Spine and Peripheral Nerve Surgery Research
The Stanford Neurospine research program seeks to discover better treatments for all spine patients. Our researchers are investigating spinal cord development, injury, and regeneration, as well as implants to improve the lives of patients with spinal cord injury and ways to improve clinical outcomes in spine surgery. We work collaboratively with basic scientists, statisticians, and other academic researchers from throughout the Stanford community and beyond. The close relationship between our clinical and research efforts, with some individuals contributing directly to both, helps Stanford Neurospine to propel advances in spine research from our laboratory benches to our patients’ bedsides.
The Stanford Partnership for Spinal Cord Injury and Repair (SP-SCIR) is a consortium between members of the Department of Neurosurgery and the Spinal Cord Injury Units at the VA Palo Alto Health Care System and the Santa Clara Valley Medical Center. It aims to restore function after spinal cord injury by investigating the mechanisms underlying a traumatic spinal cord injury, developing novel methods of repair and regeneration, and maximizing quality of life with bioengineering and technology such as neural prostheses. Internal research collaborators include the Departments of Anesthesiology, Chemical and Systems Biology, Comparative Biology, Electrical Engineering, Materials Science and Engineering, Neurology and Neurological Sciences, and Orthopaedic Surgery. External research collaborators include the University of California San Francisco, Case Western Reserve University, the University and Federal Institute of Technology (ETH) Zurich, the Universities of Oxford and Cambridge, Harvard University, University of California Irvine and University of Western Australia.
Our laboratory connects electronic systems to the nervous system to restore health and function after spinal cord injury. People whose bladder is paralyzed often have difficulty with bladder emptying and with continence. We are developing a second generation neural prosthesis, or implanted electrical stimulator, to restore these functions and reduce urinary tract infection, stone formation and kidney damage, and reduce the costs of their health care. People whose legs are paralyzed develop severe osteoporosis that can cause pathological fractures and other complications. We are studying whether osteoporosis can be prevented or reversed by vigorous exercise produced by electrical stimulation of leg muscles while on a rowing machine, in collaboration with the University of Oxford.
Our laboratory studies the clinical outcomes and biomechanical properties of various dynamic stabilization devices to improve upon the traditional rigid devices currently in use. We study the intradiscal pressures (IDPs) at the level of the semi-rigid fusions, as well as the effects of the fusions on adjacent segment IDPs. We are also investigating the biomechanical properties of various artificial discs placed into human cadaveric spines, as well as carrying out research with human disc cells with the goal of creating replacement discs formulated from the patient's own disc material.
Our laboratory aims to elucidate new cellular and molecular repair strategies that will improve functional and anatomical outcomes following SCI. We are currently investigating the efficacy of human neural stem cells and induced pluripotent stem cell (iPS) lines to improve functional outcomes in cervical SCI, the capacity of intraspinal and intravenous mesenchymal stem cells to improve functional outcomes in cervical SCI models, the capacity of adult and embryonic olfactory glia to induce axonal regeneration and myelination in the injured and demyelinated central nervous system (CNS), the endogenous stem cell responses within defined models of SCI, and biomaterials for spinal cord injury.
Our research group explores using administrative databases to improve patient outcomes in spine surgery procedures. Collaborating with the Biostatistics and Health Research and Policy departments at Stanford, we are developing statistical models that may be used to predict adverse event occurrence and to assist in relative risk modelling. The goal of this effort will be to develop a clinical tool that may be used to assess pre-operatively the risk of peri-operative adverse events given patient-, condition- and approach-related variables. This will contribute to patient counseling and may inform post-operative care in at risk patients.
My laboratory’s mission is to discover treatments to restore function following spinal cord injury, either by manipulation of transplanted stem cells or by activation of endogenous progenitors. Our laboratory is particularly interested in microRNAs: small non-coding RNAs that simultaneously regulate the expression of multiple genes. We are working to identify microRNA controls over corticospinal motor neuron development and over spinal cord injury.