The University of Washington proposes a Multidisciplinary Clinical Research Center devoted to the study of spine and upper extremity disorders. These conditions, especially low back pain and carpal tunnel syndrome, are among the most common and disabling conditions in working age populations. This Center will incorporate investigators from the Departments of Medicine, Radiology, Orthopaedics and Sports Medicine, Neurological Surgery, Rehabilitation Medicine, and Psychiatry and Behavioral Sciences in the School of Medicine; and the Departments of Biostatistics and Health Services in the School of Public Health. The Methodology Core will provide key support to each project: assistance with protocol details choice and implementation of outcome measures, central data accumulation, data quality monitoring, analytic strategies, statistical analysis, advice on presentation of results, and education of investigators regarding research architecture and statistical techniques. The projects proposed address key controversies and uncertainties related to spinal disorders and upper extremity complaints. These include: 1. Carpal Tunnel Syndrome. Diagnostic and Treatment Strategies: this incorporates a randomized trial to evaluate the efficacy of surgery for early but well-documented carpal tunnel syndrome, and will determine whether the new technique of MR neurographic imaging (MRNI) accurately identifies the patients most likely to benefit from early surgery. 2. Cohort Study of Treatment for Discogenic Back Pain: a prospective cohort study will compare patients undergoing lumbar arthrodesis for degenerative discogenic pain with those having non-surgical treatments. We seek to identify any differences in baseline characteristics as well as outcomes, and to identify characteristics that may predict unique success from either surgical or non-surgical therapy. 3. Epidemiology of Lumbar Spine Surgery: Rates and Trends: this analysis of national survey data, state hospital discharge registries, and Medicare claims will update the U.S. rates of various forms of back surgery; examine a possible increase in spine fusion rates with the introduction of interbody fusion cages; quantify the shift of spine surgery to the ambulatory setting; and determine if reoperation rates are increasing over time, as suggested in some earlier analyses. 4. Synthesis of CT and MR images of the Cervical Spine: This feasibility project will assess the potential for combining data from CT and MRI scans of the cervical spine to produce more useful imaging for surgical planning purposes than either test alone. It will require computer modeling, based on precedents in MR-PET scanning. We will determine if surgeons will accept the synthesized images as a replacement for CT-myelography for purposes of surgical planning.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Comprehensive Center (P60)
Project #
5P60AR048093-03
Application #
6696582
Study Section
Special Emphasis Panel (ZAR1-AAA-C (O1))
Program Officer
Panagis, James S
Project Start
2002-02-15
Project End
2006-12-31
Budget Start
2004-01-01
Budget End
2004-12-31
Support Year
3
Fiscal Year
2004
Total Cost
$1,005,884
Indirect Cost
Name
University of Washington
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
605799469
City
Seattle
State
WA
Country
United States
Zip Code
98195
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Mirza, Sohail K; Deyo, Richard A; Heagerty, Patrick J et al. (2013) One-year outcomes of surgical versus nonsurgical treatments for discogenic back pain: a community-based prospective cohort study. Spine J 13:1421-33
Lee, Michael J; Konodi, Mark A; Cizik, Amy M et al. (2013) Risk factors for medical complication after cervical spine surgery: a multivariate analysis of 582 patients. Spine (Phila Pa 1976) 38:223-8
Hacquebord, Jacques; Cizik, Amy M; Malempati, Sree Harsha et al. (2013) Medicaid status is associated with higher complication rates after spine surgery. Spine (Phila Pa 1976) 38:1393-400
Baker, Geoff A; Cizik, Amy M; Bransford, Richard J et al. (2012) Risk factors for unintended durotomy during spine surgery: a multivariate analysis. Spine J 12:121-6
Lee, Michael J; Konodi, Mark A; Cizik, Amy M et al. (2012) Risk factors for medical complication after spine surgery: a multivariate analysis of 1,591 patients. Spine J 12:197-206
Hu, Yangqiu; Ledoux, William R; Fassbind, Michael et al. (2011) Multi-rigid image segmentation and registration for the analysis of joint motion from three-dimensional magnetic resonance imaging. J Biomech Eng 133:101005
Lee, Michael J; Hacquebord, Jacques; Varshney, Anuj et al. (2011) Risk factors for medical complication after lumbar spine surgery: a multivariate analysis of 767 patients. Spine (Phila Pa 1976) 36:1801-6
Hsu, Clarissa; Bluespruce, June; Sherman, Karen et al. (2010) Unanticipated benefits of CAM therapies for back pain: an exploration of patient experiences. J Altern Complement Med 16:157-63
Deyo, Richard A; Mirza, Sohail K; Turner, Judith A et al. (2009) Overtreating chronic back pain: time to back off? J Am Board Fam Med 22:62-8

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