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NASS names outstanding papers
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ORLANDO, Fla. — The North American Spine Society and The Spine Journal announced three 2010 winners of the Outstanding Paper Award at the society’s 2010 annual meeting, here. The winning papers addressed adjacent level disease, guideline-based care and spinal cord injuries.
Ajay Jawahar, MD, MS, of the Spine Institute of Louisiana, in Shreveport, and colleagues received the surgical science outstanding paper award for their research into how total disc arthroplasty (TDA) impacted cervical spine adjacent level degeneration compared to anterior cervical disc fusion (ACDF). The prospective investigation involved six surgeons at two centers and 170 patients at the latest follow-up.
For adjacent level disease the investigators came up with their own criteria, which had clinical and radiologic components.
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“At median 4 year follow-up, adjacent segment degeneration in ACDF and TDA was equivalent. The only two factors that significantly affected adjacent level degeneration were osteopenia and having lumbar disease at the time of the surgery,” Jawahar said.
Guideline use studied
In the article that received the medical and interventional science outstanding paper award, Paul B. Bishop, DC, MD, PhD, of Vancouver, British Columbia, and colleagues compared effectiveness of a clinical practice guideline-based clinic that included chiropractic care to usual care from a family physicians for acute low back pain low back pain.
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Patients were randomized to receive care at one of the two types of clinics, with their success based on results of the Roland Morris Disability Questionnaire, the primary outcome measure, at 8, 16 and 24 weeks follow-up.
Bishop said in his presentation, “Full guideline-based care including guideline-based chiropractic spinal manipulative therapy in a hospital-based spine program was more effective in reducing disability with our primary outcome than family physician-administered usual care, which proves that the guidelines are important.”
Study of post-SCI pain
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The 2010 basic science outstanding poster used a rat model to analyze the role of cannabinoid subtype-2 receptors in modulating the antihyperalgesic effect of a specific receptor agonist in neuropathic spinal cord injury (SCI). Mostafa M. Ahmed, who presented results of the multicenter study, said, “Neuropathic pain happens after SCI and it is excruciatingly challenging to patients and clinicians to deal with.”
He noted that since SCI alters nocioceptive processing the team hoped to help patients by solving the puzzle of which related changes most affect the modulation action.
References:
Jawahar A, Cavanaugh DA, Kerr EJ, et al. Total disc arthroplasty does not affect the incidence of adjacent segment degeneration in cervical spine: Results of 93 patients in three prospective randomized clinical trials.
Bishop PB, Quon JA, Fisher CG, Dvorak MF. The chiropractic hospital-based interventions research (CHIRO) study: A randomized controlled trial on the effectiveness of clinical practice guidelines in the medical and chiropractic management of patients with acute mechanical lower back pain.
Resnick DK, Ahmed MM, Rajpal S, et al. Cannabinoid Subtype-2 receptors modulate the antihyperalgesic effect of WIN 55,212-2 in rats with neuropathic SCI pain. All presented at the 2010 Annual Meeting of the North American Spine Society. Oct. 6-9, 2010. Orlando, Fla.
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