[Global Medical Leader | Field of Spine disease]

An authority in the spinal disease leading orthopedics

Kim Ki-taek, Honorary Director of Spine Center, Dongtan City Hospital | President of the Korean Orthopedic Association

It is never easy to be recognized as a noted doctor. When a doctor accumulates expertise in the field for a long time and becomes a competent person recognized by others, he or she becomes a noted one. Kim Ki-taek, honorary director of the Spine Center at Dongtan City Hospital, is a person who made the history of spinal medicine and spinal disease treatment in Korea while serving as the chief of Kyung Hee Univesity Medical Center and the director of Kyung Hee University Hospital at Gangdong. He met a patient with ankylosing spondylitis, and successfully led the major surgery after seven months. As a result, the patient who was unable to see properly due to waist bending at 40 degrees can walk by himself. The surgery has been praised by the field of domestic orthopedic surgery and published several times in overseas journals.

Recently, Honorary Director Kim newly established himself at Dongtan City Hospital. His invitation was good news for severe patients who were difficult to treat, such as ankylosing spondylitis and scoliosis, in southern Gyeonggi and Dongtan. This is because it is possible to undergo active treatment, including spinal surgery, which could not be easily attempted even at university hospitals. Honorary director Kim is determined to fulfill his mission as a doctor. Journalists_Kim Yu Wi and Kim Yu Jin

A new start at Dongtan City Hospital

Honorary Director Kim is known as the name of high-level spinal surgery that has completed more than 9,000 operations so far, including spinal deformities such as disk dislocation, scoliosis, and ankylosing spondylitis since 1994.

Kim, a graduate of Kyung Hee University Medical School, served as the director of Gangdong Kyung Hee University Hospitals spinal center, orthopedics, and medical deputy director. Then since 2015, he served as the director of Gangdong Kyung Hee University Hospital. When he was the director of Gangdong Kyunghee University Hospital, he treated 700,000 outpatients and actively attracted overseas patients, making a great contribution to improving profitability. Also, he made his full effort to foster young biomedical scientists with various supports.

Despite his busy schedule, he actively engaged in activities at the Korean Society of Spine Surgery and the Korean Orthopedic Association and devoted himself to academic development. He was recognized for his contribution by receiving the Best Paper award from the Korean Fracture Society, an academic award from the Korean Society of Spine Surgery and the Japanese Orthopedic Association. In November 2022, he was elected as the next president of the Korean Orthopedic Association. From 2018 to 2022, he served as the director of Kyung Hee Medical Center and the medical vice president of Kyung Hee University and was invited as the honorary director of Dongtan City Hospital in September 2022.

The reason why he made a new start at Dongtan City Hospital is because of his special connection with Shin Jae-heung, the director of Dongtan City Hospital. Honorary Director Kim is also a university alumnus of Shin. Moreover, they are in a relationship between a mentor and a mentee. Shin Jae-heung, the director of the hospital, reportedly tried to invite honorary director Kim to strengthen medical capabilities and expertise. Honorary Director Kim also decided to join Dongtan City Hospital, deeply sympathizing with the human values that the hospital aims for.

¡°When I left Kyung Hee Medical Center, where I had been for more than 40 years, I received several suggestions, and I decided to go to the place that needed me the most. Among them, I chose Dongtan City Hospital as I wanted to help Shin by watching his running of the hospital for a long time, and I felt that he was a student who needed me most desperately. I thought that leaving the patients would be the end of my life as my major job is in the field of medicine. I chose Dongtan City Hospital because I was moved by Shin and Dongtan City Hospital, which emphasize patient-centered medical beliefs, that the mind of understanding patients at first met skilled and rich technologies.¡±

Dongtan City Hospital expects that with the joining of Kim, it will play a pivotal role in spinal treatment by further strengthening its capacity and expertise in the area of spinal disease. Currently, Dongtan City Hospital operates neurosurgery, general surgery, and department of rehabilitation medicine, internal medicine, family medicine, radiology, anesthesiology and pain medicine, and medical check-up centers in addition to spinal joint orthopedics. Since its opening in 2010, it obtained certification from the Ministry of Health and Welfare for the first time in Hwaseong and Osan. In addition, 2,000 spinal endoscopic surgeries were performed nine years after the opening of the hospital. In recognition of their excellence in spinal surgery and treatment, the quality of medical services has been improved through the result of obtaining T-4 certification, an excellent technology evaluation company, for three consecutive years since 2019.

The true treatment is the patients own

In the past, it was often said that if the lumbar disc bursts, surgery should be performed unconditionally. However, with the development of medical technology, the number of patients who can normally live their daily lives with only non-surgical treatment is increasing. Some statistics show that more than 8 out of 10 patients suffering acute back pain can be better only with lifestyle correction and non-surgical treatment. Originally Kim has long been famous as a doctor who does not easily conduct operations. Because of this, he was reported by a patient who said he was not friendly. For mild patients, he says, ¡°You can take a break from taking painkillers,¡± and most patients are told to come back two to three months after receiving an injection to treat pain and inflammation. He also asks not to take MRI scans too often.

¡°A doctor is not a god. If there is no huge problem within the body, the patients should change their lifestyle and try to fix it by themselves. Even if they really have a structural problem in the body, they should start with non-surgical treatment, and after having enough time, they need to undergo surgery as they really need it. Two-thirds of patients who have judged that surgery is necessary at other hospitals have alleviated pain through only non-surgical treatment. That is the problem that patients¡¯ impatient attitude to decide on surgery within two to three months unconditionally. We totally understand that the patient is sick right now and wants to make a decision. However, the degree of pain is really subjective. So if you go to various hospitals and want answers only from doctors, even small diseases feel like big diseases.¡±

Kim emphasizes that ¡®the patients themselves are their own doctors¡¯ in spinal disease. This is because the more he treats patients, the more he realizes that the cause of the spinal disease is due to wrong lifestyle habits, and these things can only be corrected by the patients own effort. He believes that doctors are only assistants in treatment, and that true treatment should start on the patients own. However, he did not forget the advice that doctors should provide sufficient information to elicit the will of patients.

¡°If a patient receives expensive medical treatment and does not hear enough explanation from the doctor, he or she will have distrust in the doctor. Once the doctor has treated the patient, they should explain in detail how there is no problem even if there is no problem, and how normal it is if it is normal to patients. In the past, there was a vertical relationship between doctors and patients but trust is the basis now. Trust between doctors and patients increases treatment effectiveness and provides critical solutions. The treatment effect is great only when we trust each other and discuss treatment together. However, it is difficult to expect improvement in the way that the patient is told to do it on themselves.¡±

Despite expensive non-surgical treatment, which is popular in some orthopedics, he expressed his negative opinion. Since only 70% of the normal surgery insurance premiums in the country have been given, doctors have decided to stick to procedures that they do not have to do. From the perspective of patients, they often pay expensive money because they hear that ¡°only a minimum incision is made¡±, ¡°the procedure can be performed without anesthesia¡±, and ¡°you can live your daily life immediately after the procedure on the day.¡± However, Kim was wary of excessive procedures, saying ¡°The effect is not much different compared to spending two to three months under pain injections.¡±

Surgery praised as "spinal art"

Kim does not unconditionally refuse surgery. Surgery is sometimes recommended if daily life is difficult because there is a clear cause and it has not improved after about three months of non-surgical treatment. In particular, if your toes are paralyzed or you cant cover your urine, it is considered that surgery is essential.

He carries out long-term treatment if the patients will is strong and it is clear that the quality of life will be improved by surgery. Kims surgery on a patient with ankylosing spondylitis over seven months is very famous in domestic and foreign orthopedic medicine fields. Ankylosing spondylitis refers to a chronic inflammatory disease in which inflammation of the articulatio sacroiliaca of the pelvis spreads throughout the spine, and it is also an autoimmune disease in which immune cells attack the spine. Without proper treatment, chronic inflammation causes the spine to get harder and the waist to bend. Since it is an uncommon disease, it is difficult to meet more than five patients with ankylosing spondylitis throughout the life of a doctor, even if they are spinal specialists.

Honorary director Kim first encountered ankylosing spondylitis surgery when he went on training in the United States. After returning to Korea, he accidentally met a patient with ankylosing spondylitis. The patient who came to him was bent at more than 40 degrees due to severe ankylosing spondylitis, which prevented him from looking straight ahead because his neck was bent forward.

¡°Spinal surgery is a difficult operation as a large number of nerves pass through, but ankylosing spondylitis surgery is among the highest difficulties. At that time, the surgery was a major surgery that required the amputation of the spine. We decided to return the center of the spine that was bent and then fix the bone with screws and iron columns. Although the possibility of success was lower than in other surgeries as the bones and nerves were attached to each other, the surgery was completed safely based on extreme concentration and several surgical experiences. The spine, which was -43 degrees before surgery, returned close to normal levels of +11 degrees. The surgery, which allowed him to walk with his bent back upright over seven months, was praised as a ¡®spinal art¡¯ at the conference, and it is memorable. Its the most rewarding moment as a doctor when the patient walks out well after the surgery.¡±

For successful surgery, Kim produced 3D stereoscopic images through computer simulation and CT before surgery and found out the optimal trajectory to insert screws. When the patients two curved vertebrae were cut into a triangular shape and attached up and down, the spine that had been bent forward was finally straightened. After surgery, the patient was able to walk close to the normal using a walker.

At that time, no successful orthodontic surgery for highly deformed ankylosing spondylitis was reported, so the repercussions in the orthopedic field were even greater. With this operation, Kim became the best doctor in the spinal field and the case was introduced to the world-renowned spinal journal . Since the surgery was introduced in Korea in 1995, he has performed ankylosing spondylitis surgery more than 500 times, making the history of the Korean orthopedic.

Maintaining the right posture rather than exercising

One of the most common words for patients visiting orthopedics because of back pain is ¡°Please exercise.¡± However, Kim does not nag the patient to ¡°exercise.¡± Often, people dont exercise much to make time for themselves, so his view is that the "posture" of daily life is more important than exercise.

¡°If youre an office worker who has to sit in a chair for a long time, you should keep your back upright and strengthen with your stomach sticking out properly. The most important muscle for back health is the ¡®erector¡¯, and if you dont strain your standing muscles, your back will bend and your spine will be adversely affected. Relaxing your back and leaning or crossing your legs is fatal to your back, so you should never do it. Another important muscle is the hip muscle, the gluteus maximus. These muscles are developed by twitching when walking fast. Thats why I recommend to patients that the most important point is to stretch your back and walk fast.¡±

Waist muscles do not grow by popping out through exercise like arm muscles. Therefore, you should make it a habit to give strength to your erector. When your erector is well established, you will maintain the correct posture on your own even when you sit down. If you dont have the power to support your erector, and you keep wanting to lean on them, your posture will also be twisted. In particular, young people in their 20s and 30s can strengthen their muscle strength by stretching or exercise, but if they are in their 40s or older, aging is progressing quickly, so maintaining the correct posture is much more important than exercising.

¡°The disc, a spinal buffer mechanism, degenerates so fast that it begins to age over 15. It is recommended that you lie down or stand to reduce the pressure on the disk. And the worst thing is the sitting position. Especially, squatting is the worst, and sedentary living on the floor is one of the big problems. Housewives huddled together on the floor, peeling garlic and green onions is the main root for worsening the health of the spine.¡±

Honorary director Kim emphasized people to be careful of excessive stretching when they are in their 60s. Young people can develop back muscle strength by exercising, but older people should be careful because they can hurt their backs while working out. Thats why he doesnt force his patients to exercise. He stressed that the secret to his back health is also in the right posture rather than exercise.

Another thing he suggests as a habit of protecting health is regular checkups. This is because you need to check your health in advance so that you can maintain it with simple treatment before the disease worsens. There are surprisingly many patients who avoid surgery due to concerns about it and miss the golden time when non-surgical treatment is possible. He said, ¡°Most of the spinal diseases get worse over time when symptoms appear and it takes a long time to treat them. Therefore it is advisable to receive early treatment through checkups.¡±

The importance of trust between doctors and patients

What should a doctor have in order to be respected by his patients? Kim says that ¡®trust¡¯ between patients and doctors is the most important. In particular, they practice the belief that doctors should not give authoritative treatment to patients. This is because if trust is broken unnecessary complaints occur and medical quality deteriorates even if treatment is performed well. On the other hand, if doctors and patients discuss treatment methods with each other and try to meet the patients needs as much as possible the effectiveness of treatment will be increased. Of course, doctors are also people, so they sometimes make mistakes, but depending on how they cope, the trust relationship is restored or broken.

¡°Sometimes when I explain to patients, I give an example of baseball. Shortstop makes the most mistakes among baseball players. Because the ball goes that way the most. Of course, a doctor who performs a lot of surgery is bound to cause the most accidents. Because the ball goes that way the most. Of course, a doctor who performs a lot of surgery has the possibility of the most accidents. So in the event of an accident to the patients, I honestly apologize and say ¡°I was working hard, but Im sorry for the bad results.¡± Surprisingly, most of them accept it. However, if you lie, the so-called ¡®rapport¡¯ is broken and cannot be reversed.¡±

Honorary director Kim is trusted by patients because he is honest. If there is a fault of his own, he frankly admits the fault and apologizes to the patient. Then it usually goes smoothly without any further deterioration. Therefore, Honorary Director Kim often emphasizes to his disciples to ¡°communicate as you are.¡±

Another thing he asks them to do is to ¡®stay true to their work¡¯. Honorary director Kim spent more than 65 years as a doctor and served as the chief of Kyung Hee Univesity Medical Center and the director of Gangdong Kyung Hee University Hospital. However, he explained that he had never been greedy to get a position and was just faithful to his role as a doctor.

¡°There are two kinds of people who come to the school of medicine. One is someone who wants to come in Hippocratic karma, and the other is someone who is forced to come as a technician. What I want to say to my juniors is that if you force yourself to get everything you cant have it. However, if you stick to your medical work, you can achieve everything that you want. Anyone who enters the school of medicine only to earn money gets into trouble later. On the other hand, a person who works faithfully as a doctor has all the honor, money, and power in the long term. Therefore above all, what I want to say is focusing on your own work as a doctor.¡±

Elevating the status of the Korean Orthopedic Association
Honorary director Kim continues to make academic efforts to develop medical technology as the president of the Korean Orthopedic Association. This year, he was invited to the AAOS (American Academy of Orthopedic Surgeons) 2023 Annual Meeting held at the Venetian Convention & Expo Center in Las Vegas, USA. Also he held the 67th Korean Orthopedic Association Spring Conference in Daegu to showcase various programs.

¡®AAOS 2023 Annual Meeting¡¯ is an annual conference held by the American Academy of Orthopedic Surgeons (AAOS). AAOS reached its 90th anniversary this year since its foundation in 1933 and is recognized as the worlds largest and most prestigious academic association. Every year, orthopedic medical staff and presidents from around the world, including the United States, gather together. The honorary director Kim Ki-taek was invited by AAOS this year to visit the U.S. with the executive branch of the Korean Orthopedic Association as the current president of the Korean Orthopedic Association.

He participated in several lectures to check the trend of orthopedic surgery around the world. In addition, he actively exchanged opinions on the latest issues of the Orthopedic Association and the educational situation for future generations at breakfast meetings of the presidents of each country. He also visited the corporate PR department to look at medical devices and encourage Korean corporations.

Kims invitation to the AAOS annual conference is significant in that it proved the global status of domestic orthopedic surgery again. He also said, ¡°It was a much more meaningful time to check the current status of orthopedics in the world and we will continue to contribute to the development of orthopedic fields to increase the international status.¡±

The executive branch of the Korean Orthopedic Association held the 67th Korean Orthopedic Association Spring Conference in Daegu from April 13 to 15 and successfully finished it. At this conference, symposiums on various topics such as ¡ã minimally invasive surgery ¡ã extracorporeal shockwave ¡ã treatment of rheumatoid diseases were held. Under the theme of ¡°From the Life of an Orthopedic Surgeon to the Opening of the Hospital,¡± orthopedic surgeons in their second, fifth, and 10th years shared their experience in preparing for the opening of the hospital and received great responses. In addition, Professor Pierre Roussouly (France), a world-renowned master of spinal posterior transformation, and Professor Takagi Michiaki (Japan), a master of hip joints, gave invited lectures.

Kim said ¡°I would like to thank the organizing committee and everyone who worked hard to hold the conference,¡± adding, ¡°The Korean Orthopedic Association will continue to make a strong base for the development of the medical community and efforts to be of practical improvements.¡±

In addition, Shin Jae-heung, head of Dongtan City Hospital, gave a lecture as an invited speaker at the ¡®23rd Pacific and Asian Society of Minimally Invasive Spine Surgery (PASMISS 2023)¡¯ held in Taiwan from July 13 to 15. Honorary director Kim Ki-taek sat together as the president of the society and shared academic discourse.

Shin, director of the hospital was then invited as an instructor and Kim, honorary director was invited to the ¡®International Society for the Advancement of Spine Surgery, Asia-Pacific Section 2023¡¯ (ISASS AP 2023) held in Seoul from August 16 to 19. 44 scholars and domestic experts from 15 countries in the United States, Europe, and Asia gathered together to give lectures and discussions on the latest knowledge with the goal of ¡®innovation in spinal surgery.¡¯

In addition, the academic conference was held with a congratulatory speech from Honorary director Kim Ki-taek at the "2023 Minimally Invasive Spine Therapy Research Society Fall Conference" organized by Dongtan City Hospital in September. Ahead of the Spinal Societys Incheon and Autumn Societys Jeju, Kim Ki-taek has continued his various academic activities.

As such if a good doctor with spinal disease such as honorary director Kim Ki-taek is at the core of domestic orthopedic surgery, it is expected that the international status of the Korean Orthopedic Association as well as the future vision of the Korean medical field will be strengthened. Photos from Dongtan City Hospital

2023

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¡¤The current president of the Korean Orthopedic Association
¡¤Executive Vice President, Kyung Hee Medical System
¡¤Chief of Kyung Hee University Healthcare System
¡¤Chief/director of collaborative medical treatment/deputy director of planning treatment/director of orthopedics/center leader of Spinal Center at Gangdong Kyung Hee University Hospital
¡¤Seoul National University Medical School Orthopedic Spine surgeon
¡¤President of the Pacific and Asian Society of Minimally Invasive Spine Surgery
¡¤President of the Korean Society of Spine Surgery
¡¤Scoliosis Center researcher, University of Minnesota, Twin Cities
¡¤University of Minnesota Twin Cities Medical School training
¡¤Board chairman of the Korean Orthopedic Association
¡¤Member of the Preparatory Committee for the 60th Anniversary Conference in the Korean Society of Spine Surgery
¡¤Medical doctor of Kyung Hee University
¡¤EBS program ¡®best doctors¡¯ in episode 5


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