"At the Instituto Clavel I have learned a lot about minimally invasive spine surgery,” says Dr. Elías Javier


Elías Javier is the latest physician who has visited the operating rooms of Instituto Clavel to train in spine surgery thanks to the Fundación Clavel training grant. We talked to him, so he could tell us what his everyday experience has been like and all he has learned from professionals highly specialized in this surgical modality. 

Dr. Elías Javier originally from the Dominican Republic, moved to Spain more than seven years ago to develop his professional career as a doctor. Two years ago, he completed his residency in orthopedic surgery and traumatology and began to practice his profession in Tolosa (Basque Country, Spain). 

Within the scope of orthopedic surgery, spine surgery is the one that elicited his interest; therefore, his intention was to continue training in this area. One year ago he found an opportunity to do so through the recommendation of a colleague who had obtained the training grant awarded by the Fundación Clavel. His friend's experience went very well, so he decided to apply and he was eventually selected.

The training grant consists of a two-month stay with an individual monthly allowance of €1,200 (gross). During this time the fellow physicians acquire knowledge in innovative techniques in spine surgery such as ADR with anterior approach or the lateral XLIF approach, among others. Elías tells us about his experience during his stay at the Instituto Clavel.

Do you remember how was your first day?

It was a Monday in the early morning. On arrival I was impressed to discover that the Instituto Clavel is inside the Hospital Quirón because it is like seeing a hospital inside another hospital. A completely separate service, with a different organization and its own staff, despite having the resources of Quirón. 

On arrival, did they explain what your functions were going to be?

Yes, but they have informed me even before. When I was awarded the training grant, they sent me a description of what I was going to do there and, honestly, it has exceeded all my expectations. 

Tell us what your everyday life as a fellow is like.

Generally, in the early morning we review patients who are admitted to the ward to determine their treatment of the day. Then we attend patients, who mostly have been operated on the previous days. Then I go to the operating room. Personally, I tend to stay on both morning and evening shifts. 
In addition, one or two days per week I am in consultation rooms to complement what I see in the operating room, learning about how patients are assessed to get there, because apart from performing the procedure, it is essential to know when to indicate it correctly. I am also present at the day that they perform percutaneous procedures, since seeing it on a large scale contributes a lot to my training. 

How has the experience of working with the rest of the team members been? Do you feel integrated?

Yes, I completely do. They are extremely friendly and have welcomed me right away. It is a team very specialized in the pathology that they manage and they care a lot about their patients. It is something they convey when you deal with them. 

Regarding the technology used at Instituto Clavel, is there anything that has caught your attention? 

Yes, I was positively struck by the fact that they offer the most cutting-edge technological devices for treatment. They have high-tech resources to deal safely and efficiently with patients' diseases. 

What have you learned during your stay?

When I got here, I thought that I was going to learn about spine surgery in general, but now I realize that I have learned very specifically about minimally invasive spine surgery. Although the Instituto Clavel has a very high presence in the anterior approach of the lumbar spine, for both fusion surgery and for arthroplasties. Thanks to the different specializations of the team's neurosurgeons, I have been able to learn much more than that. I have also been able to be see up close the lateral approach to the lumbar and the thoraco-lumbar spine, called XLIF, thanks to the experience of Dr. Caiazzo and to know the treatment of the sacroiliac joint, in which Dr. Català is very specialized. In addition, they virtually breathe microdiscectomy and make it look easy, although it is a technique that requires a lot of work. 

What differences have you noticed from previous experiences?

The work on degenerative pathology, mainly from a minimally invasive point of view, and this is something that is not performed by the vast majority of clinics in Spain.  

Has the pandemic affected the development of your training at Instituto Clavel in any way?

No, they have taken many additional measures to maintain a safe environment for both professionals and patients attending the facility. 

Would you recommend the Fundación Clavel training grant to other physicians? Why?

Yes, I would recommend it without hesitation. I believe that for a medical professional who intends to focus on minimally invasive regenerative surgery, this is the ideal center because it has a fairly important workload and a team with professionals specialized in diverse techniques. Moreover, the best thing about Instituto Clavel is that all decisions are made by consensus. Twice a week, all professionals meet to review each case and decide which treatment option is the best. This is beneficial for both the team and the patients, who are guaranteed to receive the most effective treatment for their injury.

What will you do after the training grant ends? Has it help you to progress professionally?

Yes, I now feel completely confident to perform procedures in minimally invasive spine surgery of degenerative disease. Once I finish here, my next step is to continue with the training, as I have been offered another scholarship at the Hospital La Fe in Valencia to complement what I learned here, with the surgery for spine tumors and for deformity in children. Then the final objective will be to return to Tolosa in February to put into practice everything learned during this year of training that they have provided me.