Spinal Imaging

[Spine Specialist]

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Can some one suggest a good basic book to improve knowledge on spinal imaging for a physiatric surgeon? I want to improve my diagnostic radiology skills.
Thanks! 🙂

 

[C Fiber]

are you wanting MRI/CT imaging or plain films?

 

[Spine Specialist]

are you wanting MRI/CT imaging or plain films?

MRI/CT.

 

[Tenesma]

what the hell is a physiatric surgeon???

books are good but nothing beats spending time with neuro-rads looking at films with them...

 

[chinochulo]

what the hell is a physiatric surgeon???
books are good but nothing beats spending time with neuro-rads looking at films with them...

So if a PMnR guy who does a few procedures calls himself (jokingly?) a physiatric surgeon, then what do interventional pain guys with anesthesiology backgrounds call one another? Anesthesiologists are already interventional by nature, although I think there are a few guys who go by the title of "minimally invasive spine surgeon", which is quite misleading to the public, IMHO. Cardiologists who implant pacemakers and defibrillators are not cardiac surgeons, and dermatologists who perform Mohs procedures are not plastic surgeons.....C'mon now.

And I agree with Tenesma, go down and spend some quality time in the dungeons with the neuroradiologists if you want to learn to read MRI/CTs.

 

[Spine Specialist]

what the hell is a physiatric surgeon???

books are good but nothing beats spending time with neuro-rads looking at films with them...

sorry Tenesma to annoy you by claiming myself as 'surgeon'. My intention is only good.

Recently, i attended this medtronic implantation course in LasVegas. There was one excellent lecture by a neurosurgeon on post-op complications. He claimed that infection rate in implantations done by non-surgeons ( Physiatrists & Anesthesiologists) is nearly 15% compared to less than 5% done by surgeons. He did not say it was a study. He showed that slide of comparison and lectured how we are careless in sterile techniques. It was so embarrasing to me. I made a decision on that moment that i have to be extremely sterile in my procedures and be very anal in even less invasive procedures. If i think myself as Physiatric surgeon....i will be very careful in operating room techniques. Only if i think like a surgeon, i will act like a surgeon. Right?

You are right. There cannot be better learning than seeing films with radiologists. My residency chairman is a classy spine physiatrist. He will not read any radiologist report before seeing films. He always see films thoroughly by himself and walks to radiologist office if he has any doubts. He has picked up findings missed by very experienced radiologists and even neurosurgeons which has changed the whole diagnosis and patient management. Actually, i called him yesterday to ask for a radiology book recommendation. I also told him that my goal is to beat him in spine diagnostic skills. well...it is going to be very hard. but, there is no harm in trying. 😀

My prediction of future minimally invasive spine management....

Spine surgeons Vs Physiatric surgeons

 

[stim4u]

Hello:

According to my understanding of the literature, recent ISIS guidlines, and general reviews, there is NO difference in infection rates between general surgeons, anesthesiologist, & PMR when it comes to permanent implants. If someone makes such an assertion, it is best to back it up with some form of evidence (case series, controlled trials, etc.) not just one physicians experience and opinion. At our insitution Anes/Pain Med is the only group performing implants so I cannot make a biased judgement regarding our infection rate.

There are some basic sterility techniques that one should be aware of when performing permanent implants (ie. less bovie use, reduced through traffic, etc), and this info can be obtained via a comprehensive fellowship & courses (medtronic, ANS, etc).

😉

 

[defphiche]

i do surgical cases. i don't call myself a surgeon. although i have a strong surgical background, i do not want to mislead a patient or my colleages. Tenesma has his opinion and i value his contribution to the discussion. it will keep interventional physiatrists humble. i don't see how a weekend course is going to make a physiatrist a surgeon. at the same time, i do not see how a fellowship with strong surgical experience (which is what we have at the UCLA WLA PMR pain medicine fellowship), will make you a 'surgeon.' an individual must continue to practice medicine and be very careful in all the procedures that are done. Physiatrists who do interventions will have complications (infection, bleed, neurological compromise, etc...) much like a surgeon, you must be prepared to handle the complications or don't do the cases. you must be able to handle the criticism as well. do good work, help patients, and don't be something that you are not.

 

[chauffeur]

Can some one suggest a good basic book to improve knowledge on spinal imaging for a physiatric surgeon? I want to improve my diagnostic radiology skills.
Thanks! 🙂

back to the original question; can someone recommend a good book for CT/MRI spine imaging. preferrably one with normal and pathology imaging. thnx.

 

[C Fiber]

Try Musculoskeletal Imaging - A Teaching File by Felix Chew, Catherine Maldjian and Susan G. Leffler. Lippincott Williams and Wilkins, 1999. It not only have pretty good MRI/CT of spine, but also other skeletal areas. If you are like me, who enjoy seeing patients with rehab/pain pain problems other than spine/low back pain, this may be a helpful book. Though, my complaint with this book is not enough "normal" pictures. Also try ACR-American College of Radiology educational products: CD-ROM for neuro &/or Skeletal. I like the interactive CD-ROMs alot. Try them out at your local medical school library if you can, they should have them on reserve. here is the link for ACR CD-ROMs. Good luck. Send me a private message if you need more info.
http://www.acr.org/s_acr/sec.asp?CID=1158&DID=14996

 

[Aether2000]

Those who operate on patients are surgeons. Even family physicians must request surgical privileges for removal of lumps and bumps...

Main Entry: sur·geon
Pronunciation: 's&r-j&n
Function: noun
1 : a medical specialist who performs surgery : a physician qualified to treat those diseases that are amenable to or require surgery —compare INTERNIST
2 : the senior medical officer of a military unit
Source: Merriam-Webster's Medical Dictionary, © 2002 Merriam-Webster, Inc.

Main Entry: sur·gery
Pronunciation: 's&rj-(&-)rE
Function: noun
Inflected Form: plural -ger·ies
1 : a branch of medicine concerned with diseases and conditions requiring or amenable to operative or manual procedures
2 a British : a physician's or dentist's office b : a room or area where surgery is performed
3 a : the work done by a surgeon b : OPERATION
Source: Merriam-Webster's Medical Dictionary, © 2002 Merriam-Webster, Inc.