Message from the Co-Directors

Michael and Albert


As we move towards the end of our academic year, we would like to celebrate our successes for 2022/2023. In our pandemic recovery, The U of T Spine Program has continued to foster city-wide collaborations within the university and its affiliated hospitals while taking the lead in several key initiatives. Our Program has continued to develop a respected academic footprint locally, nationally and globally. Collaboration and inter-professional multi-disciplinary knowledge exchange remain as  key elements to our success. As most of the restrictive public health measures have been lifted, our program has continued to provide a full and rich calendar of academic activities (in hybrid format and encouraging in-person attendance).  This has enabled continued remote participation from alumni and spine community colleagues throughout Canada and across the globe.

On June 12th this year, our Program marks the 15th Annual Spine Academic Day “SpineFEST.” At this time of the year, we congregate to highlight our spinal community’s accomplishments and disseminate recent clinical and scientific advances.  We are pleased to host Dr. Shekar Kurpad, Professor and Chair of Neurosurgery at the Medical College of Wisconsin, as our keynote speaker for the SpineFEST Tator-Hall Lecture. Dr. Kurpad is the Co-Director of the Center for Neurotrauma Research at Medical College of Wisconsin, and the Medical Director of the Neuroscience Service Line at Froedtert Health. He is the Director of the Spinal Cord Injury Center at Froedtert and the Medical College of Wisconsin. He is also the Founding Director of the Neuroscience Institute. Dr. Kurpad is a world leader in the development of novel MRI-based imaging biomarkers for spinal cord injury (SCI) and for cervical spondylotic myelopathy, a topic on which he will provide the keynote address. Please join us in welcoming Professor Kurpad to SpineFEST 2023!.

A session on imaging biomarkers will follow the keynote lecture by Professor Kurpad. A number of faculty and trainees will share their research update on imaging biomarkers related to spinal disorders.  The meeting will continue with invited trainee presentations that highlight outstanding clinical and basic science research.

Many thanks to our program judges for reviewing a numerous abstract submissions.  We appreciate their time and expertise. Although many excellent submissions were received, we could only designate a few as Best Abstracts which will be presented orally. The remaining abstract submitters will have the chance to present their work at the Elevator Pitch session.

The U of T Spine Program continues to leverage our foundational education platform to help create and support a national spine surgery fellowship training curriculum for cognitive and procedural competencies. Apart from tracking fellowship training experience, our efforts have enhanced cross-institutional and collaborative Neurosurgery and Orthopaedic Surgery spinal training opportunities across Toronto Academic Health Sciences Network (TAHSN) teaching hospitals including Toronto Western Hospital (TWH-UHN); Sunnybrook Health Sciences Centre (SHSC); Unity Health Toronto (UHT); and the Hospital for Sick Children (HSC). We have built a top-tier academic hub that attracts 12-15 national and international clinical fellows and many additional visiting surgeons each year. Over several years, our program continues to offer both a one-year core fellowship training experience and a two-year fellowship program with a first-year comprehensive spine training experience followed by a second year focused on advanced subspecialty exposure.  While the fellowships remain primarily focused and based at one of the TAHSN hospitals, opportunities exist and have been supported for city-wide experience. Many thanks to Drs. Albert Yee, Michael Fehlings, Stephen Lewis, Eric Massicotte, Jeremie Larouche, Chris Nielsen, Joel Finkelstein, Howard Ginsberg, Henry Ahn, and Reinhard Zeller for their valued help in shaping our citywide fellowship training opportunities. Building upon our national fellowship curriculum, our Program also continues with the surgical case-log for our citywide spine fellows with around 11,000 cases and procedures recorded since 2015. We thank Drs. Jeremie Larouche, Tony Bateman, and Ms. Nadia Jaber for creating a successful case-log program for our citywide fellows, and Drs. Ahmed Cherry and Nisaharan Srikandarajah who reviewed our broader city-wide university case-log experience this year as current fellows.

In recognizing Spine Surgery as a distinct formally designated discipline at the Royal College of Physicians and Surgeons of Canada (RCPSC) level, our application to develop Area of Focused Competence (AFC) in spine surgery was approved for national development in November 2021.   The proposal to establish a RCPSC (AFC) was developed through the Canadian Spine Society (CSS) in conjunction with five other Canadian universities including the U of T. The process now has evolved into a national Royal College working group which has drafted 3 key documents (a Portfolio highlighting minimal requirements in training record, a Clinical Training Requirement CTR document which is an updated national curriculum, and a Standards of Accreditation (SA) document which will form the basis for accrediting university training programs for the diploma.  These documents are currently undergoing additional internal Royal College review. There will be both adult and paediatric streams and an eventual stream also for staff surgeons already in established practice.  We look forward to our ongoing efforts with the CSS and the RCPSC in developing the certifying standards and in-training portfolio. Thanks to Drs. Albert Yee, Jeremie Larouche, Michael Fehlings, Scott Paquette, Hamilton Hall, CSS office, and Ms. Nadia Jaber for taking the lead in engaging our national society, several university spine programs, and fellowship directors across Canada in this initiative. The diploma will provide a valued competence-based model for our international community of surgical educators. This also opens the door for international collaborations as several international specialty organizations have inquired about our approach and plans.

This year as in the past, we launched our academic calendar of events with a welcome dinner for our incoming fellows and provided an update on our citywide research opportunities. Thanks to Drs. Carlo Ammendolia and Karl Zabjek for keeping us updated on the progress of spine research in Toronto. We featured outstanding research projects being conducted by our graduate students, residents, fellows, and scientists.  Dr. Stephen Lewis continued an annual tradition in chairing a citywide fellow surgical skills course, introducing advanced anatomy of the spine with fellows performing both anterior and posterior surgical approaches as well as spinal instrumentation. Over the past several years, Dr. Lewis has expanded this course to include advanced complex procedures including deformity osteotomy, minimally invasive surgery, and trauma techniques. The course encompasses a combination of wet lab with image guidance technology, and faculty lectures with case-based discussions throughout the day. Many thanks to our industry partners: Medtronic, Stryker, and De Puy Synthes, for their continued support of this integral training experience.

We continued to complement the residents’ surgical training with our Royal College Mock Oral course prepping senior residents from both neurosurgery and orthopedic surgery through various case scenarios. We have had 8 neurosurgery residents and 11 orthopaedic surgery residents siting the Royal College examination this year. The course is Co-Chaired by Drs. Fehlings and Yee and supported by a number of faculty and spine fellows who have taken a leadership role in teaching the residents and organizing a selection of representative case scenarios in Royal College examination format. We thank our citywide fellows Drs. Ahmed Cherry (Lead), Ragavan Manoharan, Nisaharan Srikandarajah, Rajesh Kumar, Mark Chu Xu, and Raj Sakhrekarfor for teaching our residents. Also, many thanks to our faculty members Drs. Chris Witiw, Joel Finkelstein, Jeremie Larouche, and our alumnus Dr. Simon Harris for their invaluable input and guidance at the course. The Traumatic Spinal Cord Injury Course on Management and Classification this year implemented a new e-learning teaching models with pre-recorded lectures and online in-steps training followed by an in-person practicum and case-based interactive discussions. A special thanks to Dr. Sukhvinder Kalsi-Ryan and Ms. Jaber for planning and organizing a successful hybrid training model, and many thanks to the course faculty; Drs. Michael Fehlings, Jeremie Larouche, Jeff Wilson, and Julio Furlan for their valued contribution. The Spine Program continues with new educational initiatives each year, including a new course on Pediatric Deformity Surgery held on May 2nd which received very positive feedback. Thanks to Dr. David Lebel for chairing and organizing this important course. Many thanks also to SickKids faculty Drs. Stephen Lewis, Jennifer Dermott and Mark Camp for their outstanding case-based lectures and relating teaching.

Over the past several years, our Program has been keen on bringing together citywide surgeons and trainees in multiple virtual events. The citywide Fellow Journal Club continues to be held several times a year. We discussed multiple hot off the press spine articles with a focus on education in spine surgery, management of metastatic spine lesions, and controversies around spinal fusion. Thanks to our citywide fellow Drs. Ahmed Cherry, Rajesh Kumar, and Raj Shakhrekar for leading the journal club presentations. 

The Program invites several world-renowned Professors each year as part of our well established Hospital-Based Visiting Professorship series. A few previously scheduled lectures resumed when pandemic restrictions were eased. On August 22nd, we were delighted to have hosted Dr. Dror Ovadia from the Pediatric Orthopaedic Department at the Dana Dwek Children's Hospital in Tell-Aviv, Israel, who shared a number of severe scoliosis cases and their related surgical management. On April 17th, it was wonderful to have learnt from Dr. Ian Vlok (Head of Division Neurosurgery & Chief Specialist, University of Stellenbosch & Tygerberg Academic Hospital, South Africa) about the challenges and opportunities related to delivering patient care and high quality education in South Africa. On October 21st, we were excited to have had Dr. Michael Sofroniew from the University of California Los Angeles visiting us as the keynote speaker for the Tator-Turnbull Spinal Cord Injury Symposium and discussing his innovative research on cell biology and mechanism-based repair after SCI.

Our Program recognizes the university-wide initiatives around wellness, equity, diversity, and inclusion (EDI) as core values that promote excellence. We appreciate Dr. Eric Crawford’s (our alumnus) efforts in leading EDI and Wellness initiatives advocating for physicians’ wellness to minimize mental health issues and burnout. Dr. Crawford led “vulnerability is strength”, started “Wellness Rounds” for orthopaedic residence, and is currently planning to engage in the Peer-Support Champion Program at Sunnybrook and to bring this model back to the Divisions of Orthopaedic and Spine Surgery. Dr. Crawford stands as a powerful spokesperson when he openly shared his battle with depression and burnout during his training. We are proud of Dr Crawford’s leadership in physician health and we look forward to future wellness initiatives within our Program. 

Earlier this year, our program initiated a volunteer and internship program to offer university students a valuable exposure to our spine academic activities, research, and clinical management. We welcome Ms. Delphine Li, our undergraduate neuroscience students for joining our Program as the inaugural volunteer student and for supporting and shadowing Ms. Jaber in moving forward our Program agenda.

We want to take this moment and celebrate the graduation of our 2022/2023 citywide spine fellows who will be completing their fellowship training in July this year. Congratulations to Drs. Rajendra Sakhrekar, Shadi Hayek, Fabio von Faber-Castell, Mohammad Alshardan, Jay Toor, Ali Eren, Rajesh Kumar, Motti Zucker, Ahmed Cherry, Nisaharan Srikandarajah, Ragavan Manoharan, Aditya Raj, Mark Chu Xu, and Doron Edelman. We wish them a successful and rewarding professional career. We look forward to their continued future engagement in our Program’s activities as valued alumni members.

On a final note, we want to extend our appreciation to the University of Toronto Department of Surgery Spine Program Council, educators, and trainees for their continued dedication and support in making this past academic calendar a notable success. We wish to recognize the support from the U of T Department of Surgery and Divisions of Neurosurgery and Orthopedic Surgery. Special thanks to Dr. Carol Swallow, our new Chair of the Department of Surgery, and Dr. Peter Ferguson (Chair of Orthopaedic Surgery) and Dr. Gelerah Zadeh (Chair of Neurosurgery) for their longstanding and strong Departmental and Divisional support of our university wide program.  We also would like to thank all our long-standing industry partners (Medtronic, De Puy Synthes, and Stryker) for their continued support over many years and particularly during the recent challenging pandemic years. We also thank Cerapedics and Bioventus for their support to other Program educational activities occurring this year. Many thanks to our Program members, we are privileged to benefit from your diverse and specialized knowledge. Special thanks to Ms. Nadia Jaber, our Program Manager, for her outstanding expertise and valued information and communication skills. She has and remains invaluable towards moving forward our collaborative agenda.  She has been instrumental in adapting innovative models for us to deliver our academic content and events during this evolving post-pandemic time.

In closing, we wish to celebrate another outstanding academic year in our U of T Spine Program and we look forward to summer break followed by and exciting 2023-2024 academic calendar.


Michael Fehlings & Albert Yee, Co-Directors

June 12, 2023