Surgery is like a marathon. It's a big hit to the body. If you train for that marathon, you’re going to do better than if you don't. - Dr. Neil Manson
Spine research drives innovation right here
Canada East Spine Centre at Saint John Regional Hospital internationally recognized
The first evidence of spinal surgery dates back to 3000 BC, as documented in the Edwin Smith papyrus found in an Egyptian tomb. And the early treatments for back pain…well, they sound almost torturous. Often lengthy – even deadly – these operations frequently led to permanent disability and adverse psychological effects.
Treatment and surgery for back pain have come a long way. Procedures that used to require large incisions and long recovery times are now performed using minimally invasive techniques. They do less damage to healthy tissue, allowing patients to heal faster and stronger.
When you hear the word research, what comes to mind? People in white coats toiling in a lab somewhere far away? If so, you’re not alone. Many of us never get to see research in action. But while researchers don’t get a lot of the spotlight, their behind-the-scenes work plays a starring role in advancing health care and our society.
At the Saint John Regional Hospital, physicians, medical students and post-grads from various fields are conducting research. They're helping to improve patient care, working toward treatments and, in some cases cures, for disease and health-related effects of social conditions.
Research provides the framework so medical professionals can continue to provide high quality health care that is innovative, cost-effective and responsive to changes in New Brunswick.
How effective is the research taking place at Horizon, you may ask? Well, for example, last December – for the first time in its history – Horizon Health Network was included among the top 40 health research institutions in Canada for 2020. Recognition like this further validates the groundbreaking, innovative work being led by our researchers.
The research professionals and medical experts at Canada East Spine Centre perform internationally acclaimed research every day. Canada East Spine Centre’s goals are to better understand the factors that impact spinal conditions, to find the best ways to treat these complex problems, and to improve patient outcomes.
The team members at Canada East Spine Centre tackle a wide array of spine-related research, including new, innovative surgical techniques, optimizing procedures for children with spinal deformities and on ways to personalize treatment and care for each patient.
Their work is recognized by the Canadian Spine Society and internationally, particularly in the United States. They have received numerous awards and recognitions.
They really are punching above their weight and we can be proud of the innovative discoveries and advancements they’re achieving – right here in Saint John.
The Canada East Spine Centre’s research is critical in countless ways.
Eighty percent of us will experience back pain at some time in our lives. You can imagine the costs and challenges that back issues cause in our society: lost time at work, added expense for our healthcare system and an increase in narcotics use, amongothers. Spine-related issues hurt all members of our society –from businesses to patients and everyone in between.
Most of Canada East Spine Centre’s costs are covered by companies and donors to the Saint John Regional Hospital Foundation who believe in the value of research and can see the positive impacts on patients.
Dr. Neil Manson and Dr. Edward Abraham are founding members of the Canada East Spine Centre. They’re both quick to acknowledge that much of the work they do would not happen without the generosity of our community.
One ongoing study is examining the impact of working with patients before surgery to improve their ability to recover faster and better from spinal surgery.
This “prehabilitation” study is funded in part by the generosity of donors to the Saint John Regional Hospital Foundation, including a significant $75,000 donation from the McCain Family Foundation.
For the prehab study, researchers work with spinal fusion patients in the three months before their surgeries. They expect that healthy lifestyle changes before surgery will lead to better outcomes for patients. Improvements like shorter hospital stays, less pain, reduced narcotic use, faster recoveries, and improved mental health after surgery.
But they have to prove it. This sort of pre-surgery program has not been done in orthopedic patients before. So medical experts need to test it and validate its effectiveness before programming changes can happen.
Canada East Spine Centre has partnered with cardiologist Dr. Robert Stevenson and physiotherapist Stephen Mundle at the New Brunswick Heart Centre, and uses the existing cardiac rehabilitation program to help prepare patients physically and mentally before spinal fusion surgery.
“We’re also following another group of patients who will not participate in the prehab program – the control group,” Dr. Manson says. “These patients receive treatment as usual: things like encouragement from the surgeon to be as active as possible leading up to surgery and the option to participate in a one-time spine surgery education class.”
Recruitment for the prehab project began in December 2018. And while the results are not final just yet, Dr. Manson is encouraged by the promising outcomes so far
Dale Parkhill, a patient in the prehab study, had been dealing with back pain for about five years. Dr. Manson discovered that a bulging disc in Mr. Parkhill’s spine was pinching a nerve, and that nerve was sending pain down his leg and affecting his balance.
"I’m an avid curler. I love hiking, hunting and camping. But because of my back issues, I felt like I was missing out on the things I loved. I never knew when I might fall,” Mr. Parkhill says. “I couldn’t walk much, let alone deliver a curling stone.” In fact, just before his spinal surgery, his balance and ability to walk were so bad that he contemplated sitting in a wheelchair to curl with the wheelchair team.
"I was eager to get my life back and glad to finally have some answers,” Mr. Parkhill says. “So, when Canada East Spine Centre asked if I would participate in the prehab research study, I was happy to help.”
Because it's a randomized trial, he didn’t know whether he’d be in the prehab group or the control group when he signed up.
“I'm very, very pleased that I got picked to be in the prehab group,” he says. “The exercise and education sessions were so helpful for me. I know I wouldn't be where I am now if I hadn't gone through the prehab program.”
I can tell you that Canada East Spine Centre's critical research has made a huge improvement in my life, and I know that's the case for many others, too.
- Dale Parkhill
The program was two hours twice a week – one hour of classroom and one hour of exercise.
“One big takeaway for me was a food label reading tour in Sobeys," Mr. Parkhill says. “I learned how to tell if a food is high in things like sugars or sodium. At home, we changed our diet quite a bit.
So between that and the exercise sessions, I lost 33 pounds since I started the prehab program about a year and a half ago!”
“Because of the program, I felt better going into my surgery. I knew what to expect. I was prepared mentally and physically. And I think because I had done the exercise and classes prior to surgery, I was able to recover quite well. That's good for me, but it's also good for our medical system. It means patients get better faster, and there's less impact on health care.”
“I couldn't walk more than 10 minutes before surgery, and now I can hike three-kilometre trails with our children and grandchildren,” Mr. Parkhill says. “I still probably don't walk as well as I’d like, but it feels a heck of a lot better as we're going along. And I’m back to curling again!”