Spine Research at NEBH

An impressive track record of research, performed by NEBH spine surgeons and physiatrists, has posed and answered numerous relevant questions about spine treatments.  The highly regarded Spine Center provides effective rehabilitation that is continually refined by research.  Baptist spine surgeons have performed research that points to a role for genetic profiling in selecting patients for fusion surgery.  They also defined, for the first time, the prevalence of spinal stenosis in the community and thus the need to avoid overtreatment.

Surgical Spine

The Spine Research Program currently has a number of studies that fall into three broad categories:

• Surgical predictors of outcome
• Patient predictors of outcome
• Investigational Device Exemption (IDE) studies - industry-sponsored contracts for clinical trials that investigate new medical devices for use in spine surgery.

Spine Registry

For many studies, the spine program utilizes the NEBH Spine Registry and the NEBH Spine Quality of Life (QOL) Registry. These registries contain information from physician and patients’ self-report measures to provide a full picture of the patient’s quality of life and well-being. These measures evaluate physical, social and emotional well-being using a range of standardized and validated tools. These databases allow for the generation and investigation of multiple research questions.

Data extracted from the spine registry has been used for several studies, including one on the diagnosis and treatment of Cauda Equine Syndrome—a rare, serious condition and surgical emergency—and to define the complications, including increased infections and excess bone growth, associated with the use of infused bone morphogenetic protein.

Physiatry

Over the last decade, the Spine Center has undertaken research in multiple areas related to the spine. These include 4 completed projects evaluating the utility of physical assessments used by medical providers to evaluate low back pain, cervical radiculopathy, lumbar radiculopathy and lumbar spinal stenosis.

• We have completed a study of the natural history of lumbar disc herniation in the elderly, which demonstrated that the prognosis of full recovery from non-surgical management was much more favorable than previously thought.
• We have produced a body of work examining the influence of health care provider medical advice on the function of their patients, along with the importance of patient’s attitudes in terms of recovery.
• We have also completed several studies evaluating the effectiveness of exercise for improving low back pain, including 2 studies that demonstrated the dose of exercise required to improve symptoms as less than previously thought.
• We have studied and published manuscripts on long term exercise adherence for those who received exercise oriented treatment for back pain.

We are currently enrolling our patients in our 5th study of physical assessment, this time examining the sensory deficits associated with cervical radiculopathy.

Projects Under Development

Current projects will look at data from the patients of Baptist orthopedic spine surgeons and neurosurgeons and will continue to pose the key, current questions related to spine treatments, including:

• How cost effective is spine surgery compared to physical therapy, pain injections and medications?
• Is spine surgery effective at relieving patients of neck pain?
• Which types of surgery are associated with the lowest complication rate?
• Are surgeons able to perform an effective exam in patients who experience cervical radiculopathy (numbness in the arm)?
• Are the new biological interventions, such as cell-based therapy, effective additions to specific surgeries, such as spine fusion?