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Spine
ADULT ORTHOPAEDICS
1525

Spine

Overview
Co-Chiefs: Andrew A. Sama, MD, and Harvinder S. Sandhu, MD, MBA

Visit the Service Page for the full faculty listing.

2020 Surgical Volume: 3,481
2020 Published Studies: 179

Providing exceptional, leading-edge care is the main mission of the Spinal Surgical Service. We continue to expand our presence outside of New York City to improve access to our high-quality spine care for patients beyond the immediate proximity of the main hospital. Education also continues to be a major priority. We recently added a Multi-specialty Spine Care and Surgery International Fellowship to complement our existing top-ranked US Spine Fellowship program.

Another key initiative was the establishment of the HSS Global Partnership Virtual Spine Conference series. During the pandemic, this enabled us to collaborate with our global partners, HSS alumni and other institutions across the country in virtual conferences and educational programs to discuss the latest advances in spinal surgery. Perpetuating these relationships is an important part of our academic mission and our mandate to improve spine care throughout the world.

Recent Achievements

During the 26th International Meeting on Advanced Spine Techniques, the Scoliosis Research Society awarded its Thomas E. Whitecloud Award for best clinical paper to a group of HSS researchers for their study, “Intravenous Ketorolac Substantially Reduces Opioid Use Following Lumbar Spinal Fusion: Early Results of a Randomized, Double-Blinded, Placebo Controlled Trial.”

Authors included Sravisht Iyer, MD; Todd J. Albert, MD; Frank J. Schwab, MD; Darren R. Lebl, MD; Han Jo Kim, MD; Matthew E. Cunningham, MD, PhD; James C. Farmer, MD; Federico P. Girardi, MD; Russel C. Huang, MD; Sheeraz Qureshi, MD; Bernard A. Rawlins, MD; James D. Beckman, MD; and Harvinder S. Sandhu, MD, MBA. The study found that intravenous ketorolac reduces opioid use after spine fusion by more than 40% compared to placebo and more than 30% compared to intravenous acetaminophen. They also observed improved pain control and a decreased length of stay. These findings provide compelling evidence that will help in the fight against the current opioid epidemic.

Through the generosity of the Beatrice and Samuel Seaver Foundation, a prospective study was designed and done at HSS, “The Incidence of Occult Infections in Primary Lumbar Spine Fusion.” This paper won two awards from the International Society for the Advancement of Spine Surgery: the Leon Wiltse Award for Best Overall Paper and Charles Rey Award for Best Clinical Paper. Authors were Celeste Abjornson, PhD, Antonio Brecevich, MD, Fedan Avrumova, Andrew A. Sama, MD, Darren R. Lebl, MD, and Frank P. Cammisa Jr., MD.

Understanding and measuring patient expectations after spine surgery is central to improving patient satisfaction and delivering patient-centered care. In collaboration with the surgeons on the Spine Service, epidemiologist Carol Mancuso, MD, has developed a series of patient expectation studies which have become the gold standards used in national and international outcome studies.

Postoperative dysphagia is a common complication after anterior cervical spine surgery. However, the reported dysphagia prevalence in this patient population has varied greatly due to unreliable clinical standards and evaluation tools for measuring swallowing dysfunction. In response to this issue, Alexander Hughes, MD, created the HSS Dysphagia and Dysphonia Inventory (HSS-DDI), the only validated, patient-derived survey instrument that assesses these complications in the anterior cervical spine surgery patient population. Additionally, the HSS-DDI has been shown to be reliable and more clinically sensitive to change than pre-existing survey instruments.

Notable Studies

Reaching for Peak Performance During Surgical Training: The Value in Assessment Tools and Critical Performance Measures. Louie P, McCarthy M, Albert T, Kim HJ. J Am Acad Orthop Surg 2020 Sep 1;28(17):e744-e751. PMID: 32433426

Effect of Topical Steroid on Swallowing Following ACDF: Results of a Prospective Randomized Double-Blind Control Trial. Stein D, Kim HJ, Lebl D, Huang R, Lafage R, Albert T. Spine (Phila Pa 1976). 2020 Dec 1. PMID: 33273438

Return to Activities and Discontinuation of Narcotics after Minimally Invasive Lumbar Spine Surgery. Mok JK, Avani A, Gang CH, McAnany S, Iyer S, Albert TJ, Qureshi S. Spine III. AAOS Virtual Education Experience, Paper 316

Skin Ultrasound Measurement as a Potential Marker of Bone Quality: A Prospective Pilot Study of Patients undergoing Lumbar Spinal Fusion. Salzmann SN, Okano I, Rentenberger C, Winter F, Ortiz Miller C, Schadler P, Sax OC, Miller TT, Shue J, Boskey AL, Sama AA, Cammisa FP, Girardi FP, Hughes AP. J Orthop Res. 2019; 37(12): 2508-2515. PMID: 31403220

Looking Ahead

Research remains among the highest priorities for the Spinal Surgical Service. Our goal is to identify the fundamental questions in spine surgery, design effective studies to answer these questions, and properly analyze and disseminate the learnings from our research.

Our clinical imperative is to be one of the world’s leading centers in the comprehensive care of all forms of spinal disorders. Spinal disease is the leading musculoskeletal cause of disability. We intend to leverage advances in predictive analytics, navigation and robotic technologies, and outcomes assessment to cost-effectively improve spinal conditions for humans throughout the world. Finally, we will continue to promote increased awareness and importance of musculoskeletal treatment and prevention strategies in these areas.

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