Spine unit

The spine team has grown in the last years, and now includes the Institute for Spine Surgery and Applied Research. This is a co-operative unit, together with neurosurgeons, neurophysiologists, and anesthesiologists. Clinically there is expertise especially in the field of degenerative cervical and lumbar pathology, and spinal deformities. The unit continues to evaluate the use of alternative treatment options such as bone substitutes and conservative treatments, especially for patients with chronic low back pain. The research lines run parallel to this clinical expertise.

Lumbar spine
In the field of lumbar spine, the research line on treatment of low-grade spondylolisthesis is continued with the design of an international cohort of three different surgical techniques. The earlier work in cooperation with the University Medical Center of Utrecht, a systematic literature review and a retrospective cohort, has proven invaluable in the setup of the study. Moreover, an anatomical study on the geometry of the lumbar vertebrae is performed in a case-control study of patients with low-grade spondylolisthesis. In the treatment of degenerative lumbar disc disease, several cages were evaluated with or without the combination of ChronOs as bone substitute.

Non invasive treatments
The referral of patients with spinal problems has been optimized in the One Stop Solution concept. A number of conservative treatments are available at the Sports Medical Center where the results are analyzed, such as the RealHealth program for patients with chronic low back pain. In the next year, the RealHealth program will be expanded to patients with failed back surgery and will also be closely monitored and evaluated in a randomized controlled trial.

Neuro-monitoring
The analysis of neuro-monitoring in spinal deformity surgery has been continued after research by H.L. Journée and D.H. Langeloo. Nowadays all monitored patients are being studied to investigate the side effects of the transcranial motor evoked potential monitoring during spinal surgery.

Research facilities
The upright MRI has given interesting research facilities for studying the anatomy of the spine and spinal deformities such as scoliosis in more detail. A study of the normal geometry of the spine in a loaded position was conducted in collaboration with the University Medical Center of Utrecht.

The VICON motion analysis system in the gait laboratory is used to study the effect of a corrective surgery in patients with idiopathic scoliosis.

A list of the spine studies follows:

• The efficacy of Intervertebral Dynamics Therapy in patients with low back pain
• The realhealth painmanagement program for patients with chronic low back pain
• Effects of an intensive chronic low backpain painmanagement program
• Safety and efficacy of hyalospine® in lumber laminectomy or laminotomy
• Diagnostic tests to predict the success of lumbar fusion
• Good functional outcome 10 years after single level anterior lumbar fusion
• Risk factors for deep surgical site infections after lumbar spinal fusion
• Synfix-lr® cage in degenerative disc disease
• Anatomical vertebral parameters in lumbar sponydlolisthesis
• Scoliosis in the upright mri
• Side effects of intra-operative transcranial electrical stimulation
• Syncage LR ChronOS
• Pre-existing rotation in the spine of healthy volunteers measured in the upright MRI
• Fusion for low grade isthmic spondylolisthesis
• A pilot study on balance control and gait analysis in idiopathic scoliosis before and after surgery