From November 27th to December 1st, Dr. Rosenthal, Head of the Section of Spine Surgery, Regional Hospital Bad Homburg, Germany, visited Guangdong Clifford Hospital as an international visiting professor, and carried out a series of academic exchange activities in the hospital, including outpatient consultations, ward rounds, surgical guidance, surgical practice, internal lectures, discussions on department management and complex cases, and public lecture, etc.

Highlights

Guangdong Clifford Hospital was founded by the patriotic entrepreneur Peng Linji in 2001. It is the first hospital in China that passed the international JCI certification and a national major comprehensive Class III Grade A hospital with an area of 300,000 square meters and 3,000 beds, making it top ranking private hospital in China. This morning, the hospital welcomed its first international visiting professor, Dr. Rosenthal, the former President of the German Spine Society, the Head of the Section of Spine Surgery of Regional Hospital Bad Homburg Germany, and the world-class master in thoracoscopic technique for spine surgery. He impressed the world by independently conducting 4,000 thoracoscopic spine surgeries, which attracted King Abdullah II of Jordan to visit him and receive treatment at the hospital where he worked in. This morning, the Sino-German Orthopedic Communication Center was established in Guangdong Clifford Hospital and Dr. Rosenthal is working as an international visiting professor at the hospital this week. He will carry out a series of academic exchange activities in the hospital, including outpatient clinics, ward rounds, surgical guidance, surgical practice, training within the department, discussion on department management, discussion on key and difficult cases, public class, etc. In the future, the hospital will provide better service for Guangdong people on treatment for spinal diseases.

Unveiling Ceremony for “Sino-German Orthopedic Communication Center”

On the morning of November 27th, a welcome ceremony for Dr. Rosenthal was held at Guangdong Clifford Hospital, which was organized and attended by JIAN Zhixiang and GONG Caixia, Vice Presidents of the hospital, ZHAO Hongpu, LIU Huiliang and YANG Jianhui, Directors of Orthopedics Department and others. Soon afterwards, the two sides attended the unveiling ceremony for the “Sino-German Orthopedic Communication Center”, marking the beginning of a new phase in the development of spine surgery between China and Germany!

Prof. JIAN issued a letter-of-appointment of visiting professor to Dr. Rosenthal

Led by the hospital leaders, Dr. Rosenthal visited various areas of Guangdong Clifford Hospital, including Orthopedics Dept., VIP Center, International Health Management Center and Clifford Plastic Surgery and Beauty Center and more.

After the visit, Dr. Rosenthal said that Guangdong Clifford Hospital owns a reasonable layout, spacious and bright space and quiet environment, all of which can provide patients with a comfortable and reliable medical environment. The leaders of the hospital also said that they were very honored to invite Dr. Rosenthal to their hospital for academic exchanges and building up friendship. They also hope to have in-depth exchanges with Dr. Rosenthal during this week to jointly explore the future development of orthopedics, especially spinal surgery, so as to improve its professional strength and academic level of scientific research, and promote the specialty construction of spine surgery at Guangdong Clifford Hospital to a higher level!

Outpatient Consultation

On the morning of November 28th, Dr. Rosenthal, together with Doctor LIN Shide from Orthopedics Dept. I receive a total of 6 outpatients, all of whom had complicated spinal diseases, and some of them came all the way here just because of the reputation of Dr. Rosenthal. Dr. Rosenthal gave each patients a physical examination and detailed treatment recommendations after carefully reading the imaging materials.

Sharing the Geman Experience of the Specialty Construction of Spinal Surgery

On the afternoon of November 28th, Dr. Rosenthal came to the Orthopedics Dept. I of the hospital and delivered a lecture to doctors on the topic of “Educating spine surgeons - The german (DWG) experience”.

Dr. Rosenthal introduced that the spine surgeons in Germany are coming from neurosurgeons and orthopedic/trauma surgeons. The Society for Spine Research and the Society for Spine Surgery merged to become the German Spine Society(DWG) in 2006. And since 2010, the DWG has been offering the training program for neurosurgeons, orthopedic/trauma surgeons who have completed a 6-year residency program. For these two types of surgeons, the program provides comprehensive and standardized courses for learning knowledge of the spine, as well as hands-on opportunities for simulated surgery in cadaver laboratories or on realistic human models. After completing a 2-year training program in spine surgery, the DWG will award certification to the surgeons. Depending on the doctor’s practical experience and academic status, the certificate is divided into 3 levels: Basic, Master and Excellence.

Since 2015, the DWG has also evaluated the complexity of spinal diseases that different hospitals could handle from different parameters (such as the equipment, the team, case volume, etc.), and certified them with Level 1, Level 2, Level 3 respectively, where Level 1 stands for the highest level, indicating that the hospital is capable of offering the best care for patients with complex spinal diseases. After the lecture, the doctors said that Dr. Rosenthal’s lecture gave them a fresh understanding of the training of German spine surgeons.

Case Discussion on Sharing of Surgical Treatment Experience

On the morning of November 29th, Dr. Rosenthal came to the office of Orthopedics Dept. I of Guangdong Clifford Hospital to discuss the cases and share surgical experience with doctors. The topics of the treatments for spinal fracture, such as the operation skills of PVP and PKP, the necessity of implanting cage from the front after posterior internal fixation, and the treatment of osteoporosis patients, are all covered in detail.

In the afternoon, Dr. Rosenthal gave a lecture titled “Thoracic Disc Herniation and Diagnostic and therapeutic Algorithm” to orthopedic surgeons, in which he introduced the epidemiology and typical clinical symptoms of thoracic disc herniation, and clearly explained how do they diagnose and treat the disease in their department through flow charts. Meanwhile, through the videos of surgical practice, he vividly illustrated his experience in the surgical treatment of thoracic disc herniation.

Dr. Rosenthal concluded that thoracic disc herniation is not as seldom as published; Acute progression of neurological deficits in patients does not mean acute surgery for the patient, but rather the patient should be operated at a selected time after a comprehensive pre-operative examination; If the patient is diagnosed with thoracic disc herniation but does not present with any symptoms, then treatment is not necessary. Finally, Dr. Rosenthal emphasized that although thoracic disc herniation is relatively rare among spinal disorders, spinal surgeons still need to consider its possibility. After the lecture, Director YANG Jianhui and doctors in the department had an in-depth discussion with Dr. Rosenthal on the treatment of spinal diseases.

Surgical Observation and Ward Rounds

On the morning of November 30th, Dr. Rosenthal visited the Orthopedics Dept. of Guangdong Clifford Hospital and shared six cases pertaining to thoracic diseases. During the sharing, Dr. Rosenthal explained in detail how to perform surgery under thoracoscopy or microscope for patients with thoracic fractures, disc herniation and bone tumors. He suggested that spinal surgeons should learn more about anterior approach, so that they could be able to perform direct decompression through the anterior approach in cases of anterior vertebral compression.

At noon, Dr. Rosenthal visited the operating room under the guidance of the doctors, and observed an open thoracic spine internal fixation surgery through the posterior approach which was operated by Director YANG Jianhui.

In the afternoon, Dr. Rosenthal made ward rounds with the doctors and conducted physical examinations for patients.

Subsequently, Director YANG Jianhui and Dr. Rosenthal discussed the surgical plan for a patient with C7-T1 intervertebral disc herniation. Although it’s compressed in the front, Dr. Rosenthal pointed out that it was difficult to locate the target segment through the anterior approach for decompression. He then proposed a technique called 'frykholm technique', which involves a posterior approach to remove part of the lamina and further down to remove the protruding intervertebral disc for decompression. What’s more, Dr. Rosenthal also provided detailed explanations of the procedures through videos and spine models, hoping to bring new surgical ideas to the orthopedic team.

Public lecture

On the morning of December 1st, Dr. Rosenthal came to the Orthopedics Dept. I of the hospital to share his last lecture, named “Rationale for Anterior Approach”, for orthopedic  surgeons and some neurosurgeons.

During the public lecture, Dr. Rosenthal introduced the proportion of loads on the anterior and posterior parts of the spine, the distribution of blood vessels and nerve roots. Plus, he also  introduced the development of anterior spinal surgery over the course of 30 years. By looking back at the past anterior spinal surgery, Dr. Rosenthal analyzed the reasons and advantages of choosing anterior approach or combined both anterior and posterior approach in spinal surgery. In the end, Dr. Rosenthal introduced the selection of indications for anterior, posterior and combined those two approaches, meanwhile stressed the significance of innovation in the medical field.

After the public lecture, regarding to the combined surgical plan of anterior fusion and posterior fixation, YANG Jianhui, ZHAO Hongpu, Directors of Orthopedics Dept. and other doctors had a heated discussion with Dr. Rosenthal.

Chinese doctors all expressed their sincere gratitude to Dr. Rosenthal for bringing them new knowledge and perspectives. Dr. Rosenthal also welcomed doctors from Guangdong Clifford Hospital to visit the Hochtaunus-Kliniken gGmbH, Bad homburg in Germany for academic exchanges.