Orthopaedic Spine Service

Now in its 14th year, the Orthopaedic Spine Service at MGH, under the direction of Dr. Kirkham B. Wood, is responsible for all aspects of spine care, teaching and research. Dr. Thomas Cha, the newest member of the Service, is doing fabulous as he completes his second year. Dr. Cha’s interests include the degenerative lumbar and cervical spines as well as medical economics and spine surgery. He has been named Head of Clinical Research and is actively involved with the Biomechanics Lab under the direction of Dr. Guoan Li, Ph.D. The Service also includes Drs. Brian Grottkau, Chief of Pediatric Surgery, and Joseph Schwab, and Physiatrists James Sarni, Leonid Shinchuk and David Binder. Dr. Schwab is an integral part of the Chordoma Center at MGH and has lectured and presented all over the world on this topic. Drs. James Rathmell and Christopher Gilligan are both pain specialists who work with the Pain Center here and provide a full breadth of services to our patients.

The Harvard Combined Spine Fellowship has three fellows, two of whom rotate at MGH and the third at BWH. In addition to their clinical duties, the fellows are actively involved in teaching and research programs. Over the last year, the Spine Fellowship has authored papers in the Journal of Biomechanics, Spine Journal, Journal of Spinal Disorders & Techniques, European Spine Journal, the Journal of the American Academy of Orthopaedic Surgeons and numerous textbook chapters.

This past year the Spine Service also hosted two spine surgeons from overseas to conduct a year’s sab-batical at MGH: Dr. Avraam Ploumis from Thessaloniki, Greece, and Dr. Jae-Hyuk Shin from Seoul, Korea.

Three spine fellows recently completed the combined adult spine fellowship with Brigham and Women’s Hospital and Massachusetts General. Dr. Philippe Phan has returned to the University of Ottawa where he will be taking a faculty position. Dr. Ravi Ramachandran has located to a private practice in Sacramento, California and Dr. Rayhan Jalal will be pursuing further fellowship training in joint arthroplasty.

The Spine Service also had several notable publications, including “Pain Intensity and Patients’Acceptance of Surgical Complication Risks with Lumbar Fusion” in Spine. This is an important work as more attention is being paid to the differences in how surgeons perceive adverse events and report them as opposed to patients and other caregivers. This becomes critical when counseling preoperatively in an era of informed risk decision-making.

Drs. Wood, Cha, Guoan Li and Shaobai Wang, Ph.D., continue to actively collaborate in the area of Spine Kinematics. Dr. Wood is using a dual flu¬oroscopic kinematics system to better study the motion of the cervical and lumbar spine, specif¬ically as it applies to motion preservation and surgical treatments. The implication of this work is to provide kinematic data for our orthopaedic spine surgeons in fields such as disc replacement and fusion surgery.

The database that was begun four years ago with Dr. Henrik Malchau has been reconfigured with the help of the Red Cap system at Harvard. Drs. Cha and Schwab lead this effort. All patients now provide information in the form of patient-related outcome instruments with which we are able to follow and evaluate their condition over time. The database is now quite robust with over 2,000 surgical proce-dures logged.

We are currently developing a comprehensive MGH Orthopaedic Spine Center. Our goal is to create a center that will be able to care for every aspect of a patient’s spinal condition: from sur¬gery to physiatry, medicine, geriatric treatments, pharmacology, physical therapy, radiology, orthotics, chiropractic, acupuncture, alternative medicines and patient education in both non-op¬erative as well as operative settings.