Through our quality and safety research, we hope to have an evidence-based impact on the quality of patient care. We are currently evaluating the role various physiological variables, operative and rehabilitation techniques, and care delivery systems have on patient morbidity after spinal surgery and procedures. Select projects include:
- Studying the effects of acute steroid-induced hyperglycemia on neurological morbidity during surgical treatment of spinal cord and spinal column tumors.
- Defining modifiable variables in care delivery that are associated with morbidity after spinal surgery and procedures.
- Evaluating treatment variables associated with prolonged length of hospital stay, increased resource utilization, and elevated hospital costs.
- Testing the safety and efficacy of early mobility after cervical spine surgery.
- Defining critical levels of intra-operative blood-loss and anemia associated with peri-operative morbidity.
Through our spine care outcomes research, we hope to improve the understanding of how to best define treatment effectiveness as well as how to maximize quality of life and overall health state in patients undergoing spinal surgery and procedures. We prospectively collect several patient reported outcome metrics aimed to quantify spine-related pain, disability, health state utility, quality of life, social function, somatization, and depression. Select outcome projects include:
- Defining clinically relevant improvement in disability and pain after lumbar and cervical procedures.
- Validating a standardized measure for overall treatment success in patients undergoing spine surgery and spine injections.
- Comparative effectiveness of minimally invasive versus open surgical procedures.
- Predictive value of psychological measures on outcomes after spinal surgery and injections.
Through our cost-utility research, we hope to improve the cost-effectiveness of various spine procedures and to improve understanding of cost inefficient practice paradigms. We are prospectively collecting long-term variables of resource utilization, direct medical costs, occupation loss, and assessing total direct and indirect costs of all patients undergoing spine surgery. Select outcome projects include:
- Cost-effectiveness of minimally invasive versus open vertebrectomy in patients with spinal metastasis.
- Cost-effectiveness of lumbar fusion versus medical management for low-grade lumbar stenosis.
- Cost comparison of direct lateral trans-psoas interbody fusion versus posterior fusion for adjacent segment disease.
Through our new technologies research, we evaluate the comparative effectiveness of novel surgical technologies in real-time by continuously collecting peri-operative and out-patient outcomes data as new technologies are employed into clinical practice. Select new technologies projects include:
- Minimally invasive direct lateral inter-body fusion versus posterior decompression and fusion for adjacent segment disease: Comparison of blood loss, length of hospital stay, and peri-operative morbidity.
- Percutaneous pedicle screw fixation for traumatic thoraco-lumbar compression fractures: Extent and time course of pain relief.
- Minimally invasive versus open vertebrectomy for spinal metastasis: Evaluation of morbidity and short-term quality of life.