AO Spine Knowledge Forum Spinal Cord Injury (SCI)

Traumatic incomplete cervical tetraplegia without instability: a prospective multicenter feasibility study of outcomes and prognosis

Principal investigator:

Jefferson R. Wilson

Co-Principal Investigator:

Brian Kwon

Goals:

To determine the feasibility of collecting a set of outcomes assessing hand function, gait, spasticity, neuropathic pain, and quality of life in incomplete cervical spinal cord injury patients without spinal instability and conduct exploratory analysis. The results of this study will be used to plan a large prospective study with the ultimate goal of identifying the role of timing of surgery in the management of this patient group.

Leadership team:

Brian Kwon
Michael Fehlings
Nathan Evaniew
Lindsay Tetreault

Goals:

To generate three clinical practice guidelines to implement evidence into practice. These guidelines will contain evidence-based recommendations intended to optimize the care of spinal cord injury (SCI) patients worldwide. The guideline topics include:

1. Timing of surgical decompression (update of AO Spine guideline from 2017).
2. Hemodynamic management of acute SCI (update from AANS/CNS guideline from 2013).
3. Management of perioperative SCI (de novo guideline).

Collaborators:

Praxis Spinal Cord Injury Institute - https://praxisinstitute.org/
Aggregate Analytics Inc.

Principal investigator:

Mark Kotter

Co-Principal investigator:

Benjamin Davies

Goals:

The AO Spine RECODE-DCM group created a ‘Research Toolkit’ to equip scientists with the tools to make their studies robust, comparable, and focused on the outcomes that matter most for people with Degenerative Cervical Myelopathy. To address the established research priorities, international special-interest ‘incubators’ (groups of clinicians, other healthcare professionals, and individuals with lived experience) were formed focusing on: Natural History, Diagnostic Criteria, and Peri-Operative Rehabilitation. These groups are led by Knowledge Forum representatives.

To learn more and join the global community, please go here

Combining data from two existing registries (NACTN and STASCIS)

Principal investigator (PI):

Michael Fehlings

Goals:

To combine two existing databases on patients with spinal cord injuries treated surgically (NACTN and STASCIS) and to assess descriptive data on injury/surgery details, as well as the ASIA score and complications reported

Documents:

Publication summary

Development of evidence-based clinical guidelines for the treatment of acute spinal cord injury (SCI)

Principal investigator:

Michael Fehlings

Goals:

A set of systematic reviews will deliver an understanding of the current state of the field. Based on this knowledge, a global team of clinical experts in SCI will then go through the rigorous process of developing evidence-based clinical guidelines for the treatment of acute spinal cord injury. Injury specific to the five selected topics:

• Use of methylprednisolone
• Timing of decompression
• Role and timing of magnetic resonance imaging
• Type and timing of anticoagulation
• Type and timing of rehabilitation

Note:

Co-sponsored by AO Spine North America

Documents:

Guidelines Special Issue
Publication summary

Guidelines:

Access the guidelines here

A multi-center, randomized, placebo-controlled, double-blinded trial of the efficacy and safety of Riluzole in acute spinal cord injury

Principal investigator (PI):

Michael Fehlings

Goals:

Aims to evaluate the efficacy and safety of Riluzole in the treatment of patients with acute spinal cord injury. The primary objective is to evaluate the superiority of Riluzole, as compared to a placebo, in improving motor outcomes as measured by the ASIA Motor Score at six months follow-up, in patients with acute traumatic spinal cord injury, presenting to hospital less than 12 hours after injury.

Note:

Co-sponsored by AO Spine North America, US Department of Defense, Christopher and Dana Reeve Foundation, Ontario Neurotrauma Foundation, Rick Hansen Institute

Documents:

Publication summary

ClinicalTrials.gov Identifier: NCT01597518

Modulation of Inflammatory Responses Using Neural Crest Derived Dental Pulp Stem Cells Following Acute Spinal Cord Injury

Principal investigator:

Ryan O’Hare Doig

Co-Principal investigators:

Brian James, Christopher Freeman, Stan Gronthos

Goals:

Aims to develop a better understanding of the pathophysiological pathways and effects of stem cell distribution, survival and differentiation, following spinal cord injury using advanced imaging and labelling techniques