McMaster University

McMaster University

A spinal x-ray showing the effects of scoliosis.

Disorders of the Spine

Principal Investigators

A photo link to the bio of Dr. Brian Drew

Dr. Brian Drew

Dr. Ilyas Aleem

Dr. Ilyas Aleem

Current Research Initiatives

Rick Hansen Spinal Cord Injury Registry

Three projects are currently underway which are: Current surgical practice for traumatic spinal cord injury in Canada; 2) Current surgical practice for traumatic spinal cord injury in central cord syndrome patients in Canada; and 3) Differences in surgical treatment for tSCI across Canada: are surgeons doing what they say they are doing?

INORMUS - Spine

The INORMUS-Spine study is a multi-centre, international, prospective cohort sub-study that will include 3,000 patients sustaining spinal fractures from India, Pakistan, China, Uganda, and South Africa. The objective of the INORMUS-Spine study is to determine the incidence of major complications (mortality, re-operation and infection) and the factors associated with these major complications.

Background

There are currently 200,000 individuals with spinal cord injury in the United States, with 12,000-20,000 new injuries annually or 40 individuals per one million individuals in the population. The main causes of spinal cord injury can be categorized into four major categories: motor vehicle accidents (46%), falls (22%), violence (16%) and sports (12%). Of these injuries, approximately 50%-70% of the individuals are between the ages of 15-35, resulting in more years lived with disability (YLD). There are many long-term implications associated with spine injury including paralysis, respiratory, urinary and gastrointestinal complications which have a large impact on quality of life. The cost of a spine injury for an individual across their lifespan can range from $500,000 to over $3,000,000 depending on the severity of the injury. The burden of spinal injury demonstrates the dire need for research to be conducted in the area of spine trauma.

Rick Hansen Spinal Cord Injury Registry

The Mac Ortho spine program participated in the development of the Rick Hansen Spinal Cord Injury Registry (RHSCIR). The RHSCIR is a pan-Canadian prospective observational registry of individuals sustaining a traumatic spinal cord injury at 31 major Canadian acute care and rehabilitation hospitals. RHSCIR was initiated as a research study sponsored by the Rick Hansen Institute and was developed to collect data on individuals who sustain spinal cord injuries and link clinicians, researchers, and health care administrators with the goal of improving both research and clinical practice for individuals with SCI by facilitating the translation of research into clinical practice and promotion of evidence-based practices. Using standardized research protocols and data collection forms, RHSCIR tracks the experiences and outcomes of people with traumatic SCI during their journey from acute care to rehabilitation to community reintegration. Details about participants' spinal cord injuries including extent of injury and level of paralysis, recovery, and success of various treatments are among the data recorded. Across Canada, RHSCIR is collecting comprehensive SCI data for the purpose of improving SCI care and clinical outcomes. The registry promotes, encourages, and supports the pursuit of excellence in spinal cord injury health care management.

Global Spinal Injuries

Trauma is a major public health problem globally. Injuries due to trauma have rapidly been increasing in number worldwide, particularly in developing countries such as India. This is in part due to the rapid motorization over the past two decades. Excessive speed, non-usage of helmets, driving under the influence of alcohol, and poor road design and infrastructure-related factors are some major risk factors for the increasing number of road traffic accidents. Trauma is projected to be third largest killer in the developing world by 2020, with a large number of these injuries comprising of spinal trauma and traumatic spinal cord injury.

Traumatic spinal cord injury has devastating consequences, resulting in varying degrees of paralysis, sensory loss, bladder/bowel dysfunction, and mortality. The effects of this injury are not just limited to an individual’s health, but also create enormous financial burdens on families and society at large. The burden of traumatic spinal cord injury and its sequelae is enormous, particularly in the developing world. A thorough epidemiological understanding is vital for implementing preventative measures and planning clinical services, as well as understanding disease morphology and burden.

The specific objective of the disorders of the spine theme is:

  • To be an active contributor to the Rick Hansen Spinal Cord Injury Registry.
  • To explore the factors associated with major outcomes following spinal fracture treatment in low-middle income countries.

Recent Publications

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  • Spine (Phila Pa 1976). 2013 May 1;38(10):857-64.

    Do authors report surgical expertise in open spine surgery related randomized controlled trials? A systematic review on quality of reporting.

  • Spine (Phila Pa 1976). 2009 Dec 1;34(25):2818-25.

    Attitudes toward chiropractic: a survey of North American orthopedic surgeons.

  • Evid Rep Technol Assess (Full Rep). 2009 Jan;(177):1-221.

    Complementary and alternative medicine in back pain utilization report.

  • Spine (Phila Pa 1976). 2008 Sep 1;33(19):E680-92.

    Efficacy of autologous iliac crest bone graft and bone morphogenetic proteins for posterolateral fusion of lumbar spine: a meta-analysis of the results.

  • J Spinal Disord Tech. 2002 Dec;15(6):454-7.

    Surgical preference in anterior cervical discectomy: a national survey of Canadian spine surgeons.

  • Spine. 2013 May;38(10):857-64.

    Do authors report surgical expertise in open spine surgery related randomized controlled trials? A systematic review on quality of reporting.

  • Spine. 2003;28:2268-75.

    Assessing observational studies of spinal fusion and chemonucleolysis.

  • Journal of Spinal Disorders and Techniques

    Teriparatide Treatment of a Glucocorticoid-Associated Resorbing Nonunion of a Type III Odontoid Process Fracture -A Case Report

  • Journal of Spinal Disorders and Techniques

    Uncovertebral Anatomic Midline Targeting for Cerival Disc Arthropalsty

  • Journal of Canadian Chiropractic Assocition

    Sternal insufficiency fracture related to steroid-induced osteoporosis: A case report

  • Spine

    Atlantoaxial instability in acute odontoid fractures is associated with nonunion and mortality

  • Spine

    Intrawound vancomycin to prevent infections after spine surgery: a systematic review and meta-analysis

  • Journal Cover

    The surgical management of scoliosis: a scoping review of the literature

  • Journal Cover

    Minimally invasive versus open surgery for cervical and lumbar discectomy: a systematic review and meta-analysis

  • Journal Cover

    Atlantoaxial instability in acute odontoid fractures is associated with nonunion and mortality

  • Journal cover

    Intrawound vancomycin to prevent infections after spine surgery: a systematic review and meta-analysis

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