Current Spine Projects

Finding the minimal clinically important difference estimates after surgery for degenerative conditions of the cervical spine: analysis of the Canadian Spine Outcomes and Research Network (CSORN) registry
Objective(s):
- This study aims to estimate the Minimal Clinically Important Difference thresholds for three cervical degenerative spine pathologies: degenerative disc disease, cervical spinal stenosis, and disc herniation, 1 year after surgery.

The Intersection of Sex and Psychology in Thoracolumbar Surgery Outcomes
Objective(s):
- Few studies have examined whether females and males differ in how psychological factors predict postoperative pain and disability in spine surgery populations. This represents a notable gap in understanding how sex and psychological factors interact in spine surgery, as some psychological risk factors such as depression and general mental health may influence postoperative thoracolumbar surgery outcomes.
- This study aims to address this gap by comparing the ability of psychological measures, specifically depression symptoms using the Patient Health Questionnaire (PHQ-8), comorbid depression, and mental health status using the Mental Component Score (MCS) to predict postoperative pain and disability in male versus female thoracolumbar surgery patients.

The impact of re-revision spinal fusion on post operative pain, disability, and mental health; A CSORN study.
Objective(s):
- To determine the rate of revision and re-revision surgery in the Canadian spine surgery population.
- To investigate the impact of revision and re-revision spine surgery on patient postoperative pain, disability, mental health outcomes, patient satisfaction, and length of hospital stay.

A look at Iatrogenic Dural Tears in NB: how often are they occurring, who's at risk, what are the outcomes, and are we repairing them correctly?
Objective(s):
- To identify factors that may put patients at an increased risk for dural tears (DTs).
- To explore the relationship between DTs and postoperative adverse events to determine whether patients experiencing DTs during their procedures have an increased risk of adverse events when compared to patients that did not experience a DT.
- To identify the current methods of DT repair being used in New Brunswick and note their alignment with current research findings.

Evaluating Patient Satisfaction and Functionality After Wide-Awake Local Anesthesia No-Tourniquet (WALANT) for Distal Radial Fractures.
Objective(s):
- To evaluate patients’ satisfaction and overall experience of WALANT for distal radial fracture repair and to compare functionality preoperatively and postoperatively using the validated Disabilities of the Arm, Shoulder and Hand (DASH) measure.

The Association of Preoperative Medication Usage with Postoperative Pain and Disability Following Spinal Surgery for Degenerative Spinal Conditions (Thoracic Lumbar Study & Cervical Study).
Objective(s):
- To estimate the effect of preoperative neuroleptics and narcotics on postoperative pain and disability.

Predictors of Post-Operative Urinary Retention in a Spinal Surgery Patient Population
Objective(s):
- 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).

Which psychosocial measures are most strongly related to surgical outcomes in patients with degenerative pathology of the spine?
Objective(s):
- To identify which psychosocial measures best predict postoperative clinical outcomes in patients undergoing spinal surgery.

Preoperative psychosocial factors affect the outcomes experienced by patients who undergo anterior cervical discectomy and fusion surgery for cervical radiculopathy.
Objective(s):
- To estimate the effects of preoperative psychological factors on pain and disability outcomes in patients undergoing anterior cervical discectomy and fusion (ACDF) surgery for cervical radiculopathy

The effects of antidepressants on the outcomes of patients who undergo surgery for lumbar stenosis
Objective(s):
- To determine if patients who use antidepressants for the management of their lower back and leg pain and who have undergone LSS surgery report reduced pain intensity and disability levels after surgery?
- To determine if preoperative depression status moderates the effects of antidepressants on pain intensity and disability after LSS surgery?

Describing available preoperative education methods and comparing outcomes for spinal fusion candidates: a cross-Canada study
Objective(s):
-To describe available preoperative education through survey responses completed by Canadian spine surgeons and
-To compare patient outcomes focusing on satisfaction, length of stay, mental wellbeing, pain and disability following surgery according to preoperative mode of teaching available

The Impact of Biological Sex on Thoracolumbar Surgery Outcomes in Patients with Diabetes
Objective(s):
- To determine if there are sex differences in the baseline health and surgical outcomes of patients undergoing thoracolumbar surgery with diabetes.

Pre-Operative Cannabis Use in Canadian Thoracolumbar Spine Surgery Patients
Objective(s):
- To examine prevalence of Cannabis Usage throughout Canada pain, disability, and opioid use
• Collaboration with Sherbrooke Hospital in Sherbrooke, Quebec.

5-Aminolevulinic Acid Fluorescence Guided Surgery; Brain Tumor Resection Outcomes in Atlantic Canada - A Quality Improvement and Cost-Benefit Analysis
Objective(s):
- This study will consist of a retrospective chart review to see whether - in the Atlantic Provinces - 5-
ALA improves neurosurgical outcomes; specifically, whether the dye indeed significantly improves the
Extent of Resection (calculated from radiographs), Progression Free Survival, Operating Time, and
checks whether addition of the dye doesn't have significant negative impacts (iatrogenic disability
assessed following surgery). Qualitative data will also be collected (questionnaire) to assess surgeons’
perceptions of the impact on outcomes.

MIS vs open spine surgery for patients who have lumbar spine stenosis and an ASA score of greater than 2
Objective(s):
- 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.

The Importance of Resuscitation (DNAR) Orders with Patients Undergoing Spine Surgery
Objective(s):
- To 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)

The impact of anesthesia on lumbar spine fusion outcomes
Objective(s):
- To evaluate if anesthesiologists in Saint John are adhering to standard of care in administration of anesthesia and time to extubation, and how these variables impact clinical outcomes for lumbar fusion patients immediately following surgery, 6 to 18 weeks follow-up, one year follow up, and two years follow-up.