Perfect Diary-World-class Spine Master’s Visit in the Third People’s Hospital of Henan Province

From July 31st to Aug. 4th, 2023, Dr. Daniel J. Rosenthal, an international spine expert and Director of Spinal Surgery at Hochtaunus-Kliniken gGmbH Klinik Bad Homburg in Germany, served as an international visiting professor at the Third People’s Hospital of Henan Province. He has carried out a series of academic exchanges at the hospital, including outpatient consultation, ward rounds, surgical guidance, hospital management, case discussion, academic lecture, and more.

The Communication Meeting on the Construction of the Department Brand of the Third People’s Hospital of Henan Province was held on the afternoon of July 31st. The executives of the Hospital including Vice President Yuan Qidong, Associate President and Director of Disc Center Zhou Honggang, the Directors of the Orthopedics Sha Yu, and Yan Yongchang, attended the meeting. Dr. Shen Mingkui, the representative of the Disc Center gave a presentation, sharing the current situation and prospects of the department. Dr. Rosenthal regarded that people have all witnessed the achievements of the Disc Center of the Hospital in surgical techniques, international exchanges, and supporting primary hospitals and that it has a bright future. Following the report, Dr. Rosenthal addressed a lecture on the topic of The Construction of the Discipline of Spine Surgery - German Experience. He shared the cultivation system and process of spine surgeons of Germany of the German Spine Society (Deutsche Wirbelsäulengesellschaft, DWG) starting in 2006. In Germany, ‘spine specialist’ is used to call neurosurgeons and orthopedic surgeons who dedicate to the specialty of spine surgery. They enter the cultivation system of spine surgery together to learn the procedures of the cervical, thoracic, and lumbar spine, the instrumentation, and so on.

Second Visit to the Third People’s Hospital of Henan Province

July 31st marked the beginning of Dr. Rosenthal's International Academic Activities Week as an international visiting professor at the Third People’s Hospital of Henan Province. This is Dr. Rosenthal's second visit to this hospital.

The executives of the Hospital including Vice President Yuan Qidong, Associate President and Director of Disc Center Zhou Honggang, Director of the Publicity Department Chen Aiyun, Director of Ward 1 of the Disc Center Yang Hejun, Director of Ward 2 of the Disc Center Ma Haijun and other colleagues of the department hosted a welcoming ceremony for Dr. Rosenthal.

On behalf of the hospital, Vice President Yuan Qidong extended a warm welcome to Dr. Rosenthal and thanked Dr. Rosenthal for visiting the Third People's Hospital of Henan Province again from afar. He said that Dr. Rosenthal is an internationally renowned expert in minimally invasive spine surgery. During this academic week everyone should cherish the opportunity, have more discussion from Dr. Rosenthal, and courageously find ways to overcome existing shortcomings, aiming for progress and growth.

Dr. Rosenthal said that he was very impressed by his last visit. He was very honored to be invited again to the key clinical specialty of the Third People's Hospital of Henan Province--the Disc Center, and He hoped to take the International Academic Activities Week as an opportunity to initiate active exchanges with colleagues and create fruitful results.

The Communication Meeting on the Construction of Department Brand

The Communication Meeting on the Construction of the Department Brand of the Third People’s Hospital of Henan Province was held on the afternoon of July 31st. The executives of the Hospital including Vice President Yuan Qidong, Associate President and Director of Disc Center Zhou Honggang, the Directors of the Orthopedics Sha Yu, and Yan Yongchang, attended the meeting. Dr. Shen Mingkui, the representative of the Disc Center gave a presentation, sharing the current situation and prospects of the department.

 Dr. Rosenthal regarded that people have all witnessed the achievements of the Disc Center of the Hospital in surgical techniques, international exchanges, and supporting primary hospitals and that it has a bright future.

Dr. Rosenthal addressed a lecture on the topic of The Construction of the Discipline of Spine Surgery - German Experience. He shared the cultivation system and process of spine surgeons of Germany of the German Spine Society (Deutsche Wirbelsäulengesellschaft, DWG) starting in 2006.

He introduced that in Germany, ‘spine specialist' is used to call neurosurgeons and orthopedic surgeons who dedicate to the specialty of spine surgery. They enter the cultivation system of spine surgery together to learn the procedures of the cervical, thoracic, and lumbar spine, the instrumentation, and so on. Based on the extent of the accomplishment of their study, the number of cases, etc., DWG will issue them a certificate accordingly which has three levels: Basic, Master, and Excellence. According to Dr. Rosenthal, it normally takes 10 to 15 years for a spine surgeon to grow from Level Basic to Excellence.

In the end, Yuan Qidong, the hospital Vice President, conveyed in the ending speech that he greatly agreed with Dr. Rosenthal’s idea that talents are the most essential for specialty development, and showed his gratitude for the new inspirations from Dr. Rosenthal’s lecture on the development and talent cultivation of the hospital.

Experience World-class Spinal Outpatient Services

People can enjoy world-class medical services for difficult spine diseases without having to travel abroad. On the morning of Aug. 1st at 8:00 AM, Dr. Rosenthal arrived at the clinic and conducted an outpatient consultation together with Director Yang Hejun from Ward 1 of Disc Center. Dr. Rosenthal conducted consultations for a total of 18 patients. These patients came not only from the local Zhengzhou area but also from various regions across the country, including Ningxia, Heilongjiang, and other parts of the country. Drawn by his reputation, they came to seek Dr. Rosenthal's professional advice.

The patients' conditions varied, encompassing a wide range of spinal diseases, including thoracic spinal stenosis, lumbar degenerative diseases, spinal infections, and more. One elderly patient, who had underwent cervical spine surgery, came for a follow-up visit three months after the surgery, expressing his discomfort. After reviewing the images, Dr. Rosenthal diagnosed that the patient's discomfort was due to the loosening of the screws after the surgery. However, considering the patient's age, surgery would nor be recommended. Dr. Rosenthal said that when the pain does not significantly influence daily activities, the patient can apply warm compresses and massage himself for relief. Dr. Rosenthal's professional guidance and compassionate care have brought immense comfort to the patients.

Case Discussion

On the afternoon of Aug. 1st, a meeting on difficult cases was held at the Third People’s Hospital of Henan Province. Doctors from the Disc Center prepared five difficult cases in advance and presented them in English, discussing diagnostic conclusions and surgical options with Dr. Rosenthal.

All the attendees participated in the discussion actively. Among the cases, one patient complained of pain in the right lower limb. Doctors from the Disc Center suggested performing a minimally invasive decompression surgery. Dr. Rosenthal pointed out that besides the pain symptoms, the patient's lumbar spine CT images indicated an excessively straight physiological curvature of the spine. He recommended adding full-length spine X-rays in the patient's standing position to determine if there were compensatory changes in the hip or knee joints. If confirmed, further spinal deformity surgery might be necessary.

During the seminar, a doctor pointed out that the imaging shows compression on the left side, while the patient is asymptomatic. And he asked if this needed to be operated during the surgery. Dr. Rosenthal responded by saying that treating patients is not just about treating the disease; the treatment approach should be based on the patient's symptoms rather than performing surgery solely for the sake of achieving impressive imaging results. As soon as he finished speaking, applause filled the conference room, and everyone was greatly inspired.

Shift Report and Ward Rounds

On the morning of Aug. 2nd, Prof. Zhou Honggang invited Dr. Rosenthal to participate in the morning shift report session. Dr. Rosenthal mentioned that this was a great opportunity to facilitate communication between doctors and nurses and enhance the efficiency of the department's work.

Afterward, Dr. Rosenthal participated in the ward rounds to check on the recovery of the post-operative patients and to follow up on the new patients admitted to yesterday's outpatient clinic. During the rounds, the doctors mentioned that Dr. Rosenthal always remembers each patient's specific cause of admission and the timing, expressing their admiration for his dedication.

After the ward rounds, Henan TV conducted a brief interview with Dr. Rosenthal, asking about his impressions of visiting the Third People’s Hospital of Henan Province twice and his views on the Disc Disease Specialty Alliance. Dr. Rosenthal mentioned that each visit to the hospital has been a great experience, and he witnessed the growth of the Disc Center. He also expressed that after more than three years of the pandemic, now is the perfect time for face-to-face communication and practical skill exploration, and he is looking forward to the future development of the Disc Center.

The Opening Ceremony of the 158th Session of Further Education

On the afternoon of Aug. 2nd, Dr. Rosenthal participated in the opening ceremony of the 158th session of further education. Representatives from 12 provinces including Hebei, Guizhou, Shanxi, Fujian, and Hubei, a total of 22 spine professionals, participated in the ceremony as well. During the ceremony, Vice President Yuan Qidong delivered a welcome speech, Prof. Zhou Honggang presented the current status of the Disc Center, and Deputy Director Song Kunfeng provided an presentation of the techniques involved in the Transforaminal Endoscopic Surgery.

Surgical guidance

Academic Lecture

On the morning of Aug. 3rd, Dr. Rosenthal visited the hospital's outpatient clinic and had a joint consultation with Director Ma Haijun.

After the outpatients were triaged, Dr. Rosenthal walked through the clinic looking for Director Ma to share his views on special cases. On that morning, he saw a total of 15 patients. One patient even brought a gift to the clinic to express gratitude to Dr. Rosenthal for patiently reviewing her images and diagnosis over three consecutive days.

In the afternoon, Dr. Rosenthal gave a presentation titled "Clinical and Research Translation in Spinal Surgery" at the seminar held at the Disc Center. He explained the relationship between basic research, clinical research, and translational research. Dr. Rosenthal mentioned that the direction of translational medicine research is generally from basic research to clinical research, from the laboratory to the bedside. Dr. Rosenthal believes that innovative thinking is also a crucial aspect of translational research. He shared his experiences of success and failure in reverse translational research, highlighting its significance.

Dr. Rosenthal later quoted the words of the great physicist Albert Einstein, "The true sign of intelligence is not knowledge but imagination." as a conclusion. We cannot obtain different answers from the repetition of day-to-day work. Nor can the knowledge we gain be labeled as success. Only by consistently innovating and not letting the complacency of existing knowledge restrict our imagination, can we truly enhance our personal development.

Dr. med. Daniel J. Rosenthal

Head of the Section of Spine Surgery, Regional Hospital Bad Homburg, Germany

President of the German Spine Society(2013)

Dr. Daniel J. Rosenthal was born and finished his medical study in Argentina. After graduation, he went to University Hospital Frankfurt am Main in Germany for further medical research and received his medical doctor degree. From 1992-1996, he was appointed as the Head of staff and vice director of the Clinic for Neurosurgery, University Hospital Frankfurt am Main in Germany. Now he is the Head of the Section of Spine Surgery in Regional Hospital Bad Homburg, Germany. He also holds positions in a number of academic societies around the world, for example, he served as the President of the German Spine Society in 2013. He had great achievements in thoracoscopic spine surgery. Until 2021, he went above 3,000 thoracoscopic spine surgery performed by himself. 

Surgical Focus

Minimal invasive procedures of the spine, focusing on anterior approaches to the whole spinal axis with main focus on endoscopic treatment of the dorsal

(thoracoscoppy) and lumbar spine (retroperitoneal lateral and anterior approaches)

For the cervical spine and for posterior approaches we use the microsurgical technique. 

For instrumentation we perform long fixations and when short instrumentation is needed we switch in the majority of the cases to percutaneous techniques.

Clinical Focus

Degenerative affections of the whole spine including simple disc herniations, stenosis, lysthesis ending in degenerative adult scoliosis

Infectious diseases

Tumors and trauma, especially of the cervical spine

Adolescent spine diseases are not treated in Bad Homburg

Prizes

1991 W Tönis Travelling Award(German neurosurgical society)

Patents

1994 Endoscopic instruments (Aesculap)

1995 Endoscopic Instrumentation (Sofamor Danek)

Book

Thoracoscopic Spine Surgery

Dickman C, Rosenthal D, Perrin N. Thieme Medical Publishers, New York, Stuttgart, 1999