am happy to have been associated with them. Acknowledgments I thank Drs. Adeolu and Adeleye for serving as my referees for the fellowship application at different times, my superiors
860
www.spinejournal.com
Report of 2012 ISSLS Globus Fellowship • Rabiu
Profs. Fadiora and Oluwadiya as well as Drs. Olaitan and Eegunranti for supporting me for the training, Drs. Komolafe and Yusuf for overseeing my unit while I was away and my lovely wife, son, brother, and my entire family members for supporting me all through my stay in Leiden. I remain grateful to you all.
May 2014
Copyright of Spine is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
SPINE Volume 39, Number t l , pp 858-860 ©20t4, LIppincott Williams & Wilkins
TRAVELING FELLOWSHIP
Report of the 2012 Globus International Clinical Traveling Fellowship of the International Society for the Study of the Lumbar Spine (ISSLS) Taopheeq Bamidele Rabiu, FWACS
INTRODUCTION From December 1, 2012 to February 28, 2013,1 underwent training under Prof. Wilco C. Peul at the Leids Universitair Medisch Centrum (LUMC), Leiden and the Medisch Centrum Haanglanden (MCH), The Hague, the Netherlands as the 2012 Globus International Clinical Traveling fellow of the International Society for the Study of the Lumbar Spine (ISSLS). This report gives details of the fellowship program.
APPLICATION AND SELECTION My first application for the Globus ISSLS fellowship was in 2011. The application was supported by Profs. Wilco Peul and S. Rajasekaran as well as my local trainers Drs. Augustine Adeolu and Amos Adeleye. The application was not successful. I was not deterred by the setback and in 2012,1 was glad to have secured the support of Prof. Peul in applying for the fellowship again. It was with great joy that I received the news of my selection as the 2012 fellow on June 4, 2012 via an e-mail from the ISSLS secretariat. That wonderful notice was accompanied by a note from Prof. Peul promising me the full support of his team for the fellowship.
PREPARATION FOR MY STAY IN LEIDEN Through the wonderful support of Yvon Vd Voort and Margot Vianen, both of the LUMC and Katarina Orlinder of the ISSLS secretariat, I was able to secure accommodation in Leiden and make arrangements for my flights. Prof. Peul and Dr. Carmen Vleggeert-Lankamp (my cosupervisor) were also in touch with me to make preliminary arrangements for the training program. A prerequisite for my stay at the LUMC was a negative methicillin-resistant Staphylococcus Aureus (MRSA) test that was to be done prior to my arrival in Leiden
From the LAUTECH Teaching Hospital, Osogbo, Nigeria. Presented to the 2013 Annual Meetingof the ISSLS, Scottsdale, AZ; May 16, 2013. The manuscript submitted does not contain information about medical device(s)/drug(s). ISSLS funds were received in support of this work. No relevant financial activities outside the submitted work. Address correspondence and reprint requests to Taopheeq Bamidele Rabiu, FWACS, LAUTECH Teaching Hospital, Osogbo, Nigeria; E-mail: eshohealth® gmail.com DOI: 10.1097/BRS.0000000000000023 858
www.spinejournal.com
and then to be repeated there. My test in Nigeria was negative. As I was to learn later, the Netherlands has the strictest policy on MRSA control worldwide.
ARRIVAL AND INITIAL STAY IN LEIDEN On Saturday, December 1, 2012, I arrived in the beautiful and quiet city of Leiden and was happy with the warmth provided by my guest room in the Paviljoen at the Museum Volkekunde as the winter was starting. I reported at the neurosurgery department on the morning of Monday, December 3, 2012, and was personally received by Prof. Peul. We discussed the overview of my training at both the LUMC and the MCH. He arranged for me to be given a train ticket for commuting between the 2 cities (first class!). Thereafter, I had repeat swabs taken for the MRSA test. Later on that day, I accompanied Prof. Peul to the MCH where he introduced me to the staff and also showed me around the operating room (OR) complex. My first OR experience there was with Dr. Gourdard de Ruiter. My first experience with winter snow also occurred that same day. On the following day, I joined the clinical neurosurgery staff at the LUMC for the routine morning clinical reviews and later proceeded to the OR. In the afternoon, I was called out of the OR and informed that the preliminary reports of my MRSA tests were positive. That sad news was devastating, and its effect only best imagined. I learnt of the Dutch zero tolerance for MRSA and their "search and destroy" policy. I had to leave the hospital premises immediately! That marked the beginning of a tortuous journey over the next 4 weeks during which I was commenced on treatment for the MRSA carriage and had repeated swabs taken on weekly basis. I was only allowed to resume clinical activities on January 3, 2013 after 3 consecutive weekly negative swabs. During that difficult period, I had meetings (outside the hospital) with Prof. Peul and Dr. Vleggeert-Lankamp on a collaborative review of degenerative diseases of the lumbar spine in the Netherlands, a developed country, and Nigeria, a developing country. I spent that period researching into the status of degenerative diseases of the lumbar spine in Nigeria and the Netherlands. Our article on the subject, awaiting publication, discusses the differences in the management of degenerative diseases of the lumbar spine between the 2 countries as May 2014
Spine
TRAVELING FELLOWSHIP
well as the lessons that can be learnt from the differences. It was also during that waiting period that I moved to the apartment on Middelstegracht, Leiden, where I stayed till the end of the fellowship.
THE TRAINING PROGRAM Rotations My program was designed in such a way that I shuttled between the LUMC in Leiden and the MCH at The Hague. I attended the daily morning clinical reviews at the LUMC and then proceeded to the OR except for most Wednesdays that I went to the MCH. In addition, I also attended the routine neuroradiology meetings on Thursday mornings where difficult neurosurgical cases are reviewed with the radiologists as well as a neuropathology/tumor board meeting. I also had opportunities to observe some interventional neuroradiology procedures. To facilitate my full participation in the programs, the clinical reviews were conducted in English language for my benefit. The Staff Neurosurgeons I was privileged not only to work with Prof. Peul and Dr. Vleggeert-Lankamp whose primary interests were complex spine cases, but I also had the opportunities of working with their other exceptionally gifted and loving colleagues as follows:
Report of 2012 ISSLS Globus Fellowship • Rabiu
the thoracic spine for disc herniation and tumors, ACD±E (anterior cervical discectomy with/without fusion) with different cage systems, complex spinal instrumentations (lumbar, thoracic, cervical, and occipitocervical), and lumbar decompressive laminectomies for canal stenosis. Others included intracranial tumor excisions, clipping of aneurysms, brachial plexus surgical procedures, and facial reanimation procedures. I also had my first experience with neuronavigation for spinal and cranial surgical procedures and extended uses of C- and O-arm fluoroscopy.
RARE ERIENDSHIP AND PHILANTHROPY The fellowship afforded me the rare chance of not only making several friends in the Netherlands but also benefiting immensely from the warm philanthropy of Prof. Peul. His gift to me at the end of the fellowship was a pair of loupes that I have been using as "extra eyes" in several procedures after my return home. In a display of rare passion for the advancement of neurosurgical care in an underprivileged society, he is also working hard to have the LUMC and some of his associates support my center with equipments/instruments donations that would improve our spine and other neurosurgical services. A visit by him to Nigeria is also being planned for later this year. Apart from guiding me through complex neurosurgical procedures during his stay with us, he is also expected to share his knowledge with several Nigerian neurosurgeons and discuss future collaborations.
LUMC Dr. Radboud W. Koot Prof. Martijn J. A. Malessy Dr. Willem Poondaag Dr. Pieter J. Schutte Dr. Marco J. T. Verstegen Dr. Peter W A. Willems MCH Dr. Gourdard C.W. de Ruiter Dr. Jasper E C. Wolfs Dr. M. P. Arts
Neuro-oncology and skull base surgery Vestibular schwannomas and peripheral nerve surgery Complex spinal and peripheral nerve surgical procedures Complex spinal and pituitary surgical procedures Neuro-oncology and endoscopie pituitary surgery Vascular surgery
Complex spine and peripheral nerve surgical procedures Complex spine surgery Complex spine surgery
Other Members of Staff My stay in Leiden and The Hague was made memorable by the secretarial staff, resident doctors, physician assistants, and the OR nurses and anesthetists. They were all wonderful people. Clinical Exposure I had the wonderful opportunity of participating in and observing a wide variety of neurosurgical procedures. These included lumbar microdiscectomies, anterior approaches to Spine
MY RETURN HOME On Eebruary 28, 2013, I returned safely to Nigeria and resumed my work immediately. I have since deployed some of my new skills in improving patient care at my center.
APPRECIATION My profound gratitude goes to the executive council and all members of the ISSLS for awarding the 2012 fellowship to me. The fellowship is a laudable project that would help to improve spine care in less-privileged societies world over. Katarina Orlinder of the ISSLS administrative secretariat provided the 24/7 wonderful logistic support that helped me all through and after the fellowship period. I am very grateful to her. Wilco and Carmen are truly wonderful people. They surpassed my expectations from the fellowship and guided and supported me all through and after the program. I remain eternally grateful for their friendships and support for my career developmetit and improved care for my people. The attending neurosurgeons at the LUMC and the MCH were all wonderful friends and received me with open hands. They all made my stay memorable and worthwhile, and I owe them a debt of gratitude. Yvon and Nathalie provided round the clock administrative support and logistic planning without hitches. I thank them and all their colleagues. My friends and colleagues, the trainees, were wonderful. Erom the various clinical meetings to the OR and several social outings, Janneke, Hans, Justus, Sarita, Erances, and all www.spinejournal.com
859
TRAVFIINC FEI I owsHip
their colleagues were friends in the true sense of it. I am happy to have been associated with them. Acknowledgments I thank Drs. Adeolu and Adeleye for serving as my referees for the fellowship application at different times, my superiors
860
www.spinejournal.com
Report of 2012 ISSLS Globus Fellowship • Rabiu
Profs. Fadiora and Oluwadiya as well as Drs. Olaitan and Eegunranti for supporting me for the training, Drs. Komolafe and Yusuf for overseeing my unit while I was away and my lovely wife, son, brother, and my entire family members for supporting me all through my stay in Leiden. I remain grateful to you all.
May 2014
Copyright of Spine is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
