Is this where you thought you would end up? If you had it to do all over again, would you still become a spine surgeon?

Since I made my decision to become a spine surgeon, I have never changed my mind. After finishing my resident training, what I was most interested in was the skull base and vascular surgery—in other words, brain surgery—even though I was trained in Italy and most of my daily work then was about spine. There were no truly independent spine neurosurgeons in China 15 years ago, only someone operating on spinal cord tumors. No one would consider that spine surgery was part of neurosurgery at that time, and no neurosurgeon would choose spine as his/her subspecialty. After becoming a spinal neurosurgeon, I thought I could do spine surgery I like a challenge, trying new things, and as I said, there was no true spinal neurosurgeon in China 15 years ago. Because I was trained in Europe, and I knew the situation of spine in Europe and the US, I had a great expectation of spine in China for the future.not only myself, I should call upon many other neurosurgeons doing it together. I learned from many other countries, that neurosurgery is not brain surgery, and spine surgery is not orthopedic surgery. Neurosurgery should not be absent in spine surgery in China. So, from the early beginning of 2005, I began to hold hands-on courses about spine internal fixation and microsurgical technique, aimed at both neurosurgeons and orthopedic surgeons. Now the situation has changed, there are more and more young neurosurgeons in China choosing spine as their subspecialty, especially in the Department of Neurosurgery in Xuanwu Hospital, Capital Medical University, which is one of the biggest neurosurgical centers in China, spine accounts for nearly half of the total number of surgeries. So nowadays, I would absolutely choose spine as my professional career.

 

Why did you choose spine surgery and not something else?

I chose spine for two reasons. Firstly, as one of the biggest centers of neurosurgery, Xuanwu Hospital has very strict discipline for the division of subspecialty in neurosurgery—one cannot choose both There is a saying in Chinese, ‘give up, and then gain’, so I finally decided to give up brain surgery, and choose spine as my subspecialty.brain and spine as his/her subspecialty. Secondly, I like a challenge, trying new things, and as I said, there was no true spinal neurosurgeon in China 15 years ago. Because I was trained in Europe, and I knew the situation of spine in Europe and the US, I had a great expectation of spine in China for the future. There is a saying in Chinese, ‘give up, and then gain’, so I finally decided to give up brain surgery, and choose spine as my subspecialty.

 

What achievement are you most proud of?

I’m proud of two things. One is the establishment of a spine team in neurosurgery in Xuanwu Hospital, which is one of the biggest spine centers in China, among both neurosurgery and orthopedics. Currently, our spine team has eight staff, not including several other residents in training, there are 68 inpatient beds, and we expect to operate on more than 3’000 cases this year. The other thing I’m proud of is to have trained many spine neurosurgeons by holding a variety of courses in China, and constructing the fellow program in Xuanwu Hospital. Xuanwu Hospital has held nearly 30 hands-on courses about internal fixation and microsurgery of spine in China since 2005. I initiated the ‘annual national meeting of spinal neurosurgery’ in 2011, and in 2013 I organized a lecture group to train spinal neurosurgeons in China, with nearly 20 courses having now been held. Over the last four years, more than 20 fellows, both from neurosurgery and orthopedics, have received training in our hospital.

 

Who has had the greatest influence on your career? Who was the most inspiring person in your life and why?

My grandfather influenced me most in my life. Even though he was illiterate, he loved knowledge and he bought a lot of Chinese classical books when he was young. My father then went on to become the first teacher in our village, and my two brothers also entered universities. About 40 years ago, no more than one tenth of the young generation could pass the entry examination for After choosing spine as my subspecialty, I thought it’s the responsibility of our generation to develop spine subspecialty in neurosurgery, and in the specialty of spine, neurosurgeons could not be absent.university in China. My grandfather worked diligently and did every simple things into perfection. He always kept our house in order, tidy and clean, even though we were not rich at that time.

 

After choosing spine as my subspecialty, I thought it’s the responsibility of our generation to develop spine subspecialty in neurosurgery, and in the specialty of spine, neurosurgeons could not be absent. It’s easier said than done, especially in the beginning. Professor Feng Ling, ex-chairman of the Department of Neurosurgery in Xuanwu Hospital, Capital Medical University, gave me a lot of support. Her support was like a battery booster whenever I needed to rev up my courage or soothe my sagging spirit.

 

How does a typical work day look for you? How many surgeries do you perform, and what is your most frequent operation?

I have two or three operating days each week, and average two or three operations on each of those days. Cervical spondylopathy, craniovertebral junction deformity and spinal tumors are the most frequent surgeries I do. I visit outpatients one day a week and also have one day a week to discuss clinical and basic scientific study with our students.

 

What do you consider your biggest learning as a surgeon?

That not every disease can be treated surgically.

 

Working as a spine surgeon/neurosurgeon in China, is there anything particular in spine surgery to China and how has spinal surgery developed in China and in the rest of Asia in the past few years?

More and more neurosurgeons are learning internal fixation, and the number of spinal neurosurgeons is growing rapidly—several centers of spinal neurosurgery have been established in mainland China. At the same time, orthopedic surgeons are learning microscopic technique. In this respect, colleagues form Korean and Chinese Taiwan set us a good example.

 

What is currently the biggest challenge in your specialty and how do you see it developing in the next 5 years?

Functional recovery of spinal cord after surgery is a big concern, such as in cervical myelopathy and spine trauma. We, as surgeons, can do excellent surgery, but the experience of patients is not good. I’m not sure whether we could resolve this problem in the next five, 10 or 20 years, but we have to work hard on that.

 

What is the biggest change you have seen in spinal surgery over your career?

Minimally invasive surgical technique, degenerative lumbar deformity correction and complex cervical deformity.

 

Outside of your own research, what has been the most interesting paper that you have seen in the past twelve months?

The most interesting paper I have read recently was about brain-spine interface modulation for recovery of motor function of lower limbs after spinal cord injury. Even though I do not think electrical modulation will be the final resolution of spinal cord injury, it will change our thoughts on how to treat spinal cord injury.

 

What was the best advice you were ever given, and what advice would you give to a young spinal surgeon today? What are the biggest challenges they are facing today?

Professor Qi Pang from Shandong University taught me, if you want to dialogue equally with a great man, you should become great yourself first, not by flattering him. I advise young spine surgeons to learn the knowledge first, and operate on patients by brain, rather than only by hands. Nowadays, knowledge and new technique are emerging rapidly, but at the same time, many disputes also exist, especially when many so-called new techniques have a business background.

 

How do you inspire and mentor your fellows? In your opinion what makes a good leader—what is most important apart from the surgical knowledge?

As a good leader, you yourself should first have a clear goal or a dream about the future, for example, to make a big centers of spine both clinically and scientifically. Of course you should act towards that goal and set a good example to your fellows. Apart the surgical technique, one should also know very well the injury brought by the surgery. Additionally, communication with patients and relatives is very important.

 

How did you get involved with AOSpine, and what does being a member mean to you?

I became a member when AOSpine China contacted me about 10 years ago. AOSpine is an independent society which aims to encourage academic exchange and training, and it attracts many outstanding spine surgeons.

 

 

 

 

 

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Biography

 

Dr Fengzeng JIAN was born in August 1967, in Shandong province, China. Graduating from Shandong University medical school in 1990, Dr Fengzeng spent seven years working as a neurosurgeon in Beijing Hospital. From 1997 to 2003, Dr Fengzeng undertook resident training as a specialist of neurosurgery in Policlinico Umberto I, University of Rome ‘La Sapienza’, Italy. As of 2004, Dr Fengzeng is working as associated professor, professor and director of spine in the Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing. In 2014, Dr Fengzeng became vice chair of the Department of Neurosurgery, Xuanwu Hospital. Dr Fengzeng holds several professional positions, including President of Spine Committee of the Chinese Association of Neurological Surgery, executive member of Asia Pacific Cervical Spine Society and member of the spine committee, World Federation of Neurological Surgery (WFNS).