Current Spine Projects

The impact of revision spinal fusion on post operative pain, disability, and mental health; A CSORN study.
- 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
- 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?

What psychosocial measures are the greatest predictors of surgical outcomes in patients with degenerative pathology of the spine

The impact of anesthesia on lumbar spine fusion outcomes
- 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
- 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
-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
- 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.

Covid Mental Health- Exploring the Impact of the COVID-19 Pandemic/Lockdown on Spine Surgery Patients in Canada
- To investigate predictors of the biopsychosocial profile of patients waiting for spine surgery across Canada and the role played by the global pandemic.

The Impact of Biological Sex on Thoracolumbar Surgery Outcomes in Patients with Diabetes
- 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
- 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
- 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
- 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
- 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.

Levels- Multi-Level Decompression/Fusions are as Effective as Single Level Lumbar Spinal Stenosis Operations
- To determine if an increase in the number of segments fused in thoracolumbar spinal fusion surgeries effects intraoperative and long-term patient outcomes.

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.

Predictors of Post-Operative Urinary Retention in a Spinal Surgery Patient Population
- 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
- 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)