Chapter 2058: Chapter 1781: This Is Real Mentorship

Yang Ping goes to the Imperial Capital Xiehe Hospital once a month, where there’s a dedicated Orthopedics Ward for his teaching.

The old building of Xiehe was constructed in the fifties, its exterior walls covered with ivy. At this season, the leaves haven’t fully grown, and some areas of the hallway walls have peeling paint, revealing mottled bricks inside. However, the Operating Room has been newly renovated, with equipment even newer than Sanbo’s.

Yang Ping walked into the doctor’s office in the ward, where it was already crowded.

The young doctors stood in their White Gowns, neatly arranged in two rows. Some held thick medical cases; others carried notebooks. One seemed nervous, rubbing hands secretly, since Professor Yang is a top-tier doctor, which naturally made the younger doctors a bit anxious.

Upon seeing Yang Ping enter, everyone straightened up.

"Hello, Professor Yang!"

The greeting was so synchronized that it seemed rehearsed.

Yang Ping nodded: "Hmm, let’s begin."

The teaching rounds began at eight-thirty.

Song Yun led the way at the front, followed closely by Yang Ping, with a long line of doctors behind them. Two medical Doctors pushed carts with patient cases at the back, the wheels producing a soft squeaking sound as they rolled over the floor.

The first ward, yet to enter.

Song Yun lowered his voice, "Professor, you’ve seen the images of this case, it’s the patient with the upper cervical spinal tumor, very pessimistic about the effects of treatment."

Yang Ping nodded, "Does the patient know the true extent of their illness?"

"He knows!" Song Yun responded, "That’s why he’s extremely pessimistic, he’s even had suicidal thoughts in the past."

Song Yun pushed the door open, and Yang Ping entered.

On the hospital bed lay a young man in his thirties, wearing a neck brace. He was very thin, with sunken eyes and scattered gaze, looking in poor spirits. Upon seeing Yang Ping enter, he struggled to sit up, but Yang Ping gently held him down.

"Lie down, don’t move."

Song Yun started reporting, "Patient Someone Li, male, 34 years old, hospitalized due to ’neck pain accompanied by progressive limb weakness for 3 months.’ Treated as cervical spondylosis at the local hospital, symptoms worsened. Two weeks ago, he had difficulty breathing, urgently transferred to our hospital. Imaging examinations indicated: a massive lesion located posterior to the axis odontoid, suspected chordoma, tumor size approximately 4.2×3.8×3.5 cm, compressing the junction of the medulla and cervical cord, both vertebral arteries encircled by the tumor. Consultation with the Intervention Department has been requested, planning to perform vertebral artery embolization first, followed by posterior tumor excision.

Yang Ping said nothing, took the film, and examined it for a long time against the light outside the window.

The office was quiet enough to hear the rustling sound of ivy leaves blown by the wind outside the window.

After watching for a full three minutes, he put down the film, walked to the bedside, and started a physical examination. He asked the patient to move his fingers, wrists, and toes, and tested different skin zones with a cotton swab. Finally, he asked the patient to try gripping his hand; the patient used much effort, but his grip strength was noticeably weakened.

Yang Ping straightened himself up and asked a question, "How severe is the difficulty in breathing?"

Song Yun replied, "Worsens when lying flat, alleviates when lying on the side. Sometimes wakes up suffocating at night, needing to sit up to breathe better."

Yang Ping nodded and asked, "When is the vertebral artery embolization scheduled?"

"Next Wednesday."

"Who is the Chief Surgeon for the tumor excision?"

Song Yun hesitated momentarily and said, "I am."

Yang Ping looked at him, saying nothing. Song Yun felt a bit uneasy under his gaze and lowered his head.

After a while, Yang Ping said, "Explain your approach."

Song Yun took a deep breath and began, "I plan to use a midline posterior incision, exposing the occipital bone to C4. First, locate the bilateral vertebral arteries, dissecting toward the tumor direction from intact areas, trying to protect them. Then open the vertebral canal from behind, first separating the relationship between the tumor and the Dura Mater. For the tumor segment encasing the vertebral artery, if unable to separate, consider cutting one side of the vertebral artery, provided that preoperative balloon occlusion tests demonstrate adequate compensation from the contralateral side..."

He gestured as he spoke.

After listening, Yang Ping began on-site teaching, "Upper cervical spinal tumors are the crown jewels of spinal surgery. Mishandling could lead to high-level paralysis or even fatality."

He paused and continued, "I will come again for this case next Wednesday."

"In these days, refine the surgical plan, every step, every potential accident must be considered thoroughly. Call me next Tuesday night, only after hearing your plan am I reassured."

Yang Ping advised, making the patient feel particularly secure.

Song Yun nodded vigorously, "Yes, Professor."

The second ward housed a fifteen-year-old girl.

The girl was thin, wearing a loose hospital gown, curled up at the corner of the bed with her mother sitting beside her.

Song Yun whispered, "Idiopathic scoliosis, Cobb angle 105 degrees, combined thoracic kyphosis. Pulmonary function tests indicate moderate restrictive airway impairment. Previously wore a brace for three years at an external hospital with no effect; surgery correction is now considered."

Yang Ping walked to the bedside, asking the girl to stand, facing away from him. The girl timidly stood up; the hospital gown failed to hide the conspicuous bulge on her back, her right shoulder higher than her left, and her right scapula resembling a wing protruded.

Yang Ping asked her to bend over, touching the position of each spinous process from cervical to coccygeal vertebrae. Then he asked the girl to lie back, taking up the film for examination against light.

The 105-degree curve, bending from thoracic to lumbar vertebrae, made her spine look like a giant S shape. Her Heart was pressed to the left, and her right lung was compressed to a thin layer.

After watching for a long time, he asked, "How do you plan to proceed?"

Song Yun replied, "Planning posterior spinal scoliosis correction, pedicle screw internal fixation, bone graft fusion, segment fusion from T2 to L4."

"What about osteotomy?"