2017 CSRS Traveling Fellowship winners report on their whirlwind experience
Initiated in 2015, the Cervical Spine Research Society’s (CSRS) International Traveling Fellowship enables spine surgeons younger than age 45 to visit institutions with an expertise in the cervical spine to broaden their experiences and foster their academic careers. The fellowship is held every other year, and CSRS regions take turns hosting.

In 2017, we and four other traveling fellows—FeiFei Zhou, MD, Peking University Third Hospital, Beijing, China; Caroline Scemama, MD, University Pierre et Marie Curie, Hospital La Pitie Salpetriere, Paris, France; Takashi Kaito, MD, PhD, Osaka University Graduate School of Medicine, Suita, Japan; and Eduardo Tornero, MD, PhD, Parc Sanitari Sant Joan de Déu, Barcelona, Spain—had the opportunity to visit four centers in Europe over a 2-week span. Our traveling ended at the CSRS-European Section 33rd annual meeting in Salzburg, Austria.

Nuremberg, Germany
We started the fellowship at the Schön Klinik Nürnberg Fürth. We observed as our hosts, Drs. Heiko Koller and Michael Mayer, performed a complex cervical deformity surgery. We also discussed several cases and learned about the German healthcare system and practice patterns.

Fortunately, there was also time to tour the historic Nuremberg Castle and enjoy the local food.

Paris, France
Next, we flew to Paris, France, and visited the Hospital Universitaire Pitie Salpetriere, where we were met by our local hosts, Drs. Philippe Bancel and Hugues Pascal-Moussellard.

We visited the orthopaedic department and discovered that Dr. Raymond Roy-Camille, who pioneered lateral mass and pedicle screw instrumentation, was based there. We reviewed a series of cases and then enjoyed a tour of the hospital grounds. We learned that the medical pioneers such as Drs. Joseph Babinski, Jean-Martin Charcot, Jacques Jean Lhermitte, and Maurice Klippel trained or taught at Salpêtrière.

The next day, we observed in the operating room, followed by an academic schedule. Dr. Jean DuBousset shared his experience on the management of cervical spine disorders in pediatric patients. Dr. Jean-Marc Vital from University Hospital of Bordeaux discussed cervical sagittal balance; his lecture was followed by additional presentations on cervicothoracic tumors and cervical spine deformity. We finished the day with dinner at a jazz club.

Barcelona, Spain
Our host in Barcelona was Dr. Andreu Combalia from the Hospital Clinic of Barcelona. On our arrival, we took a walking tour of the city, followed by dinner.

The next morning, we attended case discussions. In collaboration with a biomedical engineer, Dr. Combalia has designed 3-D printed drill guides. We were able to observe Dr. Combalia using these guides during a C2-T1 posterior cervical fusion surgery. The focus then shifted to our own case presentations.

In addition to sightseeing in Barcelona, Dr. Tornero organized an outing to Stadium Camp Nou, the home field of the Futbol Club Barcelona (Barça). We enjoyed watching the match between Barça and Sociedad Deportiva Eibar, a Spanish futbol team based in the Basque area.

Uppsala, Sweden
The following day, we travelled to Uppsala, Sweden, where our local host, Dr. Claes Olerud, took us to dinner. Uppsala University is the oldest university in Sweden and the home of both Olof Rudbeck, who described the lymphatic system, and Anders Celsius, who developed the Celsius temperature scale.

The academic program presented in Uppsala was excellent. Among the topics presented by Uppsala faculty were the results of a prospective study comparing cervical disk arthroplasty and anterior cervical fusion.

Dr. Peter Försth discussed his prospective long-term follow-up of degenerative lumbar spondylolisthesis managed by fusion and laminectomy versus by laminectomy alone (published in The New England Journal of Medicine). Dr. Olerud reviewed cervical spine sagittal alignment.

Salzburg, Austria
Our final stop was Salzburg, Austria, to attend the 33rd annual CSRS-European section meeting. The meeting featured 57 podium and case presentations as well as 179 E-posters. In addition to papers from CSRS-Europe, several papers from CSRS North America and CSRS Asia Pacific were presented. We also visited the historic Old Town Salzburg, including Mozart’s birthplace.

Conclusion
The CSRS International Fellowship was an opportunity of a lifetime to visit European centers of excellence in cervical spine surgery. Exchanging ideas and best practices as well as learning from the surgeons we visited was invaluable. Moreover, we built great friendships and enjoyed the cultural experience of other countries. We thank both CSRS and the hosts and the administrators of the respective CSRS sections.

Beginning in April 2018, applications will be accepted for the CSRS 2019 Traveling Fellowship Program. Acceptance notices will be sent in September 2018. This program will be organized by the CSRS Asia Pacific Section.

For additional information, including requirements, please visit the CSRS website at www.csrs.org.

Addisu Mesfin, MD,is a member of the AAOS Adult Spine Assessment and Annual Meeting Spine Program Committees and associate professor of Orthopaedic Surgery at the University of Rochester School of Medicine and Dentistry in Rochester, N.Y.

Ahmad Nassr, MD,is a member of the AAOS Biomedical Engineering Committee and associate professor of Orthopedic Surgery and Biomedical Engineering at Mayo Clinic in Rochester, Minn.