The Center for Spine & Orthopedics, P.C. is solely devoted to the care of spinal disorders in the pediatric and adult populations.  The CSO staff includes two orthopedic spine surgeons, Michael E. Janssen, D.O. and Joseph Morreale, M.D., and Physiatrist, George Leimbach, M.D. in addition to other allied health professionals.  Fellows will receive a broad clinical and operative experience that includes patients with degenerative spinal disorders, deformities, and trauma.  CSO offers a unique experience with varying philosophies, exposure to multiple surgical techniques, and a well-rounded approach to spine care, including both non-surgical and surgical treatment plans.

Michael Janssen, D.O.,  and faculty members of the Spine Education and Research Institute, are committed to and volunteer many months each year in international countries building relationships with international surgeons and learning centers across the globe.  In past years, they have been invited to Saudi Arabia, United Arab Emirates, Hong Kong, Canada, Venezuela, Colombia, Chile, Netherlands, United Kingdom, Japan and China.

For further information about this program, please feel free to contact Dr. Levine or Ruth Beckham, RN, at the Center for Spine & Orthopedics at 303.287.2800.

The comprehensive spinal fellowship is designed to provide educational experience in spinal pathology to a board eligible/certified graduate of orthopedic surgery training programs with clinical and research experience in preparation for a career in spinal surgery.

Participation in ongoing research projects is mandatory.  This research is undertaken through SERI.  Each fellow is required to complete one research project suitable for presentation and/or publication in a peer reviewed forum or journal prior to completion of the fellowship.

1.  Board eligible/certified in orthopedic surgery or neurosurgery.
2.  Obtain and maintain a Colorado state licensure (4-6 month process).
3.  Have hospital privileges at the training institutions (3+ month process).
4.  Future career in spinal surgery.

There are two major teaching conferences each month.  The Spine Fellow is expected to do appropriate reading and preparation to engage in the discussions regarding the assigned topics, to prepare and deliver four presentations, and participate in the Denver Spine Monthly Journal Club.  The Spine Fellow is to attend and participate in the annual North American Spine Society meeting and other educational event that are recommended/approved by the faculty.


Completion of this Fellowship, surgeons should demonstrate clinical competency, research, teaching, and administrative skills.
A.  Clinical Competency – Be an accomplished physician and surgeon in the non-operative treatment of a wide variety of spinal disorders:
1.  Learn the key decision points in the patient’s subjective complaints and medical history.
2.  Understand the interpretive value in diagnostic tests and procedures.
3.  Read and interpret spinal imaging studies.
4.  Perform a thorough and efficient spine examination.
5.  Understand the natural history of common spinal disorders and injuries.
6.  Understand the surgical treatment options of common spinal disorders and injuries.
7.  Recognize the risks and potential benefits of each treatment intervention.
8.  Become familiar with the surgical anatomy of the spine.
9.  Understand the principles involved in specific surgical procedures.
10.  Learn the post-operative care and rehabilitation of spinal injuries and operations.
11.  Recognize the potential late consequences of spinal procedures and injuries.
12.  Learn the emergent management of spinal cord injuries.
13.  Learn the preoperative and perioperative techniques or principles involved in the management of patients with unstable spine lesions.
14.  Become proficient in surgical approaches to the spine from the occiput to the sacrum, anterior and posterior.
15.  Become proficient in decompression and resection techniques in anterior and posterior spinal surgery.
16.  Become proficient in spinal instrumentation, including anterior and posterior instrumentation from the occipital cervical junction to the sacrum.
17.  Become proficient in grafting techniques used in spinal surgery.
18.  Understand biologic processes involved in spinal fusion.
19.  Understand biomechanical characteristics of spinal implants.
20.  Understand host-tissue – implant interactions of biomaterials used in spinal surgery.
21.  Understand principles observed in spinal surgery for traumatic injuries.
22.  Understand principles observed in spinal surgery for degenerative conditions.
23.  Understand principles observed in spinal surgery for deformity.
24.  Become proficient in clinical measurement and assessment of spinal deformity.
25.  Become proficient in radiographic measurement and assessment of spinal deformity.

B.  Research:
1.  Identify deficiencies in current state of scientific spine literature.
2.  Understand the process of scientific publication.
3.  Be able to conduct efficacious literature review.
4.  Acquire and polish scientific writing skills.

C.  Teaching:
1.  Acquire and polish skills in educating peers, physicians, students, and ancillary staff at every appropriate occasion.
2.  Develop initiatives towards applying and improving educational efforts.
3.  Develop PowerPoint presentation skills.
4.  Improve on effective formal presentation skills.

D.  Administration:
1.  Refine communication skills in interactions with colleagues of various disciplines, as well as ancillary staff, administrators, and patients.
2.  Become competent in current billing with coding procedures.
3.  Understand compliance with HCFA/Medicare evaluation and billing guidelines.
4.  Understand utility and value of meticulous medical records and correspondence.
5.  Understand effective risk-management strategies.
6.  Develop relationships with hospital administrators and community leaders