The Cedars-Sinai Medical Center is the home of the Neurological Surgery Residency Program. As a tertiary care referral center it provides a large variety and volume of complex cranial and spinal neurosurgical cases.

It is the third busiest Level 1 trauma center in Los Angeles with more than 2,000 major trauma admissions a year. There are a total of 877 licensed inpatient beds. A $100 million state-of-the-art 100-bed intensive care unit tower is expected to open in 2005.

Cedars-Sinai Medical Center provides multidisciplinary specialty care through a series of institutes, including the Maxine Dunitz Neurosurgical Institute at Cedars-Sinai and the Cedars-Sinai Institute for Spinal Disorders. These centers provide focal points of excellence in patient care, scientific research and education.

Under the umbrella of the Department of Neurosurgery are:

The Maxine Dunitz Neurosurgical Institute provides multi-faceted programs encompassing brain tumors, neurovascular diseases, functional disorders, pain, trauma, congenital central nervous system malformations and other complex conditions requiring neurosurgical intervention for both adults and children.

Under the direction of Keith L. Black, MD, the institute offers the full spectrum of treatment options.

A unique strength of the Maxine Dunitz Neurosurgical Institute is the ability to translate research findings from the laboratory into clinical practice, giving patients direct and rapid access to the latest treatment alternatives. This is especially crucial for individuals with complex, neurosurgical conditions who may have limited treatment options.

The Cedars-Sinai Institute for Spinal Disorders provides comprehensive and advanced spine care using state-of-the-art technologies and procedures. The institute treats the full range of spinal disorders that cause pain and disability, including congenital problems in children, degenerative disc disease, lower back pain, spinal cord tumors and spine trauma.

The institute offers interventional pain management treatments, diagnostic blocks and a full range of treatment options, from spinal consultations, chiropractic care and alternative medicine to complex surgical reconstruction, minimally invasive surgical procedures, cervical spine stabilization and artificial disc replacement.

The institute's spine physicians and specialists are also dedicated to developing new techniques and instrumentation for spine surgery, including several clinical trials. This research is the future for more effective approaches to alleviate spine and back pain for our patients.

The Emergency Department offers an in-house trauma surgical service with magnetic resonance imaging (MRI) and computed tomography (CT) scanning services and neuroradiology and angiographic capabilities - all available 24 hours a day. Two intensive units each with 10 beds are dedicated to surgical services, including neurosurgical and spine surgery patients. The surgical intensive care units have a full-time surgical intensivist and surgery resident staff that assist in coordinating overall patient management. The trauma surgery service and the surgical intensivist co-manage neurosurgical and multi-trauma patients with the neurosurgical resident and attending staff.

Pediatric neurosurgical patients are managed in conjunction with the pediatric attending and house staff on the dedicated inpatient pediatric ward, Pediatric Intensive Care Unit (PICU) and the Neonatal Intensive Care Unit (NICU). The NICU is a new, state-of-the-art, 48-bed unit managed by a team of neonatologists, fellows, residents and nurse practitioners. It has a an active pediatric transport system for patients transferred from outlying institutions. The PICU has a full time staff of four pediatric trained intensivists and rotating residents and medical students.

Outpatient facilities include the Maxine Dunitz Neurosurgical Institute and the Cedars-Sinai Institute for Spinal Disorders, where residents will participate in a variety of outpatient management experiences in cranial, spinal, peripheral nerve and functional disorders of neurosurgical adults and pediatric patients.

The Neurosurgical Institute has 10 exam rooms and digital radiology imaging facilities. It is fully staffed with administrative and nursing personnel.

The Cedars-Sinai Institute for Spinal Disorders combines both neurosurgical and orthopedics expertise in managing spine pathology. The institute has 17 exam rooms, digital imaging facilities linked to Radiology and X-ray capabilities within the consultation suite. It also is fully staffed with administrative and nursing personnel.

Junior neurosurgical residents are expected to spend at least two days a month in outpatient settings with the neurosurgical faculty. The Chief Resident will run a clinic where he or she will examine patients, do medical interviews, order appropriate studies and provide continuity of care for his or her patients under supervision of neurosurgical faculty.

The Neurosurgical operating room suite has seven dedicated operating rooms. These operating rooms are fully equipped for microsurgery, frameless image guidance, frame based stereotaxy, endoscopy, spinal instrumentation and extensive neurophysiologic monitoring for cranial and spinal procedures.

One operating room is equipped with intraoperative magnetic resonance imaging (MRI). Adjacent to the operating suite is a biplanar interventional neuroradiology suite for endovascular neurosurgical procedures as well as a dedicated computed tomography (CT) scan.

Surgery is scheduled Mondays through Fridays, but the operating room is open for emergency cases seven days a week, 24 hours a day. Residents will work in the operating room on a daily basis, exclusive of mandatory conferences and time off mandated by the Residency Review Committee.

Residents participate in all operative procedures at a level appropriate to their individual experience, ability and year in training. It is expected that each resident will be participating in surgical procedure on a direct one-on-one basis with the neurosurgical or spine attending.

The Marvin Davis Research Center at Cedars-Sinai Medical Center provides 60,000 square feet of space for medical research.

The neurosurgical faculty maintains two, independent NIH-funded laboratories. The work these labs focus on includes:

• Mechanisms of development and growth of brain tumors
• Immunotherapy, including the use of immunotherapy for glioblastoma patients to address residual tumor cells and the placement of dendritic cells after targeted stereotactic radiotherapy inside surgically inaccessible tumors.
• Translational work that includes disruption of the blood brain barrier for delivery of chemotherapy and gene therapy for brain tumors.

The Maxine Dunitz Neurosurgical Institute also maintains a strong collaborative with the Gene Therapy Institute at Cedars-Sinai in developing novel gene therapy for brain tumors and neurodegenerative diseases with Drs Maria Castro and Pedro Lowenstein.

A collaborative effort is currently being fostered as well with the Burnham Institute, one of the largest freestanding basic science institutes in the United States focused on brain tumors and neurodegenerative diseases. Collaborative efforts are under way in immunology of brain tumors, biology of neurodegenerative diseases, basic biology of stem cells, and development of drug delivery vectors for brain tumors.

Several other collaborative projects are being developed for the use of white light spectroscopy, and lasers in clinical neurosurgery with Daniel L. Farkas, MD, Director of the Minimally Invasive Surgical Technology Institute (MISTI) and Vice Chairman of the Cedars-Sinai Medical Center Department of Surgery.

The Cedars-Sinai Institute for Spinal Disorders also maintains an independent research laboratory to study spine biomechanics. These are grant-supported research activities and have full time Ph.D. support. The clinical research programs are supported by research nurses coordinating the clinical research programs and administrative space for research personnel involved in clinical trials and research is in place.

Neurosurgical resident have access to the Cedars-Sinai medical library. A library for neurosurgical residents with standard neurosurgical texts is available to the house staff 24 hours a day, seven days a week. In addition, residents have access to we-based medical literature search engines such as pubmed through the medical library and computers in residents' offices.