布局科室新技术，引领脊柱中心新发展

五月清晨起床给河南省直第三人民医院周红刚主任通电话，我告诉他：“你们椎间盘中心已经是国家重点专科了。微创技术你们已是中国脊柱事业的天花板了，在德国，真正意义的脊柱中心必须要开展微创技术，侧弯畸形技术和脊柱肿瘤技术。微创技术是标配，侧弯畸形技术是实力，脊柱肿瘤技术是高精尖，微创手术易学简单，哪家医院都容易开展，所以微创技术没有护城河，只有瓶颈。德国是三级诊疗体系，从家庭医生到专科医院再到大学附属医院。能展示你这家医院这个科室水平的就是所有脊柱重大疑难疾病你都可以轻松搞定。大型脊柱手术微创技术是完全搞不定的，你必须要建立护城河。由于德国人人高马大，许多脊柱手术根本不能用微创技术。所以在德国，微创技术只停留在基层医院和专科医院，德国的大学附属医院只做高难度的脊柱手术。对于未来科室的发展，你必须发展脊柱侧弯和畸形技术以及脊柱肿瘤技术，从现在起，刻不容缓。你可以先选两个优秀医生先学习这两项技术，再通过开设专科门诊，把病人吸引过来。你们也可以与专科联盟和肿瘤医院合作，把肿瘤转移到脊柱部位的脊柱肿瘤病人转到你们科室。一个科室要开展一项新技术至少需要5年的时间，你现在就应该马上布局，未来什么样的脊柱病人来你们科室你们都能搞定，这才是真正意义上的脊柱中心，这样的脊柱中心才能所向无敌了。科室的江湖地位就更稳固了。科室在全中国的影响力就更大了。

In May, I got up early in the morning and had a phone call with Director Zhou Honggang of Henan Third People's Hospital. I said to him, "Your Intervertebral Disc Center has been listed as one of the national key specialties”. In China, the level of minimally invasive technique of your center is the top among all the other hospitals. However in Germany, an authentic spine center requires techniques of minimally invasive surgery and treating scoliosis and spinal tumor at the same time. Minimally invasive technique is the basic standard, whereas deformity technique represents the strength, and spinal tumor technique stands for high precision and professional skills of a spine center. Almost every hospital can carry out minimally invasive spine surgeries because it is not very difficult to be put in practice. Therefore, there is no buffer zone for minimally invasive technique in China, and many hospitals may probably encounter bottlenecks in their development process. From family doctors to specialized hospitals to university hospitals, this three-tier system composes German medical care system. The ability to handle difficult and complicated spinal diseases is the demonstration of a spine center’s high expertise. However, major spinal surgery is impossible to be treated with merely the minimally invasive technique, you have to build your own solid advantages. Since German people are mostly large in size, many spine surgeries cannot be performed with minimally invasive technique only. Therefore, in Germany, primary hospitals and specialized hospitals carry out most of the minimally invasive surgeries, while the university hospitals mainly perform highly difficult open surgeries. For the future development of a spine center, the techniques treating scoliosis, deformity and spinal tumor must be developed better and better. You can start from sending some excellent doctors for further education in these fields, and then bring patients in by setting up specialized outpatient clinic. Also, you can cooperate with the specialized hospital alliance and oncology hospitals, and receive patients with spinal tumors from them. Generally, it takes at least 5 years for a department to fully carry out a new technique. You’d better immediately set the layout now, and then you can handle patients with various spinal diseases in the future. An authentic spine center like that is truly invincible. In this way, your department will possess a stronger reputation, and a greater influence throughout China.