Julia Bellamy - Dr. Jason Spector

I collected two intervertebral disc samples from Dr. Roger Hartl's C5/6/7 disc replacement case. We have an ongoing collaboration between Dr. Bonassar's lab and the neurosurgery department to collect these tissue samples. While waiting for the tissue to be collected, I was able to observe the surgery being performed. The anterior cervical discectomy was performed by opening the patient up from the front of the neck and using microsurgery to get to the spine. Two screws were placed across the disc that needed to be replaced. Then, the disc tissue was scraped away, almost looking like cold butter shavings. These were collected into a specimen jar. Vendors from NuVasive were then with guidance on how to use their "Simplify Cervical Disc Tool" that was used to first spread apart the vertebrae, and then put in the spacer that will be used as the replacement. These were all put into the disc space with an impactor/hammer and x-rays were used throughout the insertion to determine how much farther to go in. I was able to collect the disc tissue from the two disc replacements that Dr. Hartl performed. 

Also this week was my last week in clinic shadowing Dr. Spector. One patient was there as a follow up from a fat transfer to the breast after a radical mastectomy that we've seen a couple times in his office. It was interesing to see that the patients needed to sign a form to indicate what they talked about in the appointment. Another patient was a follow up from radiation to a scalp flap and Mohs surgery near the eye, with a followup on closing the hole that was made. Another patient was here following up with a slight complication from the spine closure case we have seen before, where there was ~30 cc of fluid buildup between the tissue planes that needed to be drained with a needle. Another patient was there for a consult for their rhuemotologist for rashes/irritation on knees/elbows that was referred to Dr. Spector. The patient from the tumor resection on the mandible with flap transfer from the thigh was there for another followup, and it was interesting to see the level of healing and ability to speak even though they were missing half their jaw and part of their tongue. It was also interesting to note that part of the surgical plan was to transfer a much larger flap than what was needed so for later surgeries there is enough healthy tissue now healed in the area that can be used to reconstruct the face. Another patient was there for a recurrent abscess/cyst removal on the inner upper thigh. The patient was first numbed and then a slight removal procedure was performed in the office. Another patient was there following up on a injury to the inner index finger from an impacting screw injury. Dr. Spector performed a nerve sensitivity exam by having the patient close their eyes and determine if they had sensation in different areas of the digits. It was determined that there is a high likelihood of nerve injury, with possible blood vessel and tendon injury due to the proximity of the anatomy. The best outcome to restore function to tip of the index finger would be to preform surgery as soon as possible to ensure healing of the nerve injury. Also present during clinic hours were representatives from MTF Biologics, a tissue bank company that takes in cadaveric and biologic tissues, processes them, and then delivers the materials to the surgeons that use them. 

India had finished the bioprinter last week, so this week I calibrated the system and sent all the protocols/methods for bioprinting with the system to the lab.

This is the last week in the summer immersion program. It has been a great experience!