Current Canada East Spine Centre Projects

Prospective Projects

Enhanced Recovery After Surgery (ERAS) Quality Assurance Project
• ERAS programs ensure best practices are utilized to optimize patient outcomes and decrease resource utilization. This project supports efforts to implement a formalized enhanced recovery after surgery (ERAS) program.
• Collaboration Daphne Stuart, RN, and the Horizon Health Network’s Surgery Program.

Wait Time for Knee Arthroscopy: What are the Potential Impacts on Patients’ Quality of Life
• The objective is to determine if wait time for knee arthroscopy surgery is affecting physical health, mental health, and ability to work or study for patients over the age of 14.
• Collaboration with Dr. Brendan Sheehan (Saint John Orthopaedics) and McMaster University

Wait Time for Knee Arthroscopy: What are the Potential Impacts on Patients’ Quality of Life
• The objective is to determine if wait time for knee arthroscopy surgery is affecting physical health, mental health, and ability to work or study for patients over the age of 14.
• Collaboration with Dr. Brendan Sheehan (Saint John Orthopaedics) and McMaster University

Predictors of Post-Operative Urinary Retention in a Spinal Surgery Patient Population
• A prospective observational study to determine if post-operative urinary retention (POUR) in a spinal surgery population can be predicted by pre-operative administration of a self-report urinary tract symptoms measure (I-PSS questionnaire).
• Collaboration with Dr. Thomas Whelan (Urology, Saint John Regional Hospital).

Psychological Risk Factors for Poor Spine Surgery Outcomes
• A prospective, observational study to test the hypothesis that a combination of psychological risk factors can affect the recovery of a spine surgery patient.
• Collaboration with Dr. Dean Tripp (Pain Psychology, Queens University)

Cannabis and Spine
• Prevalence of Cannabis Usage throughout Canada pain, disability, and opioid use
• Collaboration with Sherbrooke Hospital in Sherbrooke, Quebec.

Cardiac- The Impact of Cardiovascular Health on the Outcomes of Lumbar Fusion Surgery
• To determine if patients with stenosis with neuroclaudication who underwent fusion surgery with 3 or more cardiac comorbidities have worse adverse events, disability, death after spine surgery.

The Impact of Biological Sex on Thoracolumbar Surgery Outcomes in Patients with Diabetes
•To investigate the role of diabetes on gender undergoing with thoracolumbar spine surgery

MIS vs open spine surgery for patients who have lumbar spine stenosis and an ASA score of greater than 2
• Stenotic Patients with ASA scores of greater than 2 will have better operative outcomes when undergoing minimally invasive surgical (MIS) compared to open surgical (OPEN) thoraco-lumbar (TL) decompression with or without fusion for lumbar spinal stenosis (LSS).
• Stenotic Patients with ASA scores of greater than 2 will have better long-term surgical outcomes when undergoing MIS compared to OPEN TL decompression with or without fusion for LSS.

Upcoming Prospective Projects

National Occupational Classification National CSORN Registry Study
• This study will be proposed nationally to the CSORN Steering Committee through the Canadian Spine Society looking at the National Occupation Classification (NOC) codes and what jobs/industries affect those with spine surgery. This is a continuation of the Canada East Spine Centre’s initial project looking at how the NOC affects return-to-work tune, post-operative opioid use, chronic pain and disability in thoracolumbar surgery patients.

Assessing the Medical Experiences of High Acuity Patients Living in Homelessness in Saint John, New Brunswick
• Our proposed study will examine the individual, community, and health system-level barriers and facilitators for providing equitable care to those experiencing homelessness in the Saint John area.
• Multi-Disciplinary Collaboration with Dr. Duncan Webster (Horizon Health Network- Infections Disease Department), Beverley Blissett (Horizon Health Network- Social Work Department), Dr. Koumari Mitra (UNB), Dr. Eric Weissman (UNBSJ), and Dr. Priscilla Medeiros (SickKids).

Retrospective Canada East Spine Centre Projects

The Importance of Resuscitation (DNAR) Orders with Patients Undergoing Spine Surgery
• This study would review elective spine surgery patients’ charts who are enrolled in the Canadian Spine Outcomes and Research Network (CSORN) registry to see if they had a DNAR form completed before their surgery from 2015 to 2020 at the Saint John site. To see the percentage of these patients who had this form completed and had intraoperative and in hospital AEs to those who did not have the form completed and experienced AEs.
• Collaboration with Nicole Miller RN (Horizon Health Network)

Paediatric Health-Related Quality of Life Outcomes Following Surgery for Adolescent Idiopathic Scoliosis
• To identify patient trajectories of recovery defined by change in health-related quality of life (HRQOL) following surgery for adolescent idiopathic scoliosis (AIS).
• Collaboration with the IWK in Halifax, Nova Scotia

Exploring the ability of radiographic parameters of stenosis severity to predict patient recovery patterns
• To explain if specific pathological features or severity of features in patients with lumbar spinal stenosis prior to surgery significantly adds to predictive models in the accuracy of surgical failure
• To identify if surgical failure in terms of improvements in pain and disability are independent of surgical correction.

Impact of undergoing thoracolumbar spine surgery on patient mental health
• To investigate the impact of thoracolumbar spine surgery on patients’ psychological profiles

Tissue Plasminogen Activator in Addition to Twist Drill Drainage as a Treatment for Chronic Subdural Hematomas – A Descriptive Analysis
• Compare volume of hematoma drainage when tPA is used in combination with either the BHD or TDD procedure for the drainage of cSDH.
• Describe haematoma recurrence rates following the use of tPA in combination with either the BHD or TDD procedure.
• Assess how often surgeons at this site are using tPA, and the parameters under which it is being used.

New Brunswick Inter-Professional Spine Assessment and Education Clinic (NB-ISAEC)
• Initially designed as a pilot project at Horizon's Saint John Regional Hospital and The Moncton Hospital to fill a gap in the current standard of care for low back pain patients, the program was created to better serve patients, and to help them return to good health through rapid assessment, and excellent individualized care. Canada East Spine Centre played a role in validating the program's success. They have shown success in reducing unnecessary imaging, improving overall patient outcomes, and reducing wait times.

Undifferentiated Presentation of Unilateral Hypoplasia of Cervical Pedicle and Contiguous Vertebral Hemangioma Case Report
• This case report demonstrates a rare presentation of cervical hemangioma with associated unilateral pedicle aplasia with features of both osseous erosion from the hemangioma, as well as morphologic abnormalities typically seen with absence of a pedicle. This study will also review the literature with regard to developmental pedicle abnormalities and vertebral hemangioma.

Photodynamic therapy and Spine
• PDT as part of a pre-operative decolonization strategy to decrease incidence of SSI in Orthopedic & Spine patient population