Spinal Surgery Research

Ross R. Moquin, MD, Associate Professor

Decreasing Morbidity of Large Deformity Surgeries

Clinically, we are looking at ways in which the morbidity of large deformity surgeries can be decreased. We are particularly interested in new methods to decrease intraoperative blood loss and subsequent coagulopathy. We have submitted an IRB study to examine the intraoperative use of Factor 7a in the very complex adult Spinal deformity patients. We also plan to study the intraoperative use of Amicar in patients undergoing less extensive deformity corrections. We are collaborating with Critical Care Medicine and the Anesthesia Pain Service in evaluating new paradigms in the post-operative management of complex spinal surgical patients.

Preoperative and Postoperative x-rays of complex spinal deformity surgery

We also plan a methodical analysis of patients who return with surgical site infection, in hopes of identifying risk factors for this serious complication. Although multiple studies have previously delineated multiple evidence-based practices for minimization of infection risk, we feel that the unique nature of complex spinal surgery and its high risk patients offers opportunity for new insights on this issue.

There is an ongoing project evaluating the use of patellar allografts in anterior cervical discectomy and fusion patients. We are also collaborating with Dr. Calancie on an IRB study developing novel electrophysiological monitoring technique to aid in the safe placement of thoracic pedicle screws. In addition, we are currently enrolling patients in an IRB approved multi-center study of a novel motion sparing device to treat some types of lumbar spinal stenosis.

Through my work with the United States Department of Defense, I have been developing life sized and scaled fused deposition models of patient specific spinal deformities to assist both with surgical correction planning as well as an aid in resident and patient education. We are in the initial phases of collaboration with The Barrow Neurological Institute in Phoenix to bring these models to Upstate Medical University.

Life size fused deposition model of a patient with posttraumatic thoracic kyphosis.

We are in the initial phases of evaluating different synthetic bone products using the New Zealand Rabbit lumbar fusion model. From this beginning, we will be looking at other types of fusion adjuncts and graft extender products including novel biologically derived spinal fusion enhancers. We currently have some industry support to study synthetic bone products.

Using the Department of Orthopedics Biomechanics Laboratory, we plan examination of the unique characteristics of long segment constructs that cross the complex spinal junctions, with special attention to the cervical thoracic junction. Of particular interest will be the comparison of laminoplasty versus screw rod fusions that cross the cervical thoracic junction.

Untreated cervical spondolytic myelopathy
Same patient post cervical thoracic decompression and fusion