Complex and Minimally Invasive Spine Deformity Fellowship

Complex and minimally invasive spine fellows are trained for all spinal diseases, degenerative, deformity, oncology, and trauma spinal pathologies. However, a special emphasis is placed on open and minimally invasive techniques to treat adult spinal deformity and perform complex reconstructive spine surgery. Conditions treated include, but are not limited to, congenital and adolescent idiopathic scoliosis, adult degenerative kyphoscoliosis, iatrogenic, deformity, complex cervical deformity and reconstruction following oncologic resection. However, all disorders of the craniocervical, cervical, thoracic, lumbar and sacral spine are treated. While there is faculty expertise on the treatment of spinal deformity, ample exposure is also given to degenerative conditions, tumors of the spine and spinal cord, infection, congenital spinal disorders, trauma and inflammatory disorders. The majority of the faculty have dual training in orthopedic and neurological surgery with busy spine practices covering the entire range of disorders of the spine and spinal cord. As a large quaternary care academics institution, UPMC provides exposure to a myriad of rare pathologies for fellows. The option for additional training in peripheral nerve, sports medicine, spinal stereotactic radiosurgery is available as well. Overall, the fellowship offers a transition to practice experience. Individuals completing the fellowship will be well-suited for a career in academic spine surgery with the ability to proficiently perform procedures in an autonomous fashion.

Academic Spine
The fellowship offers a unique opportunity for accreditation by both AO Spine and CAST. The AO Spine Fellowship Program offers a unique funded opportunity to participate in the Fellows Cadaver course, Complications course, the Banff Fellows Forum, and the Global Spine Diploma Program and Exam. It also offers AO Spine Membership and access to several AO Spine North America academic opportunities throughout the year.

The fellow is funded for any spine society meetings whereby research findings have been accepted for oral presentation. Fellows will be encouraged and supported to engage on a national level with the academic spine community via annual conferences including, but not limited: AO Spine, Spine Summit, and Scoliosis Research Society. Other opportunities for networking and research presentation include AANS, CNS, IMAST, CSRS, LSRS, ISASS, SMISS, or the North American Spine Society. Applications for the SRS North American Meeting Scholarship for Residents and Fellows are encouraged. 

Translational Research
The amount of time dedicated for research is flexible. A weekly fellow and resident spine working group conference is held and participation is encouraged. Fellows will have access to prospective spine registry to conduct research studies. Opportunities to collaborate with University of Pittsburgh School of Medicine medical students and neurosurgery residents will be available. Fellows participating research will be well-suited for conducting independent studies and securing grant funding upon completion of the fellowship. Fellows have exposure to high level team science. Faculty are members of the International Spine Study Group (ISSG) and frequently collaborate with investigators from the American Spine Registry (Quality Outcomes Database Study Group). Applications for young investigator grant opportunities through AO spine, CSRS, LSRS, and Spine Summit will be supported. Additional funding is available for strong research proposals through several mechanisms including the internal department Walter Copeland Fund.

Education Experience
Spine case conference occurs on a regular basis. Discussion and didactic lectures are provided to the fellows and spine residents to discuss complex cases and ongoing research.

Regular cadaver courses are scheduled for advanced techniques including but not limited to lateral and prone lateral access, endoscopic surgery, robotic surgery, and advanced deformity corrections. The fellow may also participate in the schedule neurosurgical cadaveric course for additional education. The fellow will be expected to participate in this didactic training while also teaching junior residents. These didactic training conferences include: core curriculum didactic lectures, preoperative conferences, journal club, and M&M conferences. Participation in national fellow-centered courses will be supported as well. Lastly, opportunities for focused external rotations or traveling fellowships with appropriate educational agendas will be supported to enhance educational experience.  

Application Requirements
The fellow is given attending privileges as a clinical instructor in the University of Pittsburgh Department of Neurological Surgery. All fellows within Neurological Surgery must be eligible for work within the United States as well as a permanent Pennsylvania medical license and DEA license. Interested applicants should apply by sending a cover letter, curriculum vitae, and at least two reference letters. Fellowship typically fills three years in advance. Interviews are held in April each year. 

Contact Information
The UPMC neurosurgery spine fellowship is accredited by both AO Spine and CAST. Applications should be directed to Melissa Lukehart ( Additional inquiries should be directed to Nitin Agarwal, MD.

UPMC Presbyterian, UPMC Shadyside, UPMC Mercy, VA

Fellowship Director
D. Kojo Hamilton, MD

Fellowship Co-Director
Nitin Agarwal, MD

Fellowship Faculty
Nitin Agarwal, MD (Director, Minimally Invasive Spine and Robotics Surgery)
Thomas J. Buell, MD (Complex Spine, Spinal Oncology)
Peter C. Gerszten, MD (Spinal Stereotactic Radiosurgery)
D. Kojo Hamilton, MD (Director, Spine Services)
Vincent J. Miele, MD (Complex Spine, Sports Medicine)
John J. Moossy, MD (Pain, Peripheral Nerve)
David O. Okonkwo, MD, PhD (Director, Neurotrauma and Spinal Deformity)

Special Features
Dual AO Spine and CAST Accreditation
Faculty with AO Spine and Dual Orthopedic and Neurological Surgery Training
Faculty with Professional Sports Team Affiliations
Team Science Opportunities (ISSG, ASR)
Funded Research Opportunities
Funded Conferences and Presentations
Clinical Research Coordinators and Fellows
Transition to Practice Fellowship Paradigm

Surgical Techniques
Open and MIS Deformity Correction
Freehand, Navigation, and Power Screw Placement 
Minimally Invasive Percutaneous and Tubular Surgery 
Robotics Surgery
Endoscopic Surgery
Stereotactic Radiosurgery
Lateral and Prone Lateral Access (LLIF, OLIF, Lateral ALIF)
Sacroiliac Joint Fixation (Posterior and Lateral Approach)

1 Year

July 1 through June 30

Research Funding and Moonlighting Opportunities Available

AO Spine and Committee on Accreditation of Subspecialty Training (CAST)

Past Fellows
Daniel Hafez, 2021-22
Daipaya Guha, 2020-21
Jason McGowan, 2018-19
Luke Hnenny, 2017-18
Kourosh Tavanaiepour, 2016-17
Hazem Mashaly, 2014-15
Brian Bolinger, 2013-14

Past Enfolded Fellows
Nitin Agarwal
Nima Alan
Alp Ozpinar
Christian Ricks
David Salvetti
Zachary Tempel