Current Spine Projects

The effects of poor psychological health on postoperative outcomes following lumbar discectomy.
Objective(s):
- To investigate the effects that pre-operative depression and depression risk have on post-operative pain and disability following lumbar discectomy surgery as treatment for lumbar radiculopathy.
- To determine who of those with depression are more likely to experience a poor surgical outcome following discectomy surgery.

What are the Barriers and Enablers Influencing Physical Activity Among Patients Awaiting Spinal Surgery? A Qualitative Study Guided by the Theoretical Domains Framework.
Objective(s):
- To identify the barriers and enablers to physical activity engagement for patients with degenerative spinal disorders waiting for spinal surgery.Jose

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.

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.

Preliminary investigation into the impact of the COVID 19 pandemic on wait times for spinal surgery across Canada- a CSORN study.
Objective(s):
- Identify and assess the changes in wait time (days) for elective and semi-urgent spinal surgery preceding COVID-19 and after the onset of the pandemic beginning in March 2020.
- To quantify the number of patients waiting and the number of surgeries being performed for elective and semi-urgent spinal surgery before and after the onset of the pandemic.

Preoperative therapies improve postoperative disability in patients who undergo anterior cervical discectomy and fusion surgery for cervical radiculopathy.
Objective(s):
- To estimate the effects of common preoperative therapies on postoperative trajectories of pain and disability following surgery for cervical radiculopathy.

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.

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

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 impact of 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.

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?

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.

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.

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

Mortality rates of spine surgery for degenerative pathologies in a Canadian population
Objective(s):
- To determine the mortality rate in patients who undergo surgery in Canada for degenerative spinal pathology.
- To identify predictors which impact mortality risk in this patient population.

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.

The Impact of Cardiovascular Health on the Outcomes of Lumbar Fusion Surgery
Objective(s):
- 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.

Comparing outcomes of patients admitted with acute non-surgical traumatic brain injuries to peripheral vs tertiary parafacilities
Objective(s):
- To determine if outcomes for acute or acute changes in isolated, non-surgical TBIs who are admitted to either a peripheral or tertiary care centre are similar between both groups. The results will be used to support future collaboration with decision-makers, clinicians and others to improve NB’s neurotrauma care.

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.

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).

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)